sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzPlmn / M / 45 yrs.
Referred by : Dr. Abc Xyz. Tandel.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

Alleged H/O road traffic accident on 00.00.00 with left hemiparesis, slurred speech and memory impairment since December 0000.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick Fast Scan (T2 *) coronal images.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

There is a hypointense signal on the T2 Weighted images, but more pronounced on the Fast Scan (T2 *) images in the right thalamus, extending into the right corona radiata. This lesion represents residual hemosiderin, the sequelae of previous bleed. Perilesional hyperintense signal may represent gliotic changes.

There is mild dilatation of the ventricular system. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is no shift of the midline structures.

Incidentally noted is right maxillary sinusitis.







Atlanto-dens subluxation is also noted.

INTRACRANIAL MRA :

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized 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 :

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

IMPRESSION :

1. Residual hemosiderin in the right thalamus extending into the right corona radiata.

2. Mild communicating hydrocephalus.

3. Atlanto-dens subluxation.

4. No significant abnormality is detected on the intracranial and neck MRA on this study.

sb/ke/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to BLE with numbness since 1 month.

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.

The cervical and dorsal spines were screened with 4 mm thick T1 Weighted sagittal images.

OBSERVATION :

All the vertebrae of the spinal axis except the D7 vertebral body show a hypointense signal as compared to the normal marrow on the T1 Weighted images which appears slightly hyperintense on the T2 Weighted images. Slight central wedging of some of these vertebral bodies is noted with a bulge of the posterior margins of some vertebrae.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images involving the spinous process of the L3 vertebra. This lesion appears hyperintense on the T2 Weighted images. Slight bulge of the L3 vertebral body is also noted.

There is slight loss of water content of the L3-L4 intervertebral disc.
Scan-00006

The D7 vertebral body shows evidence of a hyperintense signal on the T1 Weighted images with multiple linear striations which may suggest a hemangioma. Similar smaller lesions are noted in the D12, L4 and L5 vertebral bodies.

Slight hypertrophy of the facet joints in the lower lumbar region is noted.

Hyperintense signal is seen in the epidural space circumferentially at the L5 and L5-S1 levels on the T1 Weighted images and follows fat signal intensity characteristics on all the pulse sequences. This represent epidural lipomatosis.

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 S1 level.

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

18.0 mm at L1-L2
19.0 mm at L2-L3
16.0 mm at L3-L4
13.0 mm at L4-L5
13.0 mm at L5-S1.
..3/.















- 3 - Scan-00006


IMPRESSION :

Altered signal in the spinal axis as described is not specific for a single etiology.

A myeloproliferative disorder or metastasis may be considered as differential diagnosis.

The possibility of these changes representing conversion of yellow marrow to red marrow seems less likely, in view of the hyperintense signal on the T2 Weighted images.

Soft tissue lesion is noted around the spinous process of L3.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzRlmn / F / 46 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness of the LUE since 00.00.00.

EXAMINATION :

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

INTRACRANIAL MRA :

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized 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 :

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

IMPRESSION :

No significant abnormality is detected on the intracranial and neck MRA on this study.

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzdali H. Telmn / M / 74 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : Neck M.R.A.

CLINICAL PROFILE :

H/O altered sensorium (on and off) and gait ataxia since 2 years.
H/O loss of bladder control since 2-3 months.
Known diabetic.

EXAMINATION :

The neck MRA was performed with 2D TOF sequence.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

NECK MRA :

The common carotid arteries and their bifurcations and the vertebral arteries on either side show normal signal. The visualized external and internal carotid arteries are also unremarkable.

There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

No significant abnormality is detected on the neck MRA on this study.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Sinlmn / F / 49 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness (on & off) since 3 months with gait ataxia on the right side 8 days back for a day.

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.

An MR Cisternogram was obtained in the coronal plane.

OBSERVATION :

There is seen a fairly large, approximately 5.0 x 6.6 x 4.8 cms sized well-defined, extra-axial mass lesion in the left fronto-parietal parafalcine region. This lesion is of intermediate signal on the T1 Weighted images and is relatively hypointense on the T2 Weighted images. Few cystic areas are noted within this lesion. There is perilesional edema in the underlying brain parenchyma with sulcal space effacement, midline shift to the right and inferior displacement and slight effacement of the lateral ventricles bilaterally. A CSF cleft is noted around this lesion. Multiple linear signal-void lesions around the above described mass lesion represents blood vessels.

This lesion has its broad base towards the dural surface. The superior sagittal sinus in its midsegment is most probably compressed by the lesion. There is however no evidence of definite invasion of the superior sagittal sinus by the mass lesion.


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

IMPRESSION :

An approximately 5.0 x 6.6 x 4.8 cms sized well-defined, extra-axial mass lesion in the left fronto-parietal parafalcine region with signal characteristics and extensions as described most likely represents a meningioma.

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Nalmn / M / 53 yrs.
Referred by : Dr. Abc Xyzlal.
Examination : M.R.I. of Both Thighs.

CLINICAL PROFILE :

H/O fibrous histiocytoma in 0000 of right thigh. Operated thrice since.
Patient developed right lower lobe metastasis for which received 6 cycles of Chemotherapy. Right lower and middle bilobectomy was done on 00.00.00. Histopathology s/o moderately differentiated adenocarcinoma.
Now C/O pain and swelling over the back of the right thigh since 6 months.

EXAMINATION :

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

7 mm thick T1 Weighted and T2 Weighted axial images.

7 mm thick T1 Weighted coronal images.

7 mm thick T1 Weighted and STIR sagittal images.

OBSERVATION :

The right thigh appears smaller in diameter as compared to the left. Slight atrophy of the right gluteal muscles is noted.

There is seen a well-marginated, lobulated approximately 4.5 x 4.0 x 10.0 cms sized intermediate signal intensity mass lesion on the T1 Weighted images in the posterior compartment of the middle third of the right thigh. This lesion appears hyperintense on the T2 Weighted and STIR images with a focal hypointense signal within the lesion, proximally. The lesion is seen to involve the biceps femoris muscle.
..2/.






The lesion is approximately 13.0 cms inferior to the right ischial tuberosity. The right profunda femoris vessels and the perforating vessels on the right at the site of the lesion are not well-visualized. The femoral vessels are however not encased by the lesion.

There is no bone erosion or destruction seen. The visualized marrow of the right femur shows normal signal intensity.

The visualized left thigh is unremarkable.

Scar of the previous surgery is noted along the postero-lateral margin of the right thigh.

IMPRESSION :

An approximately 4.5 x 4.0 x 10.0 cms sized, lobulated mass lesion in the posterior compartment of the middle third of the right thigh involving the biceps femoris muscles as described, most likely represents a recurrence of fibrous histiocytoma.

The patient is status post-operative.

No previous scans of the right thigh were available for comparison.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzRlmn / F / 46 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the LUE since the morning of 00.00.00.

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 T1 Weighted sagittal images.

OBSERVATION :

A prominent perivascular space is seen in the right posterior parietal deep white matter.

There is no other focal area of abnormal 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.

Incidental note is made of a small posterior disc herniation at the C2-C3 level and left maxillary sinusitis.

IMPRESSION :

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

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz. Kalmn / M / 8 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness, gait ataxia, headaches and diplopia since 6 days.
H/O similar complaints in June 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 STIR coronal images.

OBSERVATION :

There is evidence of an area which is near isointense to CSF on all the pulse sequences in the right periatrial white matter. This may represent a perivascular space or cystic changes (? demyelination ? ischemia).

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.

Inflammatory changes are seen in the maxillary sinuses and ethmoidal air cells. Note is made of enlarged adenoids.

IMPRESSION :

The MRI features are suggestive of an area which is near isointense to CSF in the right periventricular white matter. This may represent a perivascular space or cystic changes (? demyelination ? ischemia).

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Jarilmn / F / 38 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 4 months.
H/O lumbar spine tuberculosis in 0000. Received AKT.

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 evidence of a postero-central disc protrusion indenting the thecal sac at the L5-S1 level.

A posterior disc bulge is noted at the L4-L5 level. Small peridiscal osteophytes are noted at the L4-L5 and L5-S1 levels.

The L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.

The L4-L5 and L5-S1 facet joints show mild degenerative changes.

The lumbar vertebral bodies show fatty changes. The remaining intervertebral discs reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.







Incidental note is made of a retroverted uterus.

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 :

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

IMPRESSION :

1. A postero-central disc protrusion at the L5-S1 level.

2. A posterior disc bulge at the L4-L5 level.

3. Mild facetal arthropathy at the L4-L5 and L5-S1 levels.

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzra Ralmn / M / 18 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of altered sensorium since 1 month.

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 prominence of the cerebral cortical sulci and cerebellar folia bilaterally. Also seen is mild fullness of the ventricular system.

The basal cisternal spaces are prominent. 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 prominence of the cerebral cortical sulci and cerebellar folia bilaterally.