sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzvi Sulmn / F / 50 yrs.
Referred by : Dr. Abc Xyzpadia.
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 loss of water content of the lumbar intervertebral discs.

A small posterior disc bulge with peridiscal osteophytes is noted at the L4-L5 level.

Small posterior disc bulges are noted at the L2-L3 and L5-S1 levels.

There is slight facetal hypertrophy at the L3-L4, L4-L5 and L5-S1 levels.

A hemangioma with fat content (hyperintense on all the pulse sequences) is noted within the L2 vertebral body. Focal fatty marrow changes is noted adjacent to the lower lumbar intervertebral discs.







The rest of the lumbar vertebral bodies reveal normal signal intensity. The remaining 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.

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
20.0 mm at L3-L4
15.0 mm at L4-L5
14.0 mm at L5-S1.

IMPRESSION :

1. A small posterior disc bulge with peridiscal osteophytes at the L4-L5 level.

2. Slight facetal hypertrophy at the L3-L4, L4-L5 and L5-S1 levels.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 49 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias since 5 years.
Alleged H/O fall.

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 lumbar intervertebral discs.

Small posterior disc bulges are noted at the L2-L3, L3-L4, L4-L5 and L5-S1 levels. Slight right neural foraminal narrowing is noted at the L2-L3 and L4-L5 levels.

Slight facetal hypertrophy is noted at the L4-L5 and L5-S1 levels.

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-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 :

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

IMPRESSION :

1. Small posterior disc bulges at the L2-L3, L3-L4, L4-L5 and L5-S1 levels.

2. Slight facetal hypertrophy at the L4-L5 and L5-S1 levels.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzath Mhlmn / M / 29 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 2 years and weakness of the RUE since childhood.

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 :

The left cerebral hemisphere shows loss of volume when compared to the right. There is resultant prominence of the cerebral cortical sulci of the left cerebral hemisphere, mild dilatation of the left lateral ventricle and slight hyperpneumatization of the left frontal sinus and the orbital plate of the left frontal bone.

The left hippocampal complex appears smaller in volume when compared to the right with hyperintense signal on the T2 Weighted images suggesting left hippocampal sclerosis.

There is a small, well-marginated CSF signal intensity extra-axial lesion on all the pulse sequences in the left cerebello-pontine angle cistern. This lesion most likely represents an arachnoid cyst.







The right lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is mild bulge of the midline to the left. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. Left sided cerebral hemiatrophy.

2. Reduction in the left hippocampal volume with altered signal suggests left hippocampal sclerosis.

3. A small, CSF signal intensity extra-axial lesion in the
left cerebello-pontine angle cistern most likely represents an arachnoid cyst.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzDlmn / F / 24 yrs.
Referred by : Dr. Abc Xyzhalani.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O Cushings disease.
For follow-up.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.

3 mm thick T1 Weighted sagittal images.

After administration of contrast 3 mm thick T1 Weighted coronal and sagittal images (with magnetization transfer) were obtained.

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images. After contrast administration 5 mm thick T1 Weighted axial images (with magnetization transfer) of the brain were obtained.

OBSERVATION :

The left half of the anterior pituitary gland is reduced in height as compared to the right, and nearly appears as an empty sella. The right half of the anterior pituitary gland measures approximately 5.0 mms in height. The posterior pituitary gland shows normal hyperintense signal on the T1 Weighted images. No focal mass lesion is identified in the pituitary gland. The pituitary stalk is slightly pulled to the right. The suprasellar cistern and the cavernous sinuses on either side are unremarkable. The hypothalamus is also unremarkable.





After administration of contrast the anterior pituitary gland shows uniform enhancement without a focal mass lesion.

The T2 Weighted axial images of the brain show prominent perivascular spaces. The ventricular system is unremarkable. There is no midline shift. No abnormal enhancement is noted in the brain parenchyma or along the meninges.

IMPRESSION :

As compared to the previous MRI (scan no.0000) dated 00.00.00,
there is no significant change noted.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Gorlmn / F / 28 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Right Ankle.

CLINICAL PROFILE :

C/O pain in the right ankle since 2-3 months.

EXAMINATION :

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

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

4 mm thick T1 Weighted and STIR coronal images.

4 mm thick T1 Weighted and GRASS sagittal images.

Vitamin E Capsules were placed as markers at the site of pain in the lateral malleolar region.

OBSERVATION :

The visualized bones show normal configuration and signal intensity. No obvious bone destruction or erosion is evident.

The visualized tendons and ligament show normal signal intensity. No joint effusion is evident. The visualized soft tissues are unremarkable.

IMPRESSION :

No abnormality is detected within the Right Ankle Joint on this study.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz B. Rajplmn / M / 46 yrs.
Referred by : Dr. Abc XyzVasani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O pain on the right side of the face and head with difficulty in chewing since 5-6 months.
Alleged H/O head injury 7-8 years ago.

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 coronal images.
MR Cisternogram was obtained in the coronal plane.
Limited MRA sequence was obtained through the region of interest.

OBSERVATION :

There is a CSF signal intensity lesion on all the pulse sequences in the right periatrial region. A hypointense focus is noted within this lesion on the proton and T2 Weighted images. This lesion most likely represents a prominent perivascular space.

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.

There is no evidence of a vascular loop indenting the root entry zone of the trigeminal nerves or the root exit zone of the seventh cranial nerve on either side.

Inflammatory changes are noted in the left maxillary sinus, right frontal sinus and the anterior ethmoidal air cells.

IMPRESSION :

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

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Vishnupurlmn / M / 25 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of brain.

CLINICAL PROFILE :

H/O sudden onset of right sided hemiparesis on 00.00.00 (has recovered).
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.

5 mm thick FLAIR and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is a well-marginated, hypointense lesion on the T1 Weighted images in the lentiform nucleus, extending into the left corona radiata. This lesion is near isointense to CSF on all the pulse sequences and represents an area of cystic encephalomalacia, the sequelae of previous vascular insult. Similar signal intensity changes are noted in the left temporo-parietal cortex and left insular cortex. Perilesional white matter hyperintense signal on the T2 Weighted and FLAIR images may represent gliosis.

Mild fullness of the left lateral ventricle is noted as compared to the right. 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.

Inflammatory changes are noted in the ethmoidal air cells and maxillary sinuses bilaterally.


IMPRESSION :

Altered signal in the left lentiform nucleus, left corona radiata, left temporo-parietal cortex and in the left insular cortex represents cystic encephalomalacia, the sequelae of previous vascular insult.

As compared to the previous MRI (scan no. 00005/57) dated 00.00.00, the previously identified ischemic lesions have evolved to areas of cystic encephalomalacia.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzahmed Uslmn / M / 72 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O road accident at 5.30 am on 00.00.00, with loss of consciousness and bleeding from the left ear.
Right temporo-parietal craniotomy with evacuation of subdural hematoma was done on 00.00.00.
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.

5 mm thick FLAIR and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a right temporo-parietal craniotomy with post-operative changes in the subgaleal soft tissues in that region. There is a sliver of hyperintense signal on all the pulse sequences in the subdural space in the right temporo-parietal region which may represent hemoglobin breakdown products, the sequelae of previous subdural hematoma. A sliver is also seen in the left occipital region.

There is a subdural collection in the right frontal region with a maximum width of about 1.5 cms. This lesion is hyperintense to CSF on all the pulse sequences. Resultant mild indentation on the underlying brain parenchyma is noted. A similar, much smaller lesion is noted in the subdural space in the left frontal region.




Hyperintense areas on the proton, T2 Weighted and FLAIR images are seen to involve the cortical grey matter in the right temporal lobe. This lesion also appears hyperintense on the T1 Weighted images. A smaller, similar area is also noted in the left temporal lobe. These would represent cortical haemorrhagic contusions.

Areas of hyperintensity on the proton, T2 Weighted and FLAIR images are seen within the periventricular white matter bilaterally and these are most likely ischemic in etiology. Foci with similar signal characteristics are noted in the white matter in the frontal lobes bilaterally.

There is mild dilatation of both the lateral and the third ventricles. Also seen is prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The fourth ventricle is normal. There is no shift of the midline structures. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

Suspicious skull vault fracture is noted in the left fronto-parietal region.

Inflammatory changes are noted in the mastoid air cells bilaterally.

IMPRESSION :

1. Post-operative status.

2. A sliver of haemoglobin breakdown products in the subdural space in the right temporo-parietal region and a smaller one in the left occipital region.
..3/.













3. A subdural collection in the right frontal region and a smaller one in the left frontal region.

4. Haemorrhagic cortical contusions involving the cortical grey matter in the temporal lobes, right more than left.

As compared to the previous MRI dated 00.00.00 (scan no.00009), the previously detected right fronto-temporo-parietal hematoma
has significantly decreased in size. A right frontal subdural collection is however noted on the present study. The ventricles have also increased in size on the present study.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzal Vakhlmn / M / 72 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided hemiparesis.
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 T2 Weighted and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is evidence of a space occupying lesion measuring approximately 4.0 x 3.0 x 3.5 cms and having its epicentre in the right lentiform nucleus and extending into the right corona radiata and right temporal lobe. This lesion is hypointense on the T1 Weighted images and turns more hypointense on the proton, T2 Weighted and Fast Scan (T2 *) images and would represent an acute bleed. Perilesional edema which is also seen to extend into the right cerebral peduncle is noted with compression upon the right lateral ventricle with a slight shift to the left side.

There is dessection into the right lateral ventricle.

A focus of hypointensity is seen only on the Fast Scan (T2 *) images and noted in the lentiform nucleus and this may represent calcium/paramagnetic substances/hemosiderin (? the result of previous bleed).

Lacunar infarcts (iso to hyperintense to CSF) are noted within the head of the caudate nuclei and lentiform nuclei bilaterally and left cerebellar hemisphere.


Areas of hyperintensity on the proton and T2 Weighted images are seen within the periventricular white matter, pons and white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are most likely ischemic in etiology.

There is fullness of the left lateral ventricle. Also seen is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

A polyp is seen within the right maxillary sinus.

IMPRESSION :

The MRI features are suggestive of an acute bleed measuring approximately 4.0 x 3.0 x 3.5 cms and having its epicentre in the right lentiform nucleus and extending into the right corona radiata and right temporal lobe with dessection into the right lateral ventricle.

hs/sb/nl/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

C/O giddiness with vomiting and loss of consciousness on 00.00.00 followed with left sided hemiparesis.
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 is evidence of a space occupying lesion measuring approximately 3.2 x 3.0 x 2.9 cms and having its epicentre in the right thalamus and extending into the right corona radiata. This lesion is hypointense on the T1 Weighted images and turns more hypointense on the proton, T2 Weighted and Fast Scan (T2 *) images and would represent an acute bleed. There is perilesional edema with compression upon right lateral and third ventricles with a shift to the left side.

Fluid fluid levels are noted within the occipital horns and would represent intraventricular extension of this bleed. Blood is also noted in the aqueduct and fourth ventricle. There is fullness of both the lateral ventricles with periventricular hyperintensities on the proton, T2 Weighted and FLAIR images (would represent CSF ooze).





Areas of hyperintensity on the proton and T2 Weighted images are seen within the white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are most likely ischemic in etiology.

The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of an acute bleed measuring approximately 3.2 x 3.0 x 2.9 cms and having its epicentre in the right thalamus and extending into the right corona radiata and dissecting into the ventricular system as described.