sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzik Ghlmn / M / 8 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures (1 episode 19 days back).

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is no focal area of altered signal intensity in the brain parenchyma.

The hippocampal complex on either side is unremarkable.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Normal study of the brain.

ke/hs/rg.
/00000 Date : 00.00.00

Name of the Patient : Abc Xyza Mazulmn / F / 65 yrs.
Referred by : Dr. Abc Xyzatt.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O dragging of the LLE since 3-4 months with difficulty in swallowing and dysarthria since 2 days.
Known hypertensive/diabetic.

EXAMINATION :

M.R.I. of the brain was performed using the following parameters:

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

BRAIN :

There are hyperintense areas in the pons, periventricular white matter, corona radiata and centrum semiovale bilaterally on the proton, T2 Weighted and FLAIR images. These are hypointense to the white matter on the T1 Weighted images.

Lacunar infarcts (which are iso to hyperintense to CSF on all the pulse sequences) are noted in the thalamus, lentiform nuclei and corona radiata bilaterally.
..2/.








- 2 - scan-00008/00000


There is fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

INTRACRANIAL MRA :

The A1 segment of the right anterior cerebral artery on the right side is hypoplastic.

The internal carotid artery on the right side has a smaller calibre as compared to the left.

There is slight narrowing and vessel wall irregularity of the M1 segment of the left middle cerebral artery.

The petrous, cavernous and supraclinoid segments of the left internal carotid artery shows normal signal and calibre. The rest of the visualized anterior cerebral, right middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The bifurcation of the common carotid artery on the right side is lower as compared to the left. The right internal carotid artery has a smaller calibre as compared to the left.

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of these vessels noted.

IMPRESSION :

1. Altered signal in the pons, periventricular white matter, corona radiata and centrum semiovale bilaterally and would represent areas of ischemia/infarction.
..3/.





- 3 - scan-00008/00000



2. Lacunar infarcts in thalamus, lentiform nuclei and corona radiata bilaterally.

3. Slight narrowing and vessel wall irregularity of the M1 segment of the left middle cerebral artery.

4. The right internal carotid artery has a smaller calibre as compared to the left side.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Rlmn / F / 65 yrs.
Referred by : Dr. Abc Xyzli.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with numbness since 6 months.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There are posterior peridiscal osteophytes at the L1-L2, L2-L3, L3-L4 and L4-L5 levels with anterior indentation of the thecal sac. Small posterior disc bulges are also noted at these levels. There is mild bilateral neural foraminal narrowing at the L2-L3 and L3-L4 levels.

A small posterior disc bulge is seen at the L5-S1 level.

The lumbar facet joints show degenerative changes.

Anterior disc herniations are seen over the L1-L2 to L4-L5 levels. The L2-L3 and L4-L5 intervertebral discs are reduced in height. The lumbar intervertebral discs show loss of water content.

Lateral peridiscal osteophyte are seen in the lumbar region.

The lumbar vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.


The conus medullaris terminates at the L1 level and the thecal sac terminates at the S2 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

16.0 mm at L1-L2
17.0 mm at L2-L3
14.0 mm at L3-L4
15.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of posterior disc bulges with posterior peridiscal osteophytes at the L1-L2, L2-L3, L3-L4 and L4-L5 levels.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc XyzK. Karani / 66 yrs.
Referred by : Dr. Abc Xyzlsara.
Examination : M.R.I. of Pelvis.

CLINICAL PROFILE :

H/O left gluteal injection abscess 6 months back. I & D done on 00.00.00.
C/O discharging sinus since 1 month.
Known diabetic.

EXAMINATION :

M.R.I of the pelvis was performed using the following parameters:

6 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

6 mm thick T1 Weighted coronal images.

5 mm thick STIR coronal images.

6 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a linear tract in the left gluteal region postero-laterally. The opening of the tract is at a level about 4.5 cms inferior to the iliac crest and its depth is about 6.0 cms. The tract is hypointense on the T1 Weighted images and hyperintense on the STIR images and is limited to the subcutaneous fat in the left gluteal region. No collection/cavity is noted in the left gluteal region. The underlying left gluteal muscles show normal signal intensity. The visualized hip joints and the sacro-iliac joints are unremarkable.

No obvious abnormality is detected in the pelvic cavity.

IMPRESSION :

The MRI features suggests a sinus tract in the left gluteal region with extensions as described. The sinus tract is limited to the subcutaneous fat.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz G. Palmn / M / 49 yrs.
Referred by : Dr. Abc Xyzsbekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O decreased hearing bilaterally since April 0000.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

5 mm thick T1 Weighted and FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen an expansile lesion involving the clivus. This lesion is of intermediate signal on the T1 Weighted images and appears relatively hypointense on the T2 Weighted images. The margins of the clivus are not well-defined. The lesion is seen to extend anteriorly upto the posterior nasopharyngeal wall. Posteriorly the lesion is seen to indent the basilar artery and the pons with slight effacement of the prepontine cistern. There is no definite extension of the lesion into the cavernous sinus on either side. The sphenoid sinus is not well identified. Destruction of the dorsum sella is noted. The pituitary gland is however well identified separate from the lesion.

Inflammatory changes are noted in the left maxillary sinus, frontal sinuses, ethmoidal air cells and the middle ear.







There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images along the right posterior parietal cortex and in the left frontal cortex. This lesion appears relatively hypointense on the T1 Weighted images. Resultant slight volume loss is noted in this region. Small bright foci on the proton and T2 Weighted images are noted in the centrum semiovale bilaterally.

Both the lateral, third and the fourth ventricles are normal. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. An expansile mass lesion in the region of the clivus, with extensions as described, is not specific for a single etiology. A clival or a sphenoid sinus neoplasm or a small cell tumor (a nasopharyngeal carcinoma is less likely) may be considered as the differential diagnosis.

2. Altered signal in the right posterior parietal cortex, in the left frontal cortex and centrum semiovale bilaterally, most likely represent ischemic changes.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz G. Palmn / M / 49 yrs.
Referred by : Dr. Abc Xyzsbekar.
Examination : M.R.I. of the Neck.

CLINICAL PROFILE :

C/O decreased hearing bilaterally since April 0000.

EXAMINATION :

M.R.I of the neck was performed using the following parameters :

6 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
5 mm thick T1 Weighted and STIR coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are multiple enlarged lymph nodes in the neck on either side, varying in size from about 1.0 cm to 2.5 cms in maximum transverse dimensions. These lymph nodes are noted in the submandibular region, deep to the sternocleidomastoid muscles bilaterally and in the posterior triangle on either side. These lymph nodes are of intermediate signal on the T1 Weighted images and appear hyperintense on the T2 Weighted images.

The prevertebral space and the carotid sheaths bilaterally are unremarkable.

The thyroid gland and the larynx are unremarkable. No obvious intrinsic lesion is noted in the visualized trachea. The submandibular glands and the parotid glands on either side are also unremarkable.

IMPRESSION :

The MRI features suggest multiple enlarged lymph nodes in the neck as described.

On correlating the neck study with the study of the brain the lymph nodal enlargement is most likely metastatic in etiology.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzr lmn / M / 13 yrs.
Referred by : Dr. Abc Xyzonawala.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in both hip joints with inability to walk and sit since 6 months.

EXAMINATION :

M.R.I of both hips was performed using the following parameters :

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is an ill-defined, hypointense signal on the T1 Weighted images in the neck and proximal shaft of the right femur. This lesion appears hyperintense on the T2 Weighted and STIR images. No bone erosion or destruction is noted.

Similar signal intensity changes are noted in the sacrum and iliac bones adjacent to the left sacro-iliac joint, inferiorly.

The epiphysis of the femoral heads are unremarkable on either side. The acetabulum are normal bilaterally. There is no obvious bony destruction or erosions noted. The articular cartilages are unremarkable. Minimal fluid is noted in the right hip joint.

The musculature surrounding both the hip joints and the visualized pelvis is normal.


IMPRESSION :

Altered signal in the neck and proximal shaft of the right femur
and adjacent to the left sacro-iliac joint, inferiorly
is not specific for a single etiology. These changes may represent transient osteoporosis. The possibility of an inflammatory/infective osteitis with sacro-ilitis may be
considered as a differential diagnosis.

A follow up scan is recommended.

sb/hs/nl/nl
w Date : 00.00.00

Name of the Patient : Abc Xyzalmn / M / 30 yrs.
Referred by : Dr. Abc Xyzcha.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O radicular pain in the LLE with numbness.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is loss of water content of the L4-L5 and L5-S1 intervertebral discs.

There is Grade I spondylolisthesis of the L5 over the S1 vertebra with spondylolysis of the L5 vertebra. A left postero-lateral (foraminal) disc herniation is noted at the L5-S1 level with left neural foraminal narrowing and impingement of the foraminal segment of the exiting left L5 nerve root.

A small, postero-central disc herniation is noted at the L4-L5 level indenting the dural theca anteriorly.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.





The conus medullaris terminates at the D12 level and the thecal sac terminates at the S1 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

13.0 mm at L1-L2
12.0 mm at L2-L3
11.0 mm at L3-L4
12.0 mm at L4-L5
14.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L5 over the S1 vertebrae with spondylolysis of the L5 vertebra.

2. A left postero-lateral (foraminal) disc herniation at the L5-S1 level with left neural foraminal narrowing and impingement of the foraminal segment of the exiting left L5 nerve root.

3. A small, postero-central disc herniation at the L4-L5 level.

sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzid Almn / M / 17 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures with right sided hemiparesis.
Past H/O surgery for left fronto-parietal abscess at the age of 1 1/2 years.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

3 mm thick T2 Weighted coronal images.

3 mm thick T1 Weighted sagittal images through the sella and perisellar region.

OBSERVATION :

There is seen an ill-defined, CSF signal intensity lesion on all the pulse sequences in the left high frontal parafalcine region. This represents an area of cystic encephalomalacia, most likely the sequelae of previous surgery. Perilesional white matter hyperintense signal on the T2 Weighted and FLAIR images may represent gliotic changes. Scar of previous surgery is noted on the scalp in the left high frontal parafalcine region.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

- 2 - scan-00001

The pituitary gland is normal in its size, contour and location and reveals normal signal intensity. It measures approximately 6.0 mm in height. The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. The pituitary stalk is in the midline. The hypothalamus is unremarkable.

The suprasellar cistern and the cavernous sinuses are unremarkable.

Inflammatory changes are noted in the left maxillary antrum.

IMPRESSION :

Altered signal in the left high frontal parafalcine region represents an area of cystic encephalomalacia with perilesional gliosis in the left high frontal parafalcine region, may be the sequelae of previous surgery.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzPlmn / M / 45 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias.
H/O Pulmonary Kochs (6 months back). On AKT since 3 months.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is a postero-central protruded disc at the L5-S1 level.

There is a small posterior disc bulge at the L4-L5 level.

Slight facetal hypertrophy is noted at the L4-L5 and L5-S1 levels.

The lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The remaining facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.






The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

13.0 mm at L1-L2
11.0 mm at L2-L3
10.0 mm at L3-L4
8.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. A postero-central protruded disc at the L5-S1 level.

2. A small posterior disc bulge at the L4-L5 level.

3. Slight facetal hypertrophy at the L4-L5 and L5-S1 levels.