ke/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Maklmn / M / 51 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (right more than left) with paresthesias 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 slight retroplacement of the L5 over the S1 vertebra.

There is a posterior and right postero-lateral disc herniation at the L5-S1 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. The L5-S1 facet joint on the left side shows hypertrophic degenerative change. There is indentation upon the right S1 nerve root.

Posterior and a left postero-lateral disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac and left neural foraminal narrowing. A part of the disc fragment is seen to migrate inferiorly in the right lateral recess posterior to the L5 vertebra with impingement of the right L5 nerve root. There is indentation upon the foraminal and extraforaminal portion of the left L4 nerve root. The L4-L5 facet joint on the left side shows hypertrophic degenerative change with left lateral recess stenosis. Ligamentum flavum hypertrophy is seen on the left side at the L5 level with lumbar canal stenosis.
..2/.




- 2 - scan-00006


Anterior disc herniations with large peridiscal osteophytes are seen in the lower dorsal and lumbar region. Schmorls node is seen in the inferior aspect of the D12 vertebral body. The lumbar intervertebral discs except for the L1-L2 and L3-L4 discs show loss of water content.

The rest of the lumbar facet joints show mild degenerative change.

The lumbar vertebral bodies show diffuse fatty changes.

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 S2 level.

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

17.0 mm at L1-L2
16.0 mm at L2-L3
14.0 mm at L3-L4
14.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Slight retroplacement of the L5 over the S1 vertebra with a posterior and right postero-lateral disc herniation at the L5-S1 level with indentation upon the right S1 nerve root and hypertrophic facetal arthropathy on the left side at this level.
..3/.









- 3 - scan-00006


2. Posterior and a left postero-lateral disc herniation at the L4-L5 level with indentation upon the foraminal and extraforaminal portion of the left L4 nerve root with a part of the disc seen to lie posterior to the L5 vertebral body with impingement of the right L5 nerve root with canal stenosis. There is also hypertrophic facetal arthropathy on the left side with left lateral recess stenosis at this level.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzD. Hlmn / M / 22 yrs.
Referred by : Dr. Abc Xyzshar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O change in voice.
H/O Pulmonary kochs 1 year ago. Received AKT for 8 months.

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 is evidence of a hyperintense signal on the proton and T2 Weighted images within the tectum. The tectum is seen to be bulky with resultant compression of the aqueduct. There is resultant mild to moderate dilatation of the third and both the lateral ventricles.

An extramedullary mass lesion is noted within the spinal canal on the right side at the C2 and C3 vertebral levels. It is seen to compress and displace the cord to the left side (The cord shows a suspicious hyperintense signal on the T2 Weighted images at these levels and this may represent cord edema/ischemia). This lesion is hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted images. This lesion is seen to extend into the right paravertebral soft tissues via the right C2-C3 neural foramen, which is enlarged.

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 :

1. A bulky tectum with altered signal may represent a glial cell tumor or hamartoma.

2. Mild to moderate obstructive hydrocephalus.

3. An extramedullary lesion within the spinal canal on the right side at the C2 and C3 vertebral levels with extensions as described most likely represents a neurofibroma.

The above findings may be seen with neurofibromatosis and a contrast enhanced study may be worthwhile.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzMlmn / F / 59 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures on 00.00.00.
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.

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.

IMPRESSION :

Normal study of the brain.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Nlmn / F / 9 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

H/O CDH which was operated in 0000.
C/O gibbus with kyphoscoliosis of the dorso-lumbar spine.
C/O difficulty in walking.

EXAMINATION :

M.R.I of the dorso-lumbar 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.

3 mm thick Fast Scan (T2 *) coronal images.

OBSERVATION :

There is collapse of the L3 vertebral body with an angular kyphus at that level.

There is replacement of the normal marrow of the L2, L3 and L4 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted and Gradient images. There is involvement of the L2-L3 and L3-L4 intervertebral discs. Mild pre and paravertebral soft tissue extension is noted over the L2 to L4 levels. A large, right paravertebral lesion is seen extending over the L3-L4 to the S1 levels which is of intermediate signal intensity on the T1 Weighted images and turns hyperintense on the T2 Weighted images and represents abscess/granulation tissue. Minimal anterior epidural extension, to the left of the midline is seen at the L2, L3 and L4 levels.


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

The conus medullaris terminates at the L2 level.

IMPRESSION :

The MRI features are suggestive of collapse of the L3 vertebral body with kyphus and altered signal of the L2, L3 and L4 vertebral bodies with involvement of the L2-L3 and L3-L4 intervertebral discs, pre and paravertebral soft tissue extension and granulation tissue/abscess
over the L3-L4 to the S1 levels as described. These changes most probably represent a granulomatous infective process like tuberculosis.

The possibility of a round cell tumor, is less likely.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzRamchanlmn / M / 52 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tinnitus with decreased hearing bilaterally 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

MR cisternogram was obtained in the coronal plane.

OBSERVATION :

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

The seventh and eighth cranial nerve 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. The vertebro-basilar system is ectatic.

Incidental note is made of right maxillary sinusitis.

IMPRESSION :

Normal study of the Brain.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzm lmn / M / 65 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall 6 months back and 10-15 days back.
H/O altered sensorium since 6 months.
C/O gait ataxia since 1 1/2 months.

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 the periventricular white matter bilaterally. These lesions appear isointense to normal white matter on the T1 Weighted images.

There is mild to moderate dilatation of both the lateral and third ventricles which is disproportionate to the degree of cerebral cortical atrophy. The fourth ventricle is also mildly dilated.

There is slight prominence of the cerebral cortical sulci, cerebellar folia and basal cisternal spaces.

There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.








Inflammatory changes are noted in the ethmoidal air cells bilaterally and in the left frontal sinus.

IMPRESSION :

1. Altered signal in the periventricular white matter bilaterally most likely represent ischemic changes.

2. Mild to moderate dilatation of both the lateral and third ventricles which is disproportionate to the degree of cerebral cortical atrophy. Normal pressure hydrocephalus should be ruled out.

3. Mild cerebral cortical and cerebellar atrophy.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzl lmn / M / 27 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Posterior fossa and upper Cervical Spine.

CLINICAL PROFILE :

C/O pain in the nape of the neck on the right side with swelling over right side of face upto shoulder with burning sensation since 1 year. Also C/O heaviness of the head on the right side.
H/O tonsilitis 1 year back.

EXAMINATION :

M.R.I of the posterior fossa and upper cervical spine was performed using the following parameters :

5 mm thick T1 Weighted sagittal images.
5 mm thick T2 Weighted axial images.
3 mm thick T1 Weighted and T2 Weighted coronal images through the region of interest.
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

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

The ventricular system and the basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

The seventh and eighth cranial nerve complex on either side is unremarkable.

Incidental note is made of left maxillary polyp.
- 2 - scan-00000

Small posterior disc bulges are noted at the C4-C5 and C5-C6 levels.

The C4-C5, C5-C6 and C6-C7 intervertebral discs show loss of water contnet.

The cervical vertebral bodies and the remaining intervertebral discs 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 :

No significant abnormality is detected on this study.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzKalmn / M / 17 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O MR with seizures since the age of 10 months.

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.

FEW IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

There is slight reduction in the volume of the right hippocampus on the left side which shows a hyperintense signal on the T2 Weighted images.

There is mild fullness of both the lateral ventricles. The 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 :

The MRI features are suggestive of left hippocampal sclerosis.

ke/sb/nl/nl
Date : 00.00.00

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


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 posterior disc protrusion at the L5-S1 level with minimal indentation upon the S1 nerve roots. The right L5 and left S1 nerve roots appear slightly thicker. The L5-S1 facet joints show degenerative changes.

A small posterior disc herniation is seen at the L4-L5 level. The L4-L5 facet joints show mild degenerative change.

Fat is noted in the filum terminale at the L1 and L2 levels - a normal variant.

Slight increase in the epidural fat is noted at the L5 and S1 vertebral levels with trifoliate appearance of thecal sac, suggesting epidural lipomatosis.

The lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The remaining facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12 level and the thecal sac terminates at the L5 level.



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

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

IMPRESSION :

1. A small posterior disc protrusion at the L5-S1 level with minimal indentation upon the S1 nerve roots. The right L5 and left S1 nerve roots appear slightly thickened.

2. A small posterior disc herniation at the L4-L5 level.

3. Degenerative changes of the L4-L5 and L5-S1 facet joints.

4. Epidural lipomatosis at the L5 and S1 vertebral levels.

ke/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 53 yrs.
Referred by : Dr. Abc Xyzootra.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches since 15 days.
Known hypertensive/diabetic. On Rx.

EXAMINATION :

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

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

OBSERVATION :

There is a hyperintense area in the right high posterior parietal region involving the cortex and the subcortical white matter on the T2 Weighted and FLAIR images. This is isointense to hypointense to white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.

The internal carotid artery in the cavernous portion on the right side does not show its normal flow void signal on all the pulse sequences.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidental note is made of maxillary sinusitis and inflammatory changes in the ethmoidal air cells and sphenoid sinuses.



- 2 - scan-00006


INTRACRANIAL MRA :

The internal carotid artery on the right side in its entire intracranial portion is not visualized.

There is mild narrowing of the distal portion of the P2 segment of the right posterior cerebral artery.

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

NECK MRA :

The right internal carotid artery shows a very faint signal in the proximal portion just after its bifurcation and is then not visualized in the entire neck portion.

The left internal carotid artery is unremarkable.

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no other vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Areas of ischemia/infarction in the right high posterior parietal region.

2. Non-visualization of the internal carotid artery on the right side.

3. Mild narrowing of the distal portion of the P2 segment of the right posterior cerebral artery.