hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzrai Mlmn / M / 69 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided hemiparesis with slurred speech and increased blood pressure 15 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.

5 mm thick FLAIR and Fast Scan (T2 *) coronal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial, sagittal and coronal images.

FEW IMAGES SHOW MOTION INSPITE OF SEDATION.

OBSERVATION :

There is evidence of a space occupying lesion measuring approximately 5.0 x 5.0 x 4.5 cms within the left frontal lobe. This lesion is hypointense on the T1 Weighted images and turns hyperintense on the proton, T2 Weighted and FLAIR images. Few areas of hypointensity on the T1 Weighted and FLAIR images which turn hyperintense on the T2 Weighted images are seen within this lesion and would represent cystic/necrotic changes. After contrast administration, there is thick and intense enhancement of its periphery with scattered areas of enhancement within it.





Areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images are noted adjacent to this lesion and would represent white matter edema. There is effacement of the adjacent cortical sulci and compression upon the left lateral ventricle with mild shift of the midline to the right. Also seen is effacement of the left Sylvian fissure.

The right lateral 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 a space-occupying lesion measuring approximately 5.0 x 5.0 x 4.5 cms within the left frontal lobe and this most likely represents a neoplastic process like a glial cell tumor or a lymphoma.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzShlmn / F / 23 yrs.
Referred by : Dr. Abc Xyz
Examination : M.R.I. - Dorsal & Lumbo-sacral Spines.

CLINICAL PROFILE :

C/O backache radiating to BLE (left more than right) with paresthesias since 2 years.

EXAMINATION :

M.R.I of the dorsal and lumbo-sacral spines 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 :

A minimal posterior disc bulge is seen at the L4-L5 level.

The visualized dorso-lumbo-sacral vertebral bodies and the 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 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 :

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

IMPRESSION :

No significant abnormality is detected on this study.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzn Malmn / F / 70 yrs.
Referred by : Dr. Abc Xyzgaonkar.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O giddiness with weakness of BLE and loss of bladder/bowel control since 2 months.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images.

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

OBSERVATION :

Lacunar infarcts are noted in the right lentiform nucleus, bilateral thalami, left parathird ventricular region, right corona radiata and left centrum semiovale.

Ill-defined hyperintense signal on the T2 Weighted images in the posterior parietal periventricular white matter bilaterally most likely represents ischemic changes.

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

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

Inflammatory changes are noted in the right maxillary antrum, frontal sinuses and ethmoidal air cells bilaterally.







INTRACRANIAL MRA :

The right vertebral artery is slightly hypoplastic.

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

NECK MRA :

The right vertebral artery in the neck is also hypoplastic.

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. Lacunar infarcts in the right lentiform nucleus, bilateral thalami, left parathird ventricular region, right corona radiata and left centrum semiovale.

2. Altered signal in the posterior parietal periventricular white matter bilaterally most likely represents ischemic changes.

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

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzra Tellmn / M / 29 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias in BLE since 0000 which has increased since 8 days,

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

8 mm thick T1 Weighted and T2 Weighted axial images.

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

A few of the upper and mid dorsal intervertebral discs show loss of water content.

The visualized dorsal 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 visualized dorsal spinal cord shows normal signal intensity.

The conus medullaris terminates at the L1 level.







On screening the lumbar spine there is evidence of a small posterior disc herniation at the L5-S1 level.

IMPRESSION :

1. A small posterior disc herniation at the L5-S1 level.

2. No significant abnormality is detected within the dorsal spine on this study.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzsh lmn / M / 28 yrs.
Referred by : Dr. Abc Xyzankhla.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O low grade glioma in the left frontal region for which craniotomy was done on 00.00.00.
C/O swelling over the face and headaches since 2-3 days.

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 a left fronto-parietal craniotomy. A small, epidural hemorrhagic collection is noted deep to the craniotomy site, the sequelae of previous surgery. A small, left frontal subdural collection is also noted. There is also a subgaleal collection in the left fronto-temporo-parietal region extending slightly to the right of the midline. The dura at the site of surgery is not well-defined in continuity.

There is seen an approximately 2.0 x 2.8 x 2.2 cms sized well marginated, predominantly intermediate signal intensity lesion on the T1 Weighted images in the left deep fronto-parietal, parafalcine region. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images. Focal, CSF signal on all the pulse sequences is noted within this lesion, anteriorly. There is a peripheral hyperintense rim on the T1 Weighted images which appears relatively hypointense on the proton, T2 Weighted and FLAIR images. This lesion most likely is the sequelae of previous surgery, and may represent a post-operative cavity with inflammatory changes within.



Around the above described lesion there is seen a band of tissue, approximately 1.0 cm in width, predominantly along its anterior, superior and inferior margins. This lesion appears hypointense to normal white matter on the T1 Weighted images and is hyperintense on the T2 Weighted and FLAIR images. Resultant indentation and inferior displacement of the body of the left lateral ventricle is noted with mild bulge of the midline to the right. The involvement of the body of the corpus callosum cannot be entirely ruled out. The track of previous surgery is seen to extend from the mass lesion upto the dura at the operative site. The dura is not well-defined in continuity.

There is mild fullness of the left lateral ventricle as compared to the right. The third and fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

Fluid level is noted in the sphenoid sinus.

IMPRESSION :

1. Left fronto-parietal craniotomy with a small epidural and subdural collection, most likely a sequelae of previous surgery.

2. A subgaleal collection in the left fronto-temporo-parietal region.

3. An approximately 2.0 x 2.8 x 2.2 cms sized cavity in the left deep fronto-parietal parafalcine region most likely is the sequelae of previous surgery. The operative track is seen to extend upto the dura at the operative site. The possibility of communication of this post-operative cavity with the subdural, epidural and subgaleal collections cannot be ruled out.
..3/.








- 3 - Scan-00001



4. A band of tissue, approximately 1.0 cm in width along the anterior, inferior and superior margins of the post-operative cavity, as described above, may represent residual tumor tissue.

A follow-up scan with contrast is recommended.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzttam Shlmn / M / 40 yrs.
Referred by : Dr. Abc Xyzsai.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided hemiparesis since 1 day.
Known C/O cirrhosis of liver since 1 year.

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 a subtle hyperintense signal on the T1 Weighted images within the lentiform nuclei bilaterally. This may represent deposition of the paramagnetic substances.

There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

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 :

The MRI features are suggestive of a hyperintense signal on the T1 Weighted images within the lentiform nuclei bilaterally and this may represent deposition of the paramagnetic substances.

Such features may be seen with acquired hepatocerebral syndromes.

hs/sb/nl/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to BLE (left more than right).

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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

The L5 vertebra appears as marked on the film. Please correlate with plain radiographs.

A postero-central disc herniation is seen to indent the thecal sac at the L5-S1 level. The facet joints at this level show hypertrophic degenerative changes. The L5-S1 intervertebral disc shows loss of water content.

The L2-L3, L3-L4 and L4-L5 facet joints appear slightly hypertrophied.

A posterior disc bulge is seen at the L4-L5 level.

Type II degenerative changes are noted in the L4, L5 and S1 vertebrae.



- 2 - Scan-00009



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 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
17.0 mm at L3-L4
17.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

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

2. Hypertrophic facetal arthropathy at the L5-S1 level.

3. Facetal hypertrophy at the L2-L3, L3-L4 and L4-L5 levels.

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Gailmn / M / 47 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O slowiness of movement with difficulty in walking since 1 1/2 years.
Also C/O involuntary movements of the fingers of the right hand since 00.00.00 which has recovered now.

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 an ill-defined, hyperintense lesion on the proton, T2 Weighted and FLAIR images in the right cerebellar hemisphere. This lesion appears hypointense on the T1 Weighted images and most likely represents an ischemic lesion. Indentation on the posterior fourth ventricle on the right side is noted.

Lacunar infarcts are seen in the pons, lentiform nuclei bilaterally, right thalamus and in the corona radiata and centrum semiovale bilaterally.

Ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally most likely represents ischemic changes.





There is mild dilatation of both the lateral and the third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

No obvious haemorrhage is detected on this study. Inflammatory changes are noted in the maxillary sinuses bilaterally.

IMPRESSION :

1. Altered signal in the right cerebellar hemisphere most likely represents an ischemic lesion, probably recent.

2. Lacunar infarcts in the pons, lentiform nuclei bilaterally, right thalamus and in the corona radiata and centrum semiovale bilaterally.

3. Periventricular white matter ischemic changes bilaterally.

4. Mild cerebral cortical atrophy.

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzDhlmn / M / 58 yrs.
Referred by : Dr. Abc Xyztchha.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with swelling over BLE since 3-4 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 :

There is loss of normal lumbar lordosis and loss of water content of the lumbar intervertebral discs.

There is a small, right postero-lateral (foraminal) disc herniation at the L5-S1 level.

There is a postero-central and right postero-lateral disc herniation with peridiscal osteophytes at the L4-L5 level with right neural foraminal narrowing and indentation on the traversing right L5 nerve root. The exiting right L4 nerve root is also impinged in the right neural foramen at the L4-L5 level. Slight superior migration of the disc fragment is also noted.

A posterior and left postero-lateral disc herniation with peridiscal osteophytes is noted at the L3-L4 level, indenting the extraforaminal segment of the left L3 nerve root.


A small, postero-central protruded disc is noted at the L1-L2 level.

The facet joints at the L3-L4, L4-L5 and L5-S1 levels bilaterally and on the left at the L2-L3 level appear hypertrophied.

Anterior disc herniation with anterior peridiscal osteophytes is noted at the L4-L5 level.

Type II degenerative marrow changes are noted adjacent to the L3-L4 and L4-L5 discs.

The rest of the lumbar vertebral bodies 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 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 :

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

IMPRESSION :

1. A small, right postero-lateral (foraminal) disc herniation at the L5-S1 level.
..3/.











- 3 - Scan-00007


2. A postero-central and right postero-lateral disc herniation with peridiscal osteophytes at the L4-L5 level with right neural foraminal narrowing and indentation on the traversing right L5 nerve root. The exiting right L4 nerve root is also impinged in the right neural foramen at the L4-L5 level.

3. A posterior and left postero-lateral disc herniation with peridiscal osteophytes at the L3-L4 level, indenting the extraforaminal segment of the left L3 nerve root.

4. A small, postero-central protruded disc at the L1-L2 level.

5. Facetal hypertrophy at the L3-L4, L4-L5 and L5-S1 levels bilaterally and on the left at the L2-L3 level.

6. Tight lumbar canal at the L3-L4 and L4-L5 levels.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzchandra Mhlmn / M / 73 yrs.
Referred by : Dr. Abc Xyztrak.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O intracerebral hematoma.
For follow-up.

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 T2 Weighted coronal images.

OBSERVATION :

There is seen a fairly large, well-marginated, mass lesion which is hypointense with a hyperintense rim on the T1 Weighted images in the left thalamus. This lesion shows mixed signal characteristics on the T2 Weighted and FLAIR images. There is mild perilesional edema with indentation on the left lateral and third ventricles. The lesion extends inferiorly into the subthalamic region and into the midbrain on the left. Superiorly it extends into the left corona radiata, posteriorly and laterally it extends into the left posterior capsular region and left lentiform nucleus. The lesion also extends into the left lateral ventricle. Fluid-fluid levels are seen within the occipital horns of both the lateral ventricles.

There are ill-defined, hyperintense areas on the proton and T2 Weighted images in the periventricular white matter bilaterally and in the bilateral centrum semiovale. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes.






There is mild dilatation of the right lateral ventricle. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is minimal bulge of the midline to the right. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of a subacute hemorrhage within the left thalamus with extensions as described.

As compared to the previous MRI (study no:00009) dated 00.00.00, there is a slight increase in the size of the lateral ventricles.

The hematoma is now in the subacute phase.