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Sunday, 27 December 2015 16:48

13390

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyze K. Bambhlmn / M / 45 yrs.
Referred by : Dr. Abc Xyzghela / Dr. Abc Xyzstak.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O tremors in BUE with stiffening of the jaw and slurred speech (momentary) with headaches since 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.

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

OBSERVATION :

BRAIN :

There is no focal area of altered signal intensity within 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.

INTRACRANIAL MRA :

The left vertebral artery appears hypoplastic.

There is slight concentric narrowing of an approximately 1.0 cms segment of the proximal left middle cerebral artery, beginning from the bifurcation of the left internal carotid artery. The distal M1 segment of the left middle cerebral artery and it Sylvian branches are unremarkable.
..2/.





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

NECK MRA :

The left vertebral artery in the neck also appears hypoplastic.

The common carotid arteries and their bifurcations and the right vertebral artery appear normal. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. No significant abnormality is detected within the brain parenchyma.

2. Slight concentric narrowing of an approximately 1.0 cms segment of the proximal left middle cerebral artery, beginning from the bifurcation of the left internal carotid
cerebral artery.

3. Hypoplastic left vertebral artery.
Sunday, 27 December 2015 16:48

13389

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 17 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches (since 2-3 days) with seizures 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.

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.

There is prominence of the 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.

Inflammatory changes are noted in the maxillary sinuses bilaterally.

IMPRESSION :

Prominence of the cerebellar folia bilaterally.

No other significant abnormality is detected on this study.


Sunday, 27 December 2015 16:48

13388

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzsha Narvalmn / F / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O gait imbalance since 6-7 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.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in subcortical white matter in the right posterior parietal region. These lesions appear isointense to normal white matter on the T1 Weighted images and most likely represents ischemic changes (scans 102.14, 103.14, 105.5-7).

There is prominence of the cerebellar folia bilaterally with mild fullness of the fourth ventricle.

Both the lateral and third 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.

Inflammatory changes are noted in the paranasal sinuses bilaterally.

IMPRESSION :

1. Altered signal in subcortical white matter in the right posterior parietal region may represents ischemic changes.

2. Cerebellar atrophy.
Sunday, 27 December 2015 16:48

13386

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 40 yrs.
Referred by : Dr. Abc Xyzmpat / Dr. Abc Xyzhah.
Examination : M.R.I. of the Brain and Intracranial M.R.A.

CLINICAL PROFILE :

C/O headaches with vomiting since 1 day.
Known 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.

3 mm thick FLAIR sagittal images.

5 mm thick T1 Weighted sagittal images.

Intracranial MRA was performed with a 3D TOF sequence.

OBSERVATION :

BRAIN :

There are hyperintense areas on the FLAIR images within the quadrigeminal cistern, superior cerebellar cistern and few of the sulci in the parietal lobes bilaterally.

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

Both the lateral, third and the fourth ventricles are normal. There is no shift of the midline structures.
Scan-00006



INTRACRANIAL MRA :

There are small, well-circumscribed (approximately 2-3 mms in diameter) lesions in the region of the tip of the basilar artery and the distal aspect of the left posterior cerebral artery. These may represent small aneurysms.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, vertebral and right posterior cerebral arteries also show normal signal, calibre and wall margins.

IMPRESSION :

The MRI/MRA features are suggestive of :

1. Areas of altered signal intensity within the quadrigeminal cistern, superior cerebellar cistern and few of the sulci in the parietal lobes bilaterally and may represent subarachnoid hemorrhage.

2. Probable aneurysms in the region of the tip of the basilar artery and the distal aspect of the left posterior cerebral artery.

A DSA would be worthwhile.

Sunday, 27 December 2015 16:48

13385

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Amlmn / F / 28 yrs.
Referred by : Dr. Abc Xyzering.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

C/O pain and slight swelling over the right knee joint since 2 1/2 months.
H/O fall prior to this.

EXAMINATION :

M.R.I of the right knee joint was performed using the following parameters :

4 mm thick T1 Weighted, proton and GRASS sagittal images.

4 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick T1 Weighted axial images.

3 mm thick T1 Weighted sagittal images.

OBSERVATION :

Menisci

The anterior and posterior horns of the lateral and medial menisci reveal normal configuration and signal characteristics.

Cruciate Ligaments :

The fibres of the anterior cruciate ligament are ill-defined. An intermediate signal intensity is seen along the course of the ACL on the T1 Weighted images and turns hyperintense on the proton and Gradient images.

The posterior cruciate ligament shows normal contour and signal characteristics.



Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.

Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

The articular cartilage overlying the patella, tibia and femur appears normal.

Small effusion is seen within the right knee joint.

IMPRESSION :

1. Partial tear/strain of the anterior cruciate ligament.

2. Small effusion within the right knee joint.

Sunday, 27 December 2015 16:48

13383

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzKalmn / M / 33 yrs.
Referred by : Dr. Abc Xyznde.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to the RUE with paresthesias since 1 year.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

3 mm thick T1 Weighted coronal images.

OBSERVATION :

There are posterior disc bulges at the C4-C5 and C5-C6 levels with small posterior peridiscal osteophytes.

The C2-C3 to C5-C6 intervertebral discs show loss of water content.

The joint of Luschka on the right side at the C5-C6 level shows degenerative changes with right neural foraminal narrowing.

An ill-defined hypointense area is noted in the C4 vertebral body on the left side, posteriorly on the T1 Weighted images and Fast Scan (T2 *) images and would represent sclerosis.
Scan-00003


The rest of the cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The rest of the joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord reveals normal signal intensity.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

IMPRESSION :

1. Posterior disc bulges with small posterior peridiscal osteophytes at the C4-C5 and C5-C6 levels.

2. Degenerative changes of the joint of Luschka on the right side at the C5-C6 level.

Sunday, 27 December 2015 16:48

13382

ke/sb/nl/rg.
/84 Date : 00.00.00

Name of the Patient : Abc Xyzs Slmn / M / 80 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O left sided weakness with slurred speech since 1 day.
Past H/O multiple CVA in 0000.
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.

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

OBSERVATION :

BRAIN :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular deep white matter bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction. Similar but punctate areas are noted in the pons.

There is moderate dilatation of both the lateral and third ventricles. The fourth ventricle is normal. Prominence of the cerebral cortical sulci and cerebellar folia is noted.

The basal cisternal spaces and the Sylvian fissures are also prominent. There is no shift of the midline structures.



The lens are not visualized in both the globes, the result of cataract surgery.

INTRACRANIAL MRA :

Tortuosity of the intracranial vessels is noted.

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 :

There is a concentric narrowing of the left internal carotid artery about 2 cms distal to the bifurcation. This narrowing extends for about 6 mms and could be due to atherosclerosis.

The common carotid arteries and their extracranial branches appear normal bilaterally.

IMPRESSION :

1. Altered signal in the periventricular deep white matter bilaterally and in the pons are suggestive of areas of ischemia/infarction.

2. A concentric narrowing of the left internal carotid artery approximately 2 cms distal to the bifurcation with the narrowing extending for 6 mms could be due to atherosclerosis.

3. Cerebral and cerebellar atrophy.

Sunday, 27 December 2015 16:48

13381

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Deoruklmn / M / 14 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O epilepsy since the age of 2 years.
C/O abnormal movements of BLE since 12 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.

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.

Incidental note is made of enlarged adenoids.

IMPRESSION :

Normal study of the Brain.
Sunday, 27 December 2015 16:48

13380

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz S. Plmn / F / 29 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. - Brain (Post-contrast Study).

CLINICAL PROFILE :

H/O fever, headaches and vomiting for 2 days on 00.00.00.
C/O paresthesias in BLE with involuntary movements of the LUE and RLE and on the left side of the face since 00.00.00.

EXAMINATION :

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is patchy enhancement of the lesion in the left frontal lobe. There is no other area of abnormal enhancement within the brain parenchyma or along the meninges.

The previously mentioned lesions may be ischemic in etiology.


Sunday, 27 December 2015 16:48

13379

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzAntlmn / F / 38 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 2 1/2 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 Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra. Also seen is a break of the pars interarticularis of the L4 vertebra bilaterally.

A pseudoposterior disc bulge is seen to indent the thecal sac and narrow both neural foramina bilaterally at the L4-L5 level.

Type II degenerative changes are seen within the L5 vertebral body adjacent to the L4-L5 intervertebral disc.

The remaining lumbar 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 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
16.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra with spondylolysis of the L4 vertebra bilaterally.