ke/bv/rg.
s Date : 00.00.00

Name of the Patient : Abc Xyzl T. lmn / M / 54 yrs.
Referred by : Dr. Abc Xyzdar / Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O vehicular accident on 00.00.00
C/O altered sensorium since then.

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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is still seen thickening of the gyri which appear hypointense to the grey matter on the T1 Weighted images in the left anterior temporal lobe, right temporal lobe laterally and the left frontal lobe. These are seen to turn hyperintense on the proton, T2 Weighted and Fast Scan (T2 *) images. Few hyperintense areas are seen on the T1 Weighted images which are seen to remain hyperintense on the proton, T2 Weighted and FLAIR images and would represent methaemoglobin. There is effacement of the sulci in that region with surrounding edema. There is mass effect with posterior displacement of the frontal horn of the left lateral ventricle. Slight shift of the falx to the opposite side is noted in this region (scans 104.11-12. 102.11-12., 103.11-12)

Small sliver of haemorrhagic subdural collections is seen in the fronto-temporo-parietal regions bilaterally.



Suspicious fractures of the temporal bones bilaterally are noted with altered signal in the mastoid air cells bilaterally and middle ear cavity. Haemorrhage is also noted in the sphenoid sinus.

The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of :

1. Haemorrhagic contusions in the left anterior temporal lobe, right temporal lobe laterally and in the left frontal lobe.

2. Small subdural collection in the fronto-temporo-parietal regions bilaterally.

As compared to the previous MRI dated 00.00.00 (study no.00001),

a. There is slight increase in the subdural collections bilaterally.

b. Presence of edema is noted around the contusions which is seen to cause mass effect with indentation on the frontal horn of the left lateral ventricle and slight shift of the falx to the opposite side.

c. The contusions now appear in the subacute stage.

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz K. Mlmn / F / 24 yrs.
Referred by : Dr. Abc Xyzanwal Pannu.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

C/O primary infertility.
H/O being operated for ovarian cyst 1 year ago.

EXAMINATION :

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

8 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T2 Weighted sagittal images.

OBSERVATION :

There is seen a fairly large, well-defined, approximately 8.5 x 8.0 x 7.0 cms sized intermediate signal intensity mass lesion in the pelvis, posterior to the uterus, in the midline. This lesion appears hyperintense on the T2 Weighted and STIR images. The rectum is seen to be displaced to the right and is draped along the right lateral margin of the mass lesion.

Both the ovaries are well-identified and show evidence of multiple folicles.

The urinary bladder shows no intrinsic lesion. The uterus appears normal.

The ischio-rectal fossae on either side appear normal.

There are no abnormally enlarged pelvic lymph nodes identified. No obvious vascular anomaly is noted. There is no free fluid in the pelvis. There is no bone erosion or destruction seen.
..2/.







A scar is noted in the midline in the infraumblical region. Small lymphnodes are identified in both inguinal region.

IMPRESSION :

An approximately 8.5 x 8.0 x 7.0 cms sized mass lesion in the pelvis, posterior to the uterus, in the midline is not specific for a single etiology. This may represent an ovarian lesion probably a cyst arising from the left ovary.

The possibility of a rectal lesion seems unlikely.

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Jolmn / F / 58 yrs.
Referred by : Dr. Abc Xyzrankar / Dr. Abc Xyzadera
Examination : M.R.I. of the Left Ankle & Foot.

CLINICAL PROFILE :

C/O pain in the left ankle since 8 years (on & off) with inability to bear weight on the LLE.

EXAMINATION :

M.R.I. of the left ankle and foot was performed using the following parameters :

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

4 mm thick T1 Weighted and STIR coronal images.

4 mm thick T1 Weighted and GRASS sagittal images.

OBSERVATION :

There is a fairly well-defined, lesion in the superior and the medial aspect of the dome of the talus of the left ankle which measures approximately 1.6 x 1.6 x 2.8 cms. This lesion is hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted, STIR and Gradient images. Few areas within this lesion are slightly hyperintense on the T1 Weighted images. This lesion has multiloculated appearance. There is suggestion of a break in the cortex anteriorly (se/im 103/7).

A subtle hypointense signal is seen in the cuboid bone on the T1 Weighted images which is seen to turn hyperintense on the STIR images and may represent degenerative subchondral cysts.

- 2 - Scan-00007


Hyperintense signal is seen subcutaneous region along the medial malleolus on the T2 Weighted and STIR images suggestive of edema.

The rest of the visualized bones show normal configuration and signal intensity.

The visualized tendons and ligament show normal signal intensity. No joint effusion is evident. The visualized soft tissues are unremarkable.

IMPRESSION :

The MRI features are suggestive of a fairly well-defined, lesion in the superior and the medial aspect of the dome of the talus of the left ankle measuring approximately 1.6 x 1.6 x 2.8 cms. The possibilities to be considered are,

a. Degenerative cyst.

b. GCT.

c. ABC.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzSabannlmn / F / 30 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with nausea since 6 months.

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.

OBSERVATION :

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

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.

Incidental note is made of bilateral maxillary polyps and inflammatory changes are seen in the ethmoidal air cells.

IMPRESSION :

1. Normal study of the brain.

2. Maxillary polyps bilaterally with inflammatory changes in the ethmoidal air cells.

ke/bv/nl/rg.
s Date : 00.00.00

Name of the Patient : Abc Xyzeep lmn / M / 12 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O seizures 10 months back with weakness of BUE and BLE since then.

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 is unremarkable on either side.

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/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz K. Blmn / F / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O low back pain radiating to the RLE since December 0000.
H/O microlumbar discectomy done in January 0000 for similar complaints.

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 slight retroplacement of the L4 over the L5 vertebra.

There are post-operative changes in the posterior soft tissues at the L4 and L5 levels with partial laminectomy at the L4 level on the right side.

There is a postero-central disc herniation at the L4-L5 level with anterior indentation of the thecal sac and mild right neural foraminal narrowing. Inferior migration of the disc is noted which is seen to lie in the right lateral recess of L5 vertebra with impingement of the right L5 nerve root. The L4-L5 facet joints show mild degenerative change.

A small right postero-lateral disc herniation is seen at the L3-L4 level with mild right neural foraminal narrowing. This disc is reduced in height. The L3-L4 and L4-L5 intervertebral discs show loss of water content.


Type II degenerative changes are noted in the L4 and L5 vertebrae adjacent to the L4-L5 intervertebral disc. Type II/III degenerative changes are seen in the L3 and L4 vertebrae adjacent to the L3-L4 intervertebral disc.

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

The conus medullaris terminates at the D12-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 :

16.0 mm at L1-L2
15.0 mm at L2-L3
13.0 mm at L3-L4
9.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. Post-operative status.

2. A postero-central disc herniation at the L4-L5 level with inferior migration of the disc lying in the right lateral recess of L5 vertebra with impingement of the right L5 nerve root.

3. A small right postero-lateral disc herniation at the L3-L4 level.

Previous investigations were not available for comparison.

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzDlmn / M / 39 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. - Brain (Post-contrast Study).

CLINICAL PROFILE :

C/O diplopia since 1 month. Similar complaints 1 year back.
C/O giddiness, gait ataxia and change in voice.

EXAMINATION :

After administration of contrast, 5 mm thick T1 Weighted axial and coronal images with magnetization transfer, 5 mm thick T1 Weighted sagittal images and 3 mm thick FLAIR coronal images were obtained.

OBSERVATION :

On administration of contrast, there is a conglomeration of multiple ring enhancing lesions within the pons, anteriorly and more to the right of the midline. This conglomeration measures approximately 2.2 x 1.3 x 1.0 cms.

There is no area of abnormal enhancement within the meninges.

IMPRESSION :

The MRI features are suggestive of conglomeration of multiple ring enhancing lesions within the pons, anteriorly and this most probably is due to a granulomatous infective process.

It is difficult to characterize the type of granulomas.

A follow-up scan may be useful.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xylmn / F / 29 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O tingling in the LLE since 1 month.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.
10 mm thick T1 Weighted and T2 Weighted axial images.

The cervico-dorsal region was screened with 5 mm thick T2 Weighted sagittal images and brain was screened with 5 mm thick FLAIR axial images.

OBSERVATION :

There is focal increase in diameter of the dorsal spinal cord at the D5 vertebral level and over the D8 to D10 vertebral levels. The dorsal spinal cord at these levels shows a hyperintense signal on the T2 Weighted images, centrally, which appears hypointense on the T1 Weighted images.

The visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. Facetal hypertrophy is noted at the D9-D10 level on the left. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1-L2 level.

Screening images of the brain and cervico-dorsal region do not reveal any significant feature of note.
..2/.











Screening images of the lumbar spinal reveal Grade I spondylolisthesis of the L5 over the S1 vertebra.

IMPRESSION :

Altered signal in the dorsal spinal cord, centrally, at the D5 and D8 to D10 vertebral levels as described is not specific for a single etiology. Myelitis/demyelination may be considered as differential diagnosis.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzddin Bhlmn / M / 80 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O Parkinsonism.
H/O TB spondylitis 4 years back. Completed AKT.

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.

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

OBSERVATION :

BRAIN :

There are small bright foci in the left frontal deep white matter and the right centrum semiovale on the proton, T2 Weighted and FLAIR images. These are isointense to normal white matter on the T1 Weighted images and would represent ischemic changes.

A lacunar infarct is seen in the left cerebellar hemisphere. Prominent perivascular space is noted in the left lentiform nucleus.






There is mild fullness of both the lateral and third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci.

The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidental note is made of left maxillary sinusitis.

INTRACRANIAL MRA :

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, 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 common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Small bright foci in the left frontal deep white matter and the right centrum semiovale would represent ischemic changes.

2. A lacunar infarct in the left cerebellar hemisphere.

3. No significant abnormality is detected on the intracranial and neck MRA on this study.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzh Sonalmn / M / 53 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O weakness of BLE with bladder involvement since 3 years.

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 :

The lumbar facets joints show mild degenerative changes.

Schmorls node is noted at the L2-L3 level. The L2-L3 and L3-L4 intervertebral discs show loss of water content. The L2-L3 disc is also reduced in height.

There is increase in the epidural fat over the L3 to L5 levels giving the thecal sac a trifoliate appearance which can be seen with epidural lipomatosis. The intrathecal nerve roots appear clumped, in the lumbar region.

Type II degenerative changes are seen in the L2 and L3 vertebral bodies adjacent to the L2-L3 intervertebral disc. Slight anterior wedging of the L1 vertebra with fatty change is noted.

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


The conus medullaris terminates at the L1-L2 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 :

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

IMPRESSION :

1. Degenerative changes of the lumbar facets joints.

2. Epidural lipomatosis over the L3 to L5 levels.

3. Clumped intrathecal nerve roots in the lumbar region is ? due to epidural lipomatosis, ?? due to arachnoiditis (due to tuberculous meningitis)

A contrast enhanced scan would be worthwhile to rule out arachnoiditis if clinicallly indicated.