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Sunday, 27 December 2015 16:48

13109

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzi Tlmn / F / 73 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O generalized weakness with gait ataxia and bladder/bowel involvement since 2 months.

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.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Inflammatory changes are noted in the sphenoid sinus.

INTRACRANIAL MRA :

There is hypoplasia of the A1 segment of the left anterior cerebral artery.








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

NECK MRA :

Tortuousity of the neck vessels is noted.

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

Screening, T2 Weighted sagittal images of the cervical spine reveal small, postero-central disc herniations with peridiscal osteophytes at the C4-C5 and C5-C6 levels. Slight ligamentum flavum hypertrophy is also noted at these levels.

IMPRESSION :

1. Mild age related cerebral cortical and cerebellar atrophy.

2. No significant abnormality is detected on the intracranial and neck MRA except for tortuousity of the neck vessels on this study.

3. Degenerative changes in the cervical spine as described.


Sunday, 27 December 2015 16:48

13108

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Slmn / M / 17 yrs.
Referred by : Dr. Abc Xyzstak.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right focal seizures on 3rd and 4th January 0000. Detected to have a left high parietal granuloma. On anti-epileptics since then.

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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is no area of focal 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. No obvious vascular anomaly is identified on this study.

IMPRESSION :

No significant abnormality is detected within the brain on this study.

As compared to the previous MRI dated 00.00.00, the lesion is not identified on this scan.

If clinically indicated a contrast enhanced scan may be worthwhile.

Sunday, 27 December 2015 16:48

13106

Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 18 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

Alleged H/O fall from a bus 1 1/2 months back with backache and difficulty in walking.
C/O weakness of BLE since 00.00.00.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is seen a well marginated, approximately 1.5 x 1.3 x 2.3 cms sized hypointense mass lesion on the T1 Weighted images in the spinal canal at the D7 and D8 vertebral levels. This lesion appears heterogeneously hyperintense on the T2 Weighted images with focal hypointense signal within. This lesion is most likely extradural in location and is to the right of the dorsal spinal cord at these levels. There is resultant cord compression with displacement of the dorsal cord to the left of the midline. The dorsal spinal cord at the D7 and D8 vertebral levels shows a hyperintense signal on the T2 Weighted images suggestive of cord edema/ischemia.








The visualized dorsal vertebral bodies and 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.

Similar signal intensity lesions are also noted in the posterior paraspinal soft tissues at the D10 vertebral level and in the soft tissues in the right axilla/right postero-lateral chest wall (se/im 108/1, 104/6, 104/7).

IMPRESSION :

An approximately 1.5 x 1.3 x 2.3 cms sized intraspinal (most likely extradural) mass lesion to the right of the dorsal spinal cord at the D7 and D8 vertebral levels with cord compression, as
described, is not specific for a single diagnosis. This lesion most likely represents a nerve sheath tumor.

Suspicious, similar lesions are noted in the posterior paraspinal soft tissues at the D10 vertebral level and in the soft tissues in the right axilla/right postero-lateral chest wall.

Sunday, 27 December 2015 16:48

13105

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzi Tlmn / F / 73 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O generalized weakness with gait ataxia and bladder/bowel involvement since 2 months.

EXAMINATION :

M.R.I of the dorsal 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 loss of water content of the dorsal intervertebral discs. The dorsal vertebral bodies show spotty fatty marrow changes suggesting osteoporosis. Anterior peridiscal osteophytes are noted in the dorsal region.

The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The visualized dorsal spinal cord reveals normal signal intensity. There is no cord compression.

The conus medullaris terminates at the L1-L2 level.

Screening, T1 Weighted sagittal images of the lumbar spine show evidence of spotty fatty marrow changes with degenerated discs at the L3-L4 and L4-L5 levels and slight facetal hypertrophy at these levels.
Scan-00005


IMPRESSION :

Osteoporotic changes in the visualized vertebrae of the spinal axis with degenerative changes in the lumbar spine as described.

No other significant abnormality is detected on this study.


Sunday, 27 December 2015 16:48

13104

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzh Blmn / M / 51 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O RTA on 00.00.00.
C/O irrelevant talk since then.
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 are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the high parietal cortex bilaterally. These lesions appear isointense to normal brain parenchyma on the T1 Weighted images.

Small bright foci on the proton and T2 Weighted images are noted in the subcortical white matter in the left high parietal region and may be ischemic in etiology.

The CSF space in the fronto-temporal regions bilaterally appears slightly prominent.

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.

A subgaleal hematoma is noted in the right fronto-temporo- parietal region and in the periorbital region.


An air-fluid level is noted in the right maxillary antrum and in the sphenoid sinus which may represent blood, in the given clinical setting of trauma. Hyperintense signal on the T2 Weighted images in the left middle ear may represent blood/inflammatory changes.

IMPRESSION :

1. Altered signal in the high parietal cortex bilaterally most likely represents cortical contusions, in the given clinical setting.

2. Prominent CSF space in the fronto-temporal regions bilaterally may represent subdural effusion in the given clinical setting.

3. A subgaleal hematoma in the right fronto-temporo-parietal region and in the periorbital region.

4. Air-fluid level in the right maxillary antrum and in the sphenoid sinus which may represent blood, in the given clinical setting of trauma.



Sunday, 27 December 2015 16:48

13103

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzMohd. Ludhlmn / F / 19 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the RUE with weakness since 2 months.
H/O fever.

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.

The C5, C6 and C7 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. Involvement of the left sided pedicles, left laminae, and transverse process of the C5 and C6 vertebrae is noted. The left C7 pedicle is also involved. The C5-C6 and C6-C7 intervertebral discs are also involved.

There is seen an intermediate signal intensity lesion on the T1 Weighted images in the left paravertebral region, left posterior paraspinal region and in the anterior epidural space over the C5 to C7 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Resultant slight lateral displacement of the left vertebral artery over these levels is noted. There is also mild cord compression over the C5 to C7 vertebral levels. The cord shows a slight increase in signal intensity.

- 2 - Scan-00003


The rest of the cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.

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

IMPRESSION :

Altered signal of the C5, C6 and C7 vertebrae and C5-C6 and C6-C7 intervertebral discs most likely represents osteitis with discitis probably tuberculous in etiology. Left paravertebral, left paraspinal and anterior epidural soft tissue lesion over the C5 to C7 vertebral levels may represent granulation tissue/abscess. There is mild cord compression with cord edema/ischemia/myelitis.

The possibility of this lesion representing a neoplasm like a round cell tumor seems less likely.
Sunday, 27 December 2015 16:48

13101

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzoq Shlmn / M / 5 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O MR with seizures since the age of 2 years. On anti-epileptics.
FTND (cried after 1 hour).

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 (a circumscribed mix signal intensity area is seen in the left occipital region - se/im:102/10, 103/10, 106/10 - may represent a vessel in a sulcus).

The hippocampal complex is unremarkable on either side.

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.

IMPRESSION :

No significant abnormality is detected within the brain on this study.


Sunday, 27 December 2015 16:48

13100

sb/hs/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE 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 loss of water content of the L4-L5 and L5-S1 intervertebral discs.

Small posterior disc bulges are noted at the L4-L5 and L5-S1 levels. Mild facetal hypertrophy is noted at the L4-L5 level.

Left far lateral (extraforaminal) disc bulges are also noted at these levels.

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 S2 level.

Probable conjoint right sided L5 and S1 nerve root sleeves are noted.
- 2 - Scan-00000


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

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

IMPRESSION :

1. Small posterior and left far lateral (extraforaminal) disc bulges at the L4-L5 and L5-S1 levels.

2. Probable right sided conjoint nerve root sleeves at the L5 and S1 levels.

3. Mild facetal hypertrophy at the L4-L5 level.

Sunday, 27 December 2015 16:48

13099

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xylmn / M / 82 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache.

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 lumbar intervertebral discs.

There is Grade I spondylolisthesis of the L5 vertebra over the S1 vertebra without obvious spondylolysis.

Posterior and bilateral far lateral (extraforaminal) disc bulges are noted at the L3-L4, L4-L5 and L5-S1 levels. Slight right neural foraminal narrowing is noted at the L5-S1 level and slight bilateral neural foraminal narrowing is noted at the L3-L4 and L4-L5 levels.

Facetal and slight ligamentum flavum hypertrophy is noted at the L5-S1 level, more so on the right side.

The lumbar vertebral bodies show spotty fatty marrow changes.

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 :

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

IMPRESSION :

1. Grade I spondylolisthesis of the L5 vertebra over the S1 vertebra without obvious spondylolysis.

2. Posterior and bilateral far lateral (extraforaminal) disc bulges at the L3-L4, L4-L5 and L5-S1 levels.

3. Facetal and slight ligamentum flavum hypertrophy at the L5-S1 level, more so on the right side.

Sunday, 27 December 2015 16:48

13098

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 20 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache since 2 months.
H/O fever since 8 days.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) sagittal images.

8 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is seen a well-marginated CSF intensity lesion on all the pulse sequences in the dorsal spinal cord, centrally, extending over the D5 to D10 vertebral levels. This lesion most likely represents a syrinx.

The visualized dorsal vertebral bodies and 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.

IMPRESSION :

A small CSF intensity lesion on all the pulse sequences in the dorsal spinal cord, centrally, extending over the D5 to D10 vertebral levels most likely represents a syrinx.