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Sunday, 27 December 2015 16:48

13368

ke/hs/nl/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

Known C/O bipolar mood disorder.
C/O altered sensorium since 1 day.

EXAMINATION :

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

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

IMAGES SHOW GROSS PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

There is no obvious 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.

IMPRESSION :

No abnormality detected within the brain on this study.

Sunday, 27 December 2015 16:48

13367

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 17 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O wasting of the RLE since 15 months.
H/O fever prior to this.

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 Proton density sagittal images.

OBSERVATION :

There is loss of normal contour of the right femoral head. Subtle hypointense areas are seen in the right femoral head on the T1 Weighted images which are seen to remain hypointense with few areas turning hyperintense on the T2 Weighted and STIR images. There is a well-defined lesion seen in the right femoral head in the region of the epiphysis which is hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted images (se/im 104/9, 103/9). There is thinning of the articular cartilage overlying the right femoral head. A subchondral cyst is seen in the femoral head. The acetabulum is unremarkable. Effusion is seen within the right hip joint. The muscles surrounding the right hip joint appear atrophic as compared to the left. The left hip joint is unremarkable.

The right ischial tuberosity appears markedly hypointense on the T1 Weighted images and shows mixed signal characteristics on the T2 Weighted images and is of indetermined etiology.


IMPRESSION :

The MRI features are suggestive of altered signal of the right ischium and right femoral head with degenerative changes and mild effusion ? secondary osteoarthritis.

Spondyloarthropathy should be ruled out.









Sunday, 27 December 2015 16:48

13366

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Mlmn / M / 69 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

H/O fall 4 months back with C/O backache radiating to the LLE.
Now C/O weakness of the LLE since 15 days.

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.

The dorsal spine was scanned with 4 mm thick T2 Weighted sagittal images and 5 mm thick T1 Weighted and T2 Weighted axial images through the region of interest.

OBSERVATION :

Posterior disc herniations with peridiscal osteophytes are seen to indent the cord and narrow both neural foramina at the C4-C5, C5-C6 and C6-C7 levels.

A postero-central disc protrusion with peridiscal osteophytes is seen to indent the thecal sac at the C3-C4 level.

Ligamentum flavum hypertrophy is noted at the C4-C5 and C5-C6 levels. The C3-C4, C4-C5 and C5-C6 facet joints show degenerative changes.

The normal flow void signal within the right vertebral artery is not well-visualized, ? hypoplastic artery.


A small posterior disc herniation with peridiscal osteophytes is seen to indent the cord at the D10-D11 level. Severe ligamentum flavum hypertrophy with compression upon the cord is also seen at this level. The cord at this level shows a hyperintense signal on the T2 Weighted images and this may represent cord edema/ischemia. The D10-D11 facet joints show degenerative changes with severe canal stenosis.

Mild ligamentum flavum hypertrophy is noted at the D11-D12 level.

Mild posterior disc bulges with small peridiscal osteophytes are noted in the upper and mid-dorsal region.

Anterior disc herniations with peridiscal osteophytes are noted in the cervico-dorsal region.

The cervico-dorsal intervertebral discs show loss of water content.

The cervico-dorsal vertebral bodies are unremarkable.

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 :

The MRI features are suggestive of :

1. A small posterior disc herniation with peridiscal osteophytes at the D10-D11 level with severe ligamentum flavum hypertrophy, facetal arthropathy and severe canal stenosis at this level.
..3/.






- 3 - scan-00006




2. Altered signal of the cord at the D10-D11 level is suggestive of cord edema/ischemia.

3. Posterior disc herniations with peridiscal osteophytes at the C4-C5, C5-C6 and C6-C7 levels.

4. A postero-central disc protrusion with peridiscal osteophytes at the C3-C4 level.

5. Ligamentum flavum hypertrophy at the C4-C5 and C5-C6 levels and facetal arthropathy at the C3-C4, C4-C5 and C5-C6 levels.

Sunday, 27 December 2015 16:48

13365

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Talwalmn / F / 9 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O ? measles at the age of 1 1/2 years with gait ataxia since then.
? dystonia
To r/o degenerative disorder.

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 prominence of the cerebellar folia bilaterally with resultant fullness of the fourth ventricle.

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

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.

IMPRESSION :

The MRI features are suggestive of cerebellar atrophy.














Sunday, 27 December 2015 16:48

13364

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Chattelmn / F / 35 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 1 year which has increased since 2 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 slight retroplacement of the L5 over the S1 vertebra. A small pseudoposterior disc herniation is seen at the L5-S1 level with mild inferior migration. This disc shows loss of water content.

Type II degenerative changes are noted in the antero-superior portion of the L5 vertebra.

The rest of 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 L1-L2 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 :

21.0 mm at L1-L2
20.0 mm at L2-L3
19.0 mm at L3-L4
15.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

Slight retroplacement of the L5 over the S1 vertebra with a small pseudoposterior disc herniation at the L5-S1 level.

Sunday, 27 December 2015 16:48

13363

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzd Flmn / F / 11 months.
Referred by : Dr. Abc Xyzngsarkar.
Examination : Limited M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

Previous MRI S/O diastomatomyelia at D11-L1 level with weakness of the RLE since birth.
MRI now to exclude presence of a communication with the spinal canal at the D7 vertebral level.

EXAMINATION :

Limited M.R.I of the dorsal spine was performed, as requested
using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

3 mm thick T1 Weighted coronal images.

OBSERVATION :

There is diastomatomyelia extending over the D2-D3 to the D5-D6 levels with probable syrinx in the right hemicord.

A small defect is seen in the subcutaneous tissue at the D7-D8 level but not reaching upto the spinal canal. This may represent a redundant dermal sinus.



Sunday, 27 December 2015 16:48

13362

ke/sb/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

Known C/O TB Meningitis. On AKT since 2-3 days.
C/O tingling in BLE since 6 days.

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 small postero-central disc herniation at the L4-L5 level with anterior indentation of the thecal sac. This disc shows loss of water content.

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 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 :

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

IMPRESSION :

The MRI features are suggestive of a small postero-central disc herniation at the L4-L5 level.

If a meningeal pathology/arachnoiditis is suspected, a contrast enhanced scan is essential.
Sunday, 27 December 2015 16:48

13361

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Mlmn / M / 30 yrs.
Referred by : Dr. Abc Xyzkil.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the RUE with numbness on the tip of fingers of the right hand since 3 days.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

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

OBSERVATION :

There is a right paracentral disc herniation with posterior peridiscal osteophytes at the C5-C6 level with antero-lateral indentation of the cord and right neural foraminal narrowing. There is indentation upon the right C6 nerve root. A sequestered disc fragment is noted in the right lateral recess of C6 (scans 103.6, 104.15, 103.15).

A small postero-central disc herniation is seen at the C4-C5 level with anterior indentation of the thecal sac. The cervical intervertebral discs show loss of water content.

The cervical vertebral bodies show normal signal intensity. 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 :

The MRI features are suggestive of :

1. A right paracentral disc herniation with posterior peridiscal osteophytes at the C5-C6 level with a sequestered disc fragment in the right lateral recess of C6.

2. A small postero-central disc herniation at the C4-C5 level.

Sunday, 27 December 2015 16:48

13358

ke/sb/nl/nl
/60 Date : 00.00.00

Name of the Patient : Abc Xyzchandra Tamalmn / M / 36 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O tingling on the left half of the body since 1 month.
H/O left sided hemiparesis on 00.00.00 from which patient recovered in 8 days.

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 :

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 is 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, posterior cerebral and right vertebral 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 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. Hypoplastic left vertebral artery.

2. No other significant abnormality is detected on this study.


Sunday, 27 December 2015 16:48

13357

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyznt lmn / M / 15 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever with chills 12 days back with bladder involvement since 4 days with weakness in BUE and BLE and altered sensorium since 1 day.

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 proton and T2 Weighted images in the lower medulla and the cervico-medullary junction. This is isointense to normal white matter on the T1 Weighted images.

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.











The cervical and dorsal spines were screened with 4 mm thick T2 Weighted sagittal images, which show hyperintense signal within the centre of the spinal cord over the cervico-medullary junction upto the conus.

IMPRESSION :

The MRI features are suggestive of altered signal in the lower medulla and the cervico-medullary junction upto the conus medullaris. In the given clinical setting of fever this most likely represents myelitis.

The other possibilities to be considered are demyelination or ischemia/infarction.