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Sunday, 27 December 2015 16:48

13075

hs/ke/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 1 year.
H/O fall 1 year ago and injury to neck. Cervical laminectomy was done.

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 a postero-central disc herniation, more to the left of the midline and indenting both the traversing S1 nerve roots at the L5-S1 level.

Postero-central disc protrusion is seen to indent the thecal sac at the L4-L5 level. A posterior disc bulge at the L3-L4 level.

The L5-S1 facet joints show mild degenerative changes. The L5-S1 intervertebral disc shows loss of water content.

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.
..2/.







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
11.0 mm at L3-L4
11.0 mm at L4-L5
7.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A postero-central disc herniation, more to the left of the midline and indenting both the traversing S1 nerve roots at the L5-S1 level.

2. Postero-central disc protrusion at the L4-L5 level.

3. Mild facetal arthropathy at the L5-S1 level.

4. Canal stenosis at the L5-S1 level and tight canal at the L4-L5 level.


Sunday, 27 December 2015 16:48

13074

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Ralmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the RUE and RLE with paresthesias since 6 months.

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 :

The facet joints at the C4-C5 level show mild degenerative changes.

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.

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

IMPRESSION :

The MRI features are suggestive of mild facetal arthropathy at the C4-C5 level.
Sunday, 27 December 2015 16:48

13073

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzdin lmn / M / 60 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with 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 :

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

There is Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra.

A small posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level. The L4-L5 facet joints show hypertrophic degenerative changes. There is ligamentum flavum hypertrophy at this level.

A posterior disc bulge is noted at the L3-L4 level.

The L3-L4 and L4-L5 intervertebral discs show loss of water content.






An anterior disc herniation is seen at the D10-D11 level.

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 D12 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
15.0 mm at L2-L3
14.0 mm at L3-L4
11.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

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

2. A small posterior disc herniation, ligamentum flavum hypertrophy and hypertrophic facetal arthropathy with canal stenosis at the L4-L5 level.

3. Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra.

Sunday, 27 December 2015 16:48

13072

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Kathlmn / F / 45 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in BLE since 3 months.
H/O pulmonary kochs 1 year back. Received AKT.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

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

5 mm thick Proton Density sagittal images.

OBSERVATION :

There are hyperintense areas with a hypointense rim on all the pulse sequences within both the femoral heads and this would suggest Class C avascular necorsis. Also seen are hypointense areas on the T1 Weighted images which turn hyperintense on the T2 Weighted and STIR images adjacent to these lesions within both femoral heads and neck and would represent edema.

There is irregularity of both the femoral heads and also of the overlying articular cartilage.

Effusion is seen within both the hip joints.

Excessive pelvic fat is noted.

IMPRESSION :

The MRI features are suggestive of Class C avascular necrosis involving both the femoral heads.

Excessive pelvic fat may suggest pelvic lipomatosis.
Sunday, 27 December 2015 16:48

13071

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzh Diclmn / M / 18 yrs.
Referred by : Dr. Abc Xyzmat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures 1 week back.

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 T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images with magnetization transfer.

3 mm thick T1 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a small subcentimeter hypointense area in the right frontal region which is seen to remain so on the proton and T2 Weighted images. There is surrounding white matter edema with mass effect and effacement of the adjacent sulci (scans 102.13, 104.13, 103.13).

On administration of contrast, there are atleast two ring enhancing lesions in the right frontal region (scans 107.13, 106.7, 106.8, 108.18, 108.19).
- 2 - Scan-00001



There is no other area of abnormal enhancement within the brain parenchyma or the meninges.

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 :

The MRI features are suggestive of granulomatous infective lesions in the right frontal region following the signal characteristics of tuberculoma.


Sunday, 27 December 2015 16:48

13070

ke/hs/nl/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

C/O dystonia of the RUE and RLE.
CT was suggestive of calcification in the basal ganglia bilaterally (CT scan was not available).

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 are hyperintense areas in the caudate nuclei and lentiform nuclei bilaterally on the T1 Weighted images. These are mildly hypointense with peripheral hyperintense areas on the proton, T2 Weighted, FLAIR and Fast Scan (T2 *) images.

There is slight fullness of the ventricular system. There is prominence of the cerebral cortical sulci bilaterally.

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 :

Altered signal in the caudate nuclei and lentiform nuclei bilaterally is not specific for a single diagnosis. This may represent calcium (in view of the previous CT Scan).

Wilsons disease or mitochondrial disorders may be considered.





Sunday, 27 December 2015 16:48

13069

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / F / 9 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is no focal area of altered signal intensity in the brain parenchyma (Diffuse hyperintense areas seen in both parietal regions (scan 102.14) on the T2 Weighted images represent terminal areas of myelination).

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.

Incidental note is made of enlarged adenoids.

IMPRESSION :

Normal study of the brain.


Sunday, 27 December 2015 16:48

13068

ke/sb/nl/rg.
/00008 Date : 07/00.00.00

Name of the Patient : Abc Xyzta Yenclmn / F / 22 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

H/O backache with paresthesias in BLE (on and off) since 3 1/2 years.
C/O paraplegia with bladder/bowel involvement since 00.00.00.

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.

After administration of contrast the following parameters were used :

4 mm thick T1 Weighted axial images.

3 mm thick T1 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is focal swelling of the dorsal spinal cord at the D7 and D8 vertebral levels. Few hypointense areas are seen within the dorsal spinal cord at these levels on the T1 Weighted images which are seen to turn hyperintense on the T2 Weighted images. The CSF space is unremarkable. On administration of contrast, there is faint patchy enhancement within the spinal cord at the D7 and D8 levels. There is no other area of abnormal enhancement within the cervico-dorsal spinal cord or the meninges.


The visualized dorsal vertebral bodies show spotty fatty marrow changes. The 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 D12 level.

Screening T1 Weighted sagittal images of the lumbo-sacral spine reveal anterior wedging of the L1 and L2 vertebral bodies. A gravid uterus is noted.

IMPRESSION :

Altered signal in the dorsal spinal cord at the D7 and D8 vertebral levels with patchy enhancement after contrast administration is not specific for a single diagnosis.

A pial vascular malformation should be ruled out.

The possibility of demyelination or a neoplasm seems less likely.




Sunday, 27 December 2015 16:48

13067

ke/bv/rg.
Date : 00.00.00

Name of the Patient : Abc XyzDlmn / F / 78 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O gait ataxia, behavioral disturbances, memory impairment and bladder dysfunction.
Known hypertensive/diabetic.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted axial images.
5 mm thick T2 Weighted coronal images.
IMAGES SHOW PATIENT MOTION (PATIENT DOES NOT UNDERSTAND).

OBSERVATION :

Small punctate hypointense areas are seen in the right thalamus and in the right corona radiata on the T1 Weighted images which turn hyperintense on the T2 Weighted images and would represent lacunar infarcts.

Hyperintense areas are seen on the T2 Weighted images in the left thalamus and right corona radiata which appear isointense on the T1 Weighted images and represent ischemic changes.

There is fullness of both the lateral and the third ventricles. The fourth ventricle is normal. There is mild prominence of the cerebral cortical sulci. The basal cisternal spaces are prominent. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. Lacunar infarcts in the right thalamus and right corona radiata.

2. Ischemic changes in the left thalamus and right corona radiata.









Sunday, 27 December 2015 16:48

13066

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzr Ganlmn / M / 47 yrs.
Referred by : Dr. Abc Xyzarya / Dr. Abc Xyzvi /
Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O weakness of BLE apparently following a fall on 00.00.00.

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.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is a decrease in the height of the D11 vertebral body with presence of a fracture line and a break in the superior and inferior cortical endplates. There is retropulsion of this vertebral body with severe cord compression.

The D11 vertebral body shows areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images and would represent bone edema/bruise. Similar areas are also seen in the D9 and D12 vertebral bodies.

The spinal cord/conus medullaris over the D9 to L1 levels shows a hyperintense signal on the T2 Weighted images suggestive of cord edema/contusions. The cord/conus medullaris at the D12 and L1 levels is swollen (? pulpy).








There appears to be a fracture of the laminae of the D12 vertebra.

Hypointense areas on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen within the pre and paravertebral soft tissues over the D11 to L1 levels and may represent a hematoma.

The D8-D9 intervertebral disc shows loss of water content.

The rest of the visualized dorso-lumbar vertebral bodies and intervertebral discs are unremarkable.

IMPRESSION :

In a known C/O trauma, the MRI features are suggestive of a compression fracture of the D11 vertebra with retropulsion and cord compression and cord edema/contusions as described.