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Sunday, 27 December 2015 16:48

12967

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyze Godlmn / M / 11 yrs.
Referred by : Dr. Abc Xyzndya / Dr. Abc Xyzatt.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 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.

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 is unremarkable on either side.

There is mild fullness of both the lateral (left greater than right), third and fourth ventricles.

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 right maxillary antrum and enlarged adenoids.

IMPRESSION :

Mild fullness of both the lateral, third and fourth ventricles.

No other significant abnormality is detected on this study.

Sunday, 27 December 2015 16:48

12966

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 29 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.
(Post-contrast Study).

CLINICAL PROFILE :

C/O weakness with dragging of BLE since 3 years.
H/O fever prior to this.

EXAMINATION :

After administration of contrast the following parameters were used :

5 mm thick T2 Weighted axial images.

5 mm thick T1 Weighted sagittal images with fat saturation.

OBSERVATION :

The dorsal spinal cord over the D9 to D11 vertebral levels still appears expansile. There is an ill-defined, hyperintense signal in the dorsal spinal cord extending over the D8 to D12 vertebral levels.

After administration of contrast there is faint patchy enhancement especially at its periphery over the D9 to D11 vertebral levels.

A suspicious nodular lesion is seen in the left lung field (scan 105.1, 105.2) which is seen to enhance after contrast administration and requires further evaluation.

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.

- 2 - scan-00006


There is no cord compression.

The conus medullaris terminates at the L1 level.

IMPRESSION :

After administration of contrast peripheral enhancement of the dorsal spinal cord over the D9 to D11 levels most likely represents demyelination.

The possibility of a neoplasm seems less likely. Lesion in the left lung requires further evaluation.





Sunday, 27 December 2015 16:48

12965

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Vanlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzikhalikar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O giddiness and loss of consciousness on 00.00.00 with giddiness, gait imbalance to left, diplopia and dysphagia since 00.00.00.
Known hypertensive, alcoholic and smoker.

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 T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

Small hyperintense areas are seen within the medulla posteriorly on the left side, posterior aspect of the pons, left middle cerebellar peduncle and the left cerebellar hemisphere on the proton and T2 Weighted images. These are hypointense to white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction (scans 103.3, 103.4, 103.5, 102.3, 102.4, 102.5, 107.8, 107.9, 107.10).

The visualized vertebral and basilar arteries show normal flow void signal.

Both the lateral, third and the fourth ventricles are normal. There is prominence of the cerebellar folia 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 a prominent cisterna magna.
..2/.




- 2 - scan-00005


IMPRESSION :

1. Altered signal within the medulla posteriorly on the left side, posterior aspect of the pons, left middle cerebellar peduncle and the left cerebellar hemisphere are suggestive of areas of ischemia/infarction.

2. Mild cerebellar atrophy.
Sunday, 27 December 2015 16:48

12964

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzullah Shlmn / M / 38 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O head injury 6 years back.
C/O weakness of BUE and BLE, slurred speech and gait imbalance since 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.

5 mm thick FLAIR coronal images.

OBSERVATION :

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

There is mild dilatation of both the lateral ventricles with slight fullness of the third and fourth ventricles. Turbulence is seen in the aqueduct and third ventricle.

There is slight prominence of the cerebral cortical sulci.

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 mild dilatation of both the lateral ventricles with prominence of the cerebral cortical sulci.

A neurodegenerative disorder should be ruled out.

Sunday, 27 December 2015 16:48

12963

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzondlmn / F / 32 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O acute onset of quadriparesis since 3-4 days.
H/O retention of urine 8 days back.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

8 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is a hyperintense area within the centre of the spinal cord extending over the cervico-medullary junction to the conus on the T2 Weighted images. This is iso to hypointense to cord on the T1 Weighted images. The CSF space is unremarkable.

There is no cord compression.

The visualized cervico-dorsal vertebral bodies and the intervertebral discs show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.









IMPRESSION :

Altered signal within the centre of the spinal cord extending over the cervico-medullary junction to the conus is not specific for a single diagnosis.

The differential diagnosis would include :

1. Myelitis (most likely).

2. Demyelination (less likely).

3. Ischemia/infarction (unlikely).

Sunday, 27 December 2015 16:48

12962

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Jalmn / M / 63 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 00.00.00.
H/O fever since 1 month.
H/O fall in November 0000.

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 replacement of the normal marrow of the L2, L3, L4 and L5 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The pedicles of the L4 and L5 vertebrae are involved by the pathology. The L4-L5 intervertebral disc appears hyperintense suggestive of its involvement. There is slight pre and paravertebral soft tissue extension over the L4 to the L5 levels. The psoas muscles bilaterally show multiple hypointense areas on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted images. Anterior epidural extension is also noted extending over the D12 to the L2 levels. There is also encroachment into the neural foramen on the left side at the L4 level with encasement of the foraminal L4 nerve roots.

The CSF in the lumbar canal appears slightly hyperintense to normal on the T1 Weighted images.



Small posterior disc herniations are noted at the L2-L3, L4-L5 and L5-S1 levels.

The rest of the lower dorsal and lumbar intervertebral discs show loss of water content.

The rest of the lumbar vertebral bodies reveal normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.

Note is made of a renal cyst in the left kidney.

The cervico-dorsal spine was screened with 4 mm thick T1 Weighted sagittal images and which shows degenerative changes more marked at the C5-C6 and C6-C7 levels with a tight canal at the C5-C6 level.

IMPRESSION :

The MRI features are suggestive of altered signal in the L2, L3, L4 and L5 vertebrae and the L4-L5 disc with extensions as described. This most probably is infective in etiology (like tuberculosis).

The possibility of a neoplastic process like a small cell tumor is less likely.

Sunday, 27 December 2015 16:48

12961

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzr lmn / M / 7 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O mental retardation with seizures.

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 a small subcentimeter hyperintense area in the head of the caudate nucleus posteriorly on the left side on the proton and T2 Weighted images. This is hypointense to the gray matter on the T1 Weighted images (scans 105.10, 105.11, 104.10, 104.11, 102.11, 106.10).

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 inflammatory changes in the maxillary, sphenoid sinuses and ethmoidal air cells.

IMPRESSION :

Altered signal intensity area in the in the head of the caudate nucleus posteriorly on the left side is not specific for a single etiology. This may be ischemic in etiology. A contrast enhanced scan would be worthwhile.
Sunday, 27 December 2015 16:48

12960

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyznt Salmn / M / 30 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

To r/o pituitary v/s infrasellar v/s hypothalamus lesion.

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.

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

OBSERVATION :

The posterior pituitary reveals its normal hyperintense signal, slightly more to the right of the midline (scans 105.7-8).

The anterior pituitary gland appears normal in size and shows a hyperintense signal on the T1 Weighted images (as compared to normal white matter). This signal appears significantly hypointense (as compared to normal white matter) on the T2 Weighted images. No focal mass lesion is identified in the anterior pituitary gland.
..2/.





- 2 - Scan-00000


There is a hypointense signal on the T1 Weighted images in-between the anterior and posterior lobes of the pituitary gland (probably the intermediate lobe). This lesion appears hyperintense on the T2 Weighted images and may represent pars intermedia cyst.

The pituitary stalk is in the midline. The hypothalamus is unremarkable.

The left lateral ventricle is prominent as compared to the right, which may be a normal variant.

After contrast administration there is no abnormal area of enhancement within the sella and perisellar region.

There is no significant abnormality detected within the brain parenchyma per se on this study.

IMPRESSION :

1. Hyperintense signal of the anterior pituitary gland, on the T1 Weighted images as described, is not specific for a single etiology. Such signal change is noted in neonates and pregnant women due to lactotroph hypertrophy and increased protein synthesis in the pituitary gland. Such changes are also noted in patients undergoing parenteral hyperalimentation or in patients with hepatic dysfunction.

2. Cystic lesion between the anterior and posterior lobes of the pituitary gland may represent a pars intermedia cyst (a non-functional cyst).













ke.....
Date : 00.00.00

Name of the Patient : Abc Xyznt Salmn / M / 30 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

To r/o pituitary v/s infrasellar v/s hypothalamus lesion.

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.

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

5 mm thick T1 Weighted sagittal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images.

5 mm thick T1 Weighted coronal and sagittal images.

OBSERVATION :

The posterior pituitary does not reveal its normal hyperintense signal.

The anterior pituitary gland appears normal in size and shows hyperintense signal on the T1 Weighted images which is seen to follow fat signal intensity characteristics on the T2 Weighted images.



The pituitary stalk is in the midline. The hypothalamus is unremarkable.

The left lateral ventricle is prominent as compared to the right and which may be a normal variant.

After contrast administration there is no abnormal area of enhancement within the sella and perisellar region.

IMPRESSION :

Normal study of the Pituitary.






Sunday, 27 December 2015 16:48

12959

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzen Galmn / F / 76 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O memory impairment since 1 1/2 years with giddiness and gait imbalance since 1 year.

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 small bright foci on the proton and T2 Weighted images in the left periatrial white matter and left parietal deep white matter (scans 103.11, 105.12). These lesions appear isointense to normal white matter on the T1 Weighted images.

Prominent perivascular spaces are noted in the left lentiform nucleus.

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 slight prominence of the cerebral cortical sulci bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Incidentally noted is an empty sella.

IMPRESSION :

Small bright foci on the proton and T2 Weighted images in the left periatrial white matter and left parietal deep white matter most likely represent ischemic changes.

No other significant abnormality is detected on this study.
Sunday, 27 December 2015 16:48

12958

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Kotlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzhah / Dr. Abc Xyzthari.
Examination : M.R.I. of the Left Ankle & Foot.

CLINICAL PROFILE :

C/O pain, swelling and burning sensation over both ankle joints, left more than right since 1 year which has increased since 6 months.

EXAMINATION :

M.R.I. of the left ankle and foot was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted axial images.

4 mm thick T1 Weighted and STIR coronal images.

4 mm thick T1 Weighted and GRASS sagittal images.

OBSERVATION :

There is seen reduction in the posterior subtalar joint space, laterally. Marginal osteophytes are noted along the lateral and posterior margins of the posterior subtalar joint. Subchondral cysts are also noted in the talus, calcaneum and medial margin of the fibula. The talus and the calcaneum adjacent to the posterior subtalar joint appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The articular cartilage overlying these bones also seems eroded. There is synovial thickening and a small subtalar joint effusion.

Patchy, ill-defined, hyperintense signal on the T2 Weighted and STIR images is also noted in the calcaneum.

A calcaneal spur is noted.
>

The soft tissues around the subtalar and the ankle joints are unremarkable.

The visualized ankle mortice is also unremarkable.

IMPRESSION :

Changes along the posterior subtalar joint described above most likely suggests osteoarthritis. The possibility of an infective etiology seems less likely.