PROVISIONAL REPORT

Date : 00.00.00

Name of the Patient : Abc Xyzath Talmn / M / 51 yrs.
Referred by : Dr. Abc Xyzlankar.
Examination : M.R.I. of the Brain and orbits.

CLINICAL PROFILE :

H/O left sided mucormycosis since 10 days with tooth extraction on 00.00.00.
C/O ptosis, proptosis and progressive diminished vision of the left eye since last 3 days. Also C/O headaches and tinnitus (left sided) since 10 years.
Known hypertensive/diabetic. On Rx.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick FLAIR coronal images.
4 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

Areas of intermediate signal intensity on the T1 Weighted and STIR images are noted within the superior orbital fissure and optic canal on the left side. The extraocular muscles of the left orbit are seen to be bulky and slightly hyperintense on the STIR images as compared to the opposite side. Note is made of proptosis on the left side. The left optic nerve within the left optic canal cannot be identified separately from the lesion.

Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted and STIR images are seen within the left maxillary sinus and the ethmoidal air cells and sphenoid sinus on the left side. Areas of similar signal intensity are seen to involve the left infratemporal fossa. Mild inflammatory changes are noted in the frontal sinus and the mastoid air cells bilaterally.
..2/.








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

There is mild prominence of the cerebral cortical sulci bilaterally. Also seen is slight fullness of the third and both the lateral ventricles. The fourth ventricle is 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 :

1. A lesion within the left superior orbital fissure and left optic canal with bulky extraocular muscles on the left side as described most likely represents an infective pathology.

2. Inflammatory changes within the left maxillary sinus and the ethmoidal air cells and sphenoid sinus on the left side and
in the left infratemporal fossa and mild inflammatory changes in the frontal sinus and the mastoid air cells bilaterally.

In the given clinical setting of diabetes, a fungal lesion like mucormycosis should be excluded.


Please send films back for a final report.

Thanks for the reference.

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzVallmn / F / 38 yrs.
Referred by : Dr. Abc Xyzikhalikar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O backache with paresthesias in BLE with weakness.
Previous MRI showed an intramedullary cysticercus in the dorsal region.

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.

IMPRESSION :

No abnormality is detected within the Brain on this study.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 32 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O dragging of feet since 5 years which has increased since 3-4 months.
C/O slipping off of chappals.
H/O hoarseness of voice since 5 years.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

Schmorls nodes are noted in the lower dorsal region. The mid dorsal intervertebral discs show loss of water content.

The visualized dorsal vertebral bodies and 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 reveals normal signal intensity. However there is a slight decrease in the calibre of the cord over the C7 to D10 levels.

The conus medullaris terminates at the D12-L1 level.





The cervico-dorsal spine was screened with 5 mm thick T2 Weighted sagittal images and shows small posterior disc bulges at the C4-C5 and C5-C6 levels

The brain was screened with 5 mm thick T1 Weighted and T2 Weighted axial images which shows slight fullness of the ventricular system and prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

IMPRESSION :

The MRI features are suggestive of :

1. Slight decrease in the calibre of the cord over the C7 to D10 levels.

2. Mild degenerative changes in the cervico-dorsal region.

3. Cerebral and cerebellar atrophy.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzai Blmn / F / 22 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O fall on the railway track 1 year back.
C/O tremors in all four extremities, slipping off of chappals from the right foot and paresthesias in BLE.

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 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.

Inflammatory changes are seen in the posterior ethmoidal air cells.

IMPRESSION :

Normal study of the Brain.

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 25 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O Kochs in the midbrain since 1 year. On AKT since then.
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.
4 mm thick FLAIR coronal images.
3 mm thick T1 Weighted and T2 Weighted coronal images.
OBSERVATION :
There is still seen a well-marginated, approximately 0.5 cm diameter sized hypointense lesion on the proton and T2 Weighted images in the midbrain, centrally and more to the left of the midline. This lesion appears hypointense on the T1 Weighted images. There is perilesional edema which is seen to extend into the subthalamic region. 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 :An approximately 0.5 cms diameter sized lesion in the midbrain, centrally and more to the left of the midline follows a signal characteristics of a tuberculoma. As compared to the previous MRI (study no:0000) dated 00.00.00, there is reduction in the size of the lesion as well as the surrounding edema.
The previously identified small bright foci in the pons, posterior limb of the left internal capsule, left corona radiata, centrum semiovale bilaterally, in the right parieto-occipital region and right high parietal region are now not identified on this non-enhanced scan.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz. Srivalmn / M / 33 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to BUE (occasionally) with paresthesias in the LUE since November 0000.

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.

OBSERVATION :

There is a postero-central disc protrusion with small peridiscal osteophytes indenting the thecal sac at the C5-C6 level. The left facet joint at this level shows mild degenerative change.

A posterior disc bulge with small peridiscal osteophytes is noted at the C6-C7 level. A mild posterior disc bulge is noted at the C4-C5 level.

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.

- 2 - scan-00002


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

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and shows mild degenerative changes. Small posterior disc herniations are noted at the D2-D3, D3-D4, D8-D9 and D9-D10 levels.

IMPRESSION :

The MRI features are suggestive of :

1. A postero-central disc protrusion with small peridiscal osteophytes at the C5-C6 level.

2. A posterior disc bulge with small peridiscal osteophytes at the C6-C7 level.

3. Mild facetal arthropathy on the left side at the C5-C6 level.

As compared to the previous MRI dated 00.00.00, there is no significant change noted.

hs/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Hlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in BLE since 1 year.

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 the L1 vertebra is as marked on the film. Please correlate with plain radiographs.

Mild posterior disc bulges are seen at the L3-L4 and L4-L5 levels. Bilateral far lateral (extraforaminal) disc bulges are also noted at these levels.

The L4-L5 facet joints show mild degenerative changes.

There is loss of water content of the L1-L2 to L4-L5 intervertebral discs. A well-defined area of hyperintensity on all the pulse sequences is noted within the D12 vertebral body, posteriorly and this may represent a hemangioma with high fat content.

Type II degenerative changes are noted within the L4 and L5 vertebral bodies adjacent to the L4-L5 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 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 :

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

IMPRESSION :

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

2. Mild posterior disc bulges at the L3-L4 and L4-L5 levels.

3. Bilateral far lateral (extraforaminal) disc bulges at the L3-L4 and L4-l5 levels.

4. Mild facetal arthropathy at the L4-L5 level.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzm Jalmn / M / 40 yrs.
Referred by : Dr. Abc Xyzcha.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 5 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 posterior disc herniation indenting the thecal sac and narrowing both neural foramina at the L4-L5 level. A disc portion is seen to lie within the left lateral recess of the L5 vertebra with resultant impingement of the traversing left L5 nerve root.

Bilateral far lateral disc herniations are seen to indent the extraforaminal portion of the exiting L4 nerve roots at the L4-L5 level.

Large right postero-lateral and right far lateral disc herniations are seen to narrow the right neural foramen and indent the exiting right L3 nerve root at the L3-L4 level. A left far lateral disc bulge is noted at this level.

The L5-S1 facet joints show degenerative changes. A mild posterior disc bulge is noted at this level.

- 2 - scan-00009



There is facetal hypertrophy over the L1-L2 to L4-L5 levels.

The L4-L5 intervertebral disc shows loss of water content.
The L3-L4 intervertebral disc shows mild loss of water content.

Type I/II degenerative changes are noted within the L4 and L5 vertebral bodies adjacent to the L3-L4 and L4-L5 intervertebral discs.

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 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

17.0 mm at L2-L3

16.0 mm at L3-L4

15.0 mm at L4-L5

16.0 mm at L5-S1.
..3/.














- 3 - Scan-00009



IMPRESSION :

1. A posterior disc herniation with a disc portion seen to lie within the left lateral recess of the L5 vertebra with resultant impingement of the traversing left L5 nerve root.

2. Large right postero-lateral and right far lateral disc herniations indenting the exiting right L3 nerve root at the L3-L4 level.

3. Bilateral far lateral disc herniatons indenting the extraforaminal portion of the exiting L4 nerve roots at the L4-L5 level.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzngi Dharwalmn / F / 37 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache 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 a small right paracentral disc herniation with peridiscal osteophtyes at the L5-S1 level.

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

The L4-L5 and L5-S1 facet joints show mild degenerative changes.

The lumbar intervertebral discs show mild loss of water content.

The lumbar vertebral bodies 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.
scan-00008


The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

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

IMPRESSION :

The MRI features are suggestive of :

1. A small right paracentral disc herniation with peridiscal osteophtyes at the L5-S1 level.

2. A mild posterior disc bulge at the L4-L5 level.

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

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / F / 54 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Abdomen.

CLINICAL PROFILE :

C/O severe systemic hypertension.
To r/o pheochromocytoma.

EXAMINATION :

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

8 mm thick T1 Weighted and T2 Weighted axial images.
3 mm thick T2 Weighted axial images.
3 mm thick T1 Weighted coronal images.

OBSERVATION :

No mass lesion is seen in the region of the adrenal glands or along the visualized aorta.

The liver is normal in size, shape and position. There is no focal or diffuse area of altered signal intensity. There is no intrahepatic biliary radicle dilation. The intrahepatic venous architexture is normal.

The gall bladder is normal and reveals no intrinsic abnormality.

The pancreas is normal in size and shape.

The spleen is normal.

Both the kidneys appear small and shrunken suggestive of medical renal disease.
scan-00007


No lymphadenopathy is detected. There is no evidence of free fluid within the abdomen.

IMPRESSION :

Small shrunken kidneys bilaterally suggestive of medical renal disease.