sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzngee Kalmn / F / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 1 1/2 years.
H/O fall prior to this.

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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is sacralization of the L5 vertebra which is as marked on the film. There is loss of water content of the L4-L5 intervertebral disc.

There is a fairly large posteriorly extruded disc at the L4-L5 level with thecal sac compression. Slight inferior migration of the disc fragment is noted indenting the L5 nerve roots bilaterally. There is also hypertrophic facetal arthropathy, bilaterally with resultant canal stenosis.

A small posterior disc bulge is noted at the L3-L4 level. Slight facetal hypertrophy is also noted at this level.




The visualized lumbo-sacral vertebral bodies show a relatively hypointense signal as compared to the normal fatty marrow on the T1 Weighted images but appear isointense to normal marrow on the T2 Weighted images. This may suggest excess of hematopoietic marrow.

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 D12-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 :

15.0 mm at L1-L2
16.0 mm at L2-L3
13.0 mm at L3-L4
4.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra which is as marked on the film.

2. A fairly large posteriorly extruded disc at the L4-L5 level with slight inferior migration of the disc fragment indenting the L5 nerve roots bilaterally with hypertrophic facetal arthropathy, bilaterally with resultant canal stenosis.

3. A small posterior disc bulge with slight facetal hypertrophy at the L3-L4 level.

4. Altered signal in the visualized lumbo-sacral vertebral bodies may suggests replacement of normal fatty marrow by hematopoietic marrow, which needs further evaluation.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzH. lmn / M / 32 yrs.
Referred by : Dr. Abc Xyzcha.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the RUE with paresthesias since 6-7 years.

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 loss of normal cervical lordosis and loss of water content of the cervical intervertebral discs.

Minimal forward translation of the C7 over the D1 vertebra is noted.

There is a right paracentral disc herniation at the C5-C6 level, indenting the dural theca anteriorly. The disc material is seen to lie in the right neural foramen with indentation upon the right C6 nerve root (scans 105.13, 106.5) and the spinal cord. A left postero-lateral disc bulge with peridiscal osteophytes is noted at the C5-C6 level with slight left neural foraminal narrowing.

Small posterior disc bulges with peridiscal osteophytes are noted at the C4-C5, C6-C7 and C7-D1 levels.

The joints of Luschka at the C5-C6 and C6-C7 levels show mild degenerative changes.




Slight facetal hypertrophy is noted at the C3-C4 and C4-C5 levels on the left.

The upper cervical vertebral bodies show spotty fatty marrow changes. The remaining 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. A right paracentral disc herniation at the C5-C6 level with disc material seen in the right neural foramen indenting the spinal cord and the right C7 nerve root.

2. Small posterior disc bulges with peridiscal osteophytes
at the C4-C5, C6-C7 and C7-D1 levels.

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzokbandhu Slmn / M / 26 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyz
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

H/O fall 1 1/2 years ago with ? spinal surgery done. Details not available.
C/O neck pain radiating to the LUE with paresthesias, weak grip and slight wasting of the LUE.

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 loss of water content of the cervical intervertebral discs.

Suspicious surgical intervention is noted at the C5-C6 and C6-C7 disc levels.

Small posterior disc bulges with peridiscal osteophytes are noted at the C3-C4, C4-C5 and C6-C7 levels.

Small posterior disc herniations with peridiscal osteophytes is noted at the C5-C6 level with slight left neural foraminal narrowing.

Slight facetal hypertrophy is noted at the C5-C6 and C6-C7 levels on the left.
Scan-00000

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 :

1. ? Post-operative changes at the C5-C6 and C6-C7 disc levels.

2. Small posterior disc bulges with peridiscal osteophytes at the C3-C4, C4-C5 and C6-C7 levels.

3. Small posterior disc herniations with peridiscal osteophytes at the C5-C6 level.

4. Slight facetal hypertrophy at the C5-C6 and C6-C7 levels on the left.

Date : 00.00.00

Name of the Patient : Abc Xyzni Sukhatalmn / F / 2 yrs.
Referred by : Dr. Abc Xyzathak.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O fever since 15 days with semiconsciousness since 2 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.

4 mm thick FLAIR coronal images.

OBSERVATION :

There is evidence of a shunt tube coursing through the right parietal lobe with the tube tip lying within the body of the right lateral ventricle.

There is moderate dilatation of the third, fourth and both the lateral ventricles and of the aqueduct. Signal void within the fourth ventricle, aqueduct and the posterior third ventricle may reflect turbulent flow. Few periventricular hypointensities on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images may represent CSF ooze.

There is effacement of the cerebral cortical sulci which may represent increased intracranial tension.

There is hypoplasia of the inferior cerebellar vermis.

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 a moderate communicating hydrocephalus in a known C/O tuberculous meningitis.

As compared to the previous MRI (study no:00004) dated 00.00.00, there is a slight increase in the degress of the dilatation of the ventricular system.

Date : 00.00.00

Name of the Patient : Abc Xylmn / F / 37 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right side hemiparesis with aphasia on 00.00.00.
Past H/O brain stem demyelinating disorder in November 0000.

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 are hyperintense areas on the proton, T2 Weighted and FLAIR images in the midbrain on the right side (scan 102/9), left cerebral peduncle, left subthalamus and both parathird ventricular regions. Another similar area is noted in the medulla on the right side (scan 102.4). These are hypointense to white matter on the T1 Weighted images. There is slight fullness of the fourth ventricle with mild prominence of the cerebellar folia bilaterally.

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.

Incidental note is made of bilateral maxillary sinusitis and inflammatory changes in the right mastoid air cells.



Hyperintense signal is identified on all the pulse sequences in the right transverse sinus extending into the right jugular vein replacing the normal flow void signal within the sinus. This is suggestive of thrombosis/slow flow (probably the sequelae of right mastoiditis). The other sinuses show normal flow void signal.

IMPRESSION :

1. Altered signal in the midbrain and medulla on the right side, left cerebral peduncle and parathird ventricular region bilaterally is not specific for a single diagnosis.

In view of the past H/O demyelinating disorder, these most likely represent demyelinating plaques.

However similar MRI appearances may be seen with ischemia/infarction.

2. Right transverse sinus thrombosis.

No previous investigations were available for comparison.

hs/sb/nl.rg.
Date : 00.00.00

Name of the Patient : Abc XyzRlmn / M / 62 yrs.
Referred by : Dr. Abc Xyzle.
Examination : M.R.I. of the Internal Auditory Meatus.

CLINICAL PROFILE :

C/O tinnitus with decreased hearing on the right side since 1 year.

EXAMINATION :

M.R.I of the internal auditory meatus was performed using the following parameters :

3 mm thick T1 Weighted coronal images.

MR cisternogram was obtained in the axial and coronal planes.

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

OBSERVATION :

There are small bright foci on the T2 Weighted images within the right lentiform nucleus and periatrial white matter and fronto-parietal white matter bilaterally and these are most likely ischemic in etiology.

There is mild prominence of the cerebral cortical sulci bilaterally. The ventricular system is unremarkable.

Prominent perivascular spaces are seen within the lentiform nuclei bilaterally.








The seventh and eighth cranial nerve complex on either side is unremarkable. Cochlea, semicircular canals and vestibule are also unremarkable. No obvious increased fluid is noted in the region of the inner ear structures.

IMPRESSION :

The MRI features are suggestive of :

1. Small foci of altered signal intensity in the right lentiform nuclei and periatrial white matter and fronto-parietal white matter bilaterally are most likely ischemic in etiology.

2. No abnormality is detected in the region of the internal auditory meatus on this study. If clinically indicated a contrast enhanced study may be worthwhile.

hs/ke/nl/rg
Date : 00.00.00

Name of the Patient : Abc Xyz Padelmn / M / 49 yrs.
Referred by : Dr. Abc Xyzle.
Examination : M.R.I. of the Internal Auditory Meatus.

CLINICAL PROFILE :

C/O tinnitus with decreased hearing on the right side since 1 year.

EXAMINATION :

M.R.I of the internal auditory meatus was performed using the following parameters :

3 mm thick T1 Weighted coronal images.

MR cisternogram was obtained in the axial and coronal planes.

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

OBSERVATION :

There is no focal area of altered signal intensity within the brain parenchyma on the T2 Weighted images. The ventricular system is unremarkable. There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

The seventh and eighth cranial nerve complex on either side are unremarkable. Cochlea, semicircular canals and vestibule are also unremarkable. No obvious increased fluid is noted in the region of the inner ear structures.

IMPRESSION :

No significant abnormality is detected in the region of the internal auditory meatus on this study.

If clinically indicated a contrast enhanced study may be worthwhile.

hs/ke/nl/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE.

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 mild retroplacement of the L5 vertebra over the S1 vertebra.

There is evidence of a large left paracentral disc herniation indenting the traversing S1 nerve roots (left more than right) at the L5-S1 level. A disc portion is seen to lie within the left lateral recess of the L5 vertebra.

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

The L5-S1 intervertebral disc shows loss of water content. Type II degenerative changes are seen within the S1 vertebral body adjacent to the L5-S1 intervertebral disc.

A Schmorls node with adjacent Type II degenerative changes is seen at the superior aspect of the D12 vertebral body.

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 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
15.0 mm at L2-L3
16.0 mm at L3-L4
15.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of a large left paracentral disc herniation indenting the traversing S1 nerve roots (left more than right) at the L5-S1 level. A disc portion is seen to lie within the left lateral recess of the L5 vertebra.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzSlmn / M / 70 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE and paresthesias.

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 :

The lumbar intervertebral discs show loss of water content.

There is slight retrolisthesis of the L1 over the L2 and L2 over L3 vertebral bodies.

A posterior and a right postero-lateral disc herniation is seen at the L5-S1 level with mild right neural foraminal narrowing. There is slight indentation of the foraminal and the extraforaminal portion of the right L5 nerve root and posterior displacement of the right S1 nerve root. The facet joint on the right side shows degenerative changes.

A postero-central disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac.

A small, posterior disc herniation is noted at the L3-L4 level. A small disc portion is seen to migrate inferiorly in the left lateral recess of the L4 vertebral body with impingement of the traversing left L4 nerve root (scans 104.11, 102.4, 106.7).
..2/.







Diffuse posterior disc herniations with bilateral far lateral disc bulges are seen at the L1-L2 and L2-L3 levels with anterior indentation of the thecal sac and bilateral neural foraminal narrowing.

Anterior and posterior peridiscal osteophytes are seen at the L1-L2, L2-L3 and L3-L4 levels.

Schmorls nodes are noted in the inferior aspect of the D12, L1 and L2 vertebral bodies in the superior aspect of the L1 vertebral body.

The L3-L4 and L4-L5 facet joints also show degenerative changes.

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 D12-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 :

15.0 mm at L1-L2
15.0 mm at L2-L3
12.0 mm at L3-L4
10.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. Slight retrolisthesis of the L1 over the L2 and L2 over the L3 vertebral bodies.

2. A small, posterior disc herniation at the L3-L4 level with a small disc portion migrating inferiorly to the left lateral recess of the L4 vertebral body impinging the traversing left L4 nerve root.
..3/.




- 3 - Scan-00004


3. A posterior and a right postero-lateral disc herniation at the L5-S1 level with slight indentation of the foraminal and the extraforaminal portion of the right L5 nerve root and right S1 nerve root.

4. A postero-central disc herniation at the L4-L5 level.

5. Diffuse posterior disc herniations with bilateral far lateral disc bulges at the L1-L2 and L2-L3 levels

6. Facetal arthropathy at the L3-L4 and L4-L5 levels bilaterally and on the right side at the L5-S1 level.

Date : 00.00.00

Name of the Patient : Abc XyzDlmn / M / 79 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with heaviness, one episode of seizures and vertigo.

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.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and 4 mm thick T1 coronal images with magnetization transfer.

4 and 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a large well-defined mass lesion in the left cerebellar hemisphere which measures approximately 3.0 x 4.0 x 2.5 cms. This lesion has a predominant cystic portion which is slightly hyperintense to the CSF on all the pulse sequences. An intermediate signal intensity lesion is seen along the floor and the anterior portion of the lesion on the T1 Weighted images which is slightly hypointense on the proton, T2 Weighted and FLAIR image. A fluid level is also seen within this lesion. There is compression upon the left postero-lateral aspect of the fourth ventricle and the aqueduct with slight shift of the midline structures to the right. There is slight effacement of the perimesencephalic cistern on the left side. On administration of contrast, there is faint enhancement of the lesion at the periphery which is slightly irregular in the anterior and posterior aspect. There is no other area of abnormal enhancement within the brain parenchyma.
..2/.








Small lacunar infarcts (isointense to CSF on all the pulse sequences) are noted in the left temporal region, bilateral thalami and corona radiata.

Small bright foci are noted on the proton, T2 Weighted and FLAIR images in the fronto-parietal region. These are isointense to white matter on the T1 Weighted images and are probably ischemic in etiology.

There is fullness of both the lateral ventricles. The third ventricle is normal. No obvious vascular anomaly is identified on this study.

After contrast administration there is no area of abnormal enhancement in the brain parenchyma or along the meninges.

IMPRESSION :

The MRI features are suggestive of :

1. A mass lesion in the left cerebellar hemisphere measuring approximately 3.0 x 4.0 x 2.5 cms. The differential diagnosis would include :

a. A cystic glioma.

b. Hemangioblastoma.

2. Altered signal in the fronto-parietal region is probably ischemic in etiology.