sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Nlmn / M / 49 yrs.
Referred by : Dr. Abc Xyz. Modi.
Examination : M.R.I. of the Right Ankle.

CLINICAL PROFILE :

H/O fall in a hole 1 year back with pain and mild swelling over the right ankle since then.

EXAMINATION :

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

5 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 :

The visualized bones of the right ankle joint show normal configuration and signal intensity. No obvious bone destruction or erosion is evident.

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

The visualized talus is unremarkable.

IMPRESSION :

Normal study of the Right Ankle Joint.

sb/hs/nl/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O giddiness with aphasia, right sided weakness and loss of consciousness.
Known hypertensive.

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.

OBSERVATION :

There is seen a fairly large, approximately 4.1 x 3.2 x 4.5 cms sized fairly well-marginated, iso to hypointense (as compared to normal white matter) mass lesion on the T1 Weighted images in the left thalamus. This lesion appears relatively hypointense on the T2 Weighted and Fast Scan (T2 *) images. The periphery of the lesion appears hyperintense on the T2 Weighted images most likely representing serum due to clot retraction. 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.

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 midline to the right. No obvious vascular anomaly is identified on this study.

IMPRESSION :

An approximately 4.1 x 3.2 x 4.5 cms sized mass lesion in the left thalamus with extensions as described most likely represents an acute intracerebral hematoma.

sb/hs/nl/nl.
Date : 00.00.00

Name of the Patient : Abc XyzKashilmn / M / 36 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE since 9 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 loss of water content of all the intervertebral discs except the L3-L4 disc.

There is a posteriorly herniated disc with a peridiscal osteophyte at the L5-S1 level with a fairly large, right paracentral extruded disc indenting the traversing right S1 nerve root. The left L5 nerve root is impinged in the left neural foramen at the L5-S1 level. Bilateral far lateral (extraforaminal) disc herniations are noted at this level.

A postero-central disc herniation with a right postero-lateral (foraminal) and right far lateral (extraforaminal) disc herniation is noted at the L4-L5 level with right neural foraminal narrowing and indentation upon the exiting right L4 nerve root.

The facet joints at the L4-L5 and L5-S1 levels show slight hypertrophic degenerative changes.

The lumbar vertebral bodies 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 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
16.0 mm at L2-L3
16.0 mm at L3-L4
14.0 mm at L4-L5
14.0 mm at L5-S1.

IMPRESSION :

1. A posteriorly herniated disc with a peridiscal osteophyte at the L5-S1 level with a fairly large, right paracentral extruded disc indenting the traversing right S1 nerve root. The left L5 nerve root is impinged in the left neural foramen at the L5-S1 level.

2. A postero-central disc herniation with a right postero- lateral (foraminal) and right far lateral (extraforaminal) disc herniation at the L4-L5 level.

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

4. Bilateral far lateral (extraforaminal) disc herniations at the L5-S1 level.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzn Jalmn / M / 41 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered sensorium with fever since 8 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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a large ill-defined area in the left frontal lobe and the right frontal parafalcine region which is hypointense to gray matter on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images. The rostrum, genu and the anterior portion of the body of the corpus callosum is also involved by the pathology. Few hyperintense areas are seen within this lesion on the T1 Weighted images which are hyperintense on the proton, T2 Weighted and FLAIR images and may represent extracellular methaemoglobin/ paramagnetic substances. There is mass effect with effacement of the adjacent sulci with compression upon the frontal horn of both the lateral ventricles. There is slight shift of the anterior falx to the left side.

There are small well-circumscribed areas in the pons anteriorly to the right and posteriorly to the left and the right middle cerebellar peduncle adjacent to the fourth ventricle. These are hyperintense on the proton, T2 Weighted and FLAIR images.



There is slight fullness of both the lateral ventricles. 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. Altered signal in the left frontal lobe and the right parafalcine frontal region and rostrum, genu and the anterior portion of the body of the corpus callosum.

2. Altered signal in the pons anteriorly to the right and posteriorly to the left and the right middle cerebellar peduncle adjacent to the fourth ventricle.

These are not specific for a single etiology.

These changes may be seen with :

a. Neoplasia.

b. Vascular insults.

c. Demyelinating lesions.

A contrast enhanced scan may be worthwhile.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Prlmn / M / 37 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE with numbness since 1 month.

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 L5-S1 intervertebral disc.

A postero-central and left paracentral disc herniation with peridiscal osteophytes is noted at the L5-S1 level with minimal indentation on the traversing left S1 nerve root.

A probable conjoint right L5 and S1 nerve root is noted.

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

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 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 :

19.0 mm at L1-L2
19.0 mm at L2-L3
17.0 mm at L3-L4
14.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. A postero-central and left paracentral disc herniation with peridiscal osteophytes at the L5-S1 level with minimal indentation on the traversing left S1 nerve root.

2. A probable conjoint right L5 and S1 nerve root.

sb/he/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzGlmn / M / 14 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain with stiffness of the neck and wasting of BUE and BLE since 6 months.
Alleged H/O fall 5-6 years back.

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.

4 mm thick T1 Weighted sagittal images in flexion and extension were also obtained.

OBSERVATION :

There is a congenital block C4/C5 vertebra.

There is atlanto-dens subluxation with the atlanto-dens interval measuring approximately 1.4 cms in the neutral position. Resultant compression of the cervical spinal cord at the C1-C2 level is noted. The cervical spinal cord at the C1 and C2 levels shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images which suggests cord edema/ischemia/gliosis. The rest of the visualized cervical spinal cord also appears slightly smaller in calibre than normal.

Minimal posterior disc bulges are noted at the C2-C3 and C3-C4 levels.




The cervical vertebral bodies show normal signal intensity. The upper cervical intervertebral discs show loss of water content. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The flexion and extension images do not show any significant change in the atlanto-dens interval.

IMPRESSION :

The MRI features suggest atlanto-dens subluxation with the atlanto-dens interval measuring approximately 1.4 cms in the neutral position. Resultant compression of the cervical spinal cord at the C1-C2 level is noted with cord signal alteration suggesting cord edema/ischemia/gliosis.

hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzhand Vishwaklmn / M / 21 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O ? seizures ? episodic abnormal behaviour for 4-5 minutes 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 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.

Inflammatory changes are noted in the maxillary sinus and ethmoidal air cells, bilaterally.

IMPRESSION :

Normal study of the Brain.

hs/sb/rg/nl
Date : 00.00.00 Name of the Patient : Abc XyzAlmn / M / 70 yrs. Referred by : Dr. Abc Xyzah.Examination : M.R.I. of the Cervical Spine.CLINICAL PROFILE :C/O paresthesias in all four extremities with weakness and gait imbalance since October 0000.
MRI s/O demyelination with disc prolapse at the cervical level.
For follow up.
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 postero-lateral disc herniation with small peridiscal osteophytes at the C6-C7 level with antero-lateral indentation of the cord and right neural foraminal narrowing. Mild indentation upon the right C7 nerve root is noted. A small posterior disc bulge is seen at the C5-C6 level.There are postero-central disc protrusions at the C3-C4 and C4-C5 levels with anterior indentation of the thecal sac. The cervical spinal cord shows an area which is isointense to CSF, at the C3 and C3-C4 levels.

The C3-C4 facet joints show degenerative changes.
The cervical intervertebral discs show loss of water content.
The cervical vertebral bodies reveal normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.The atlanto-axial region and the cervico-medullary junction are unremarkable.Incidental note is made of a mega cisterna magna.
The brain was screened with 5 mm thick T2 Weighted axial images and shows few small bright foci in the white matter in the right fronto-parietal lobes and these may be ischemic in etiology. Also seen is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally. IMPRESSION :The MRI features are suggestive of :1. Altered signal of the cervical spinal cord, at the C3 and C3-C4 levels would represent an area of myelomalacia.
2. A right postero-lateral disc herniation at the C6-C7 level indenting the right C7 nerve root.
Previous MRI was not available for comparision.

hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Glmn / F / 20 yrs.
Referred by : Dr. Abc Xyzosale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 6 months.
H/O injury to back 6 months back.

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 appears to be sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs. There also appears to be a spina bifida of the L5 vertebra.

There are areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images involving the L3 and L4 vertebral bodies and the pedicles. Also seen is involvement of the L3-L4 intervertebral disc with erosion of the adjacent cortical endplates.

There is extension of this pathologic process into the anterior epidural space with resultant compression of the thecal sac at the L3 and L4 vertebral levels (more so on the left side at the L3 vertebral level). There is encroachment into the L3-L4 neural foramina bilaterally.

- 2 - scan-00000


There is extension into the pre and paravertebral soft tissues with involvement of the psoas muscles at the L3 and L4 levels.

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

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

The cervical and dorsal spines were screened with 4 mm thick T1 Weighted sagittal images and there appears to be enlarged mediastinal lymphnodes.

IMPRESSION :

The MRI features are suggestive of :

1. Sacralization of the L5 vertebra. Please correlate with plain radiographs.

2. A pathologic process involving the L3 and L4 vertebrae and the L3-L4 intervertebral disc with soft tissue extensions as described. This most likely represents an infective lesion like tuberculosis.

The possibility of this being a neoplastic process like a small cell tumor is less likely.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzJ. Perlmn / M / 40 yrs.
Referred by : Dr. Abc Xyzi.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O being hit by an iron rod in the left fronto-temporal region 00.00.00 with semiconsciousness, vomiting and nasal bleed.
Now C/O loss of vision of the left eye.

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 T1 Weighted and STIR coronal images and 3 mm thick T2 Weighted axial images through the optic nerves.

OBSERVATION :

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the left inferior frontal cortex and subcortical white matter. This lesion appears predominantly hypointense on the T1 Weighted images with a subtle hyperintense signal within.

There is a very small, epidural lesion in the left anterior temporal region which is hyperintense on all the pulse sequences and represents a very small epidural hematoma, in the given clinical setting.

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




The optic nerves on either side are normal in their course and calibre and show normal signal.

No obvious entrapment of the optic nerves is noted.

IMPRESSION :

1. Altered signal in the left inferior frontal region represents a haemorrhagic contusion, in the given clinical setting.

2. A very small, epidural lesion in the left anterior temporal region represents a very small epidural hematoma, in the given clinical setting.

3. No significant abnormality is detected along the optic nerves on either side.