ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzolmn / M / 13 yrs.
Referred by : Dr. Abc Xyznkad / Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O road traffic accident 2 days back with injury to the face.

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 a depressed fracture of the right frontal bone. The depressed fragment is seen to compress upon the right frontal underlying brain parenchyma.

Hypointense areas are seen in the right frontal grey matter and subcortical white matter with few hyperintense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images with few hypointense areas which are seen to bloom on the Fast Scan (T2 *) images and these would represent altered blood. There is slight mass effect with shift of the anterior falx to the left.

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






Incidental note is made of contusion/edema in the frontal subgaleal region.

IMPRESSION :

1. Depressed fracture of the right frontal bone with the depressed fragment compressing upon the right frontal underlying brain parenchyma.

2. Altered signal in the right frontal grey matter and subcortical white matter suggests haemorrhagic contusion.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzak Almn / M / 14 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O paraplegia since 1 month with bladder involvement.
H/O fever prior to this.
Known C/O congenital progressive kyphoscoliosis of dorsal spine.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

8 mm thick T1 Weighted, T2 Weighted and STIR axial images.

OBSERVATION :

There is kyphoscoliosis of the dorso-lumbar spine. Also seen is anti-clockwise rotational anomaly of the lower dorsal and clockwise rotational anomaly of the upper dorsal vertebrae.

There is presence of an extradural hyperintense lesion on the T1 Weighted images within the spinal canal in the visualized lumbar and dorsal region. This is seen to follow fat signal characteristics on all the pulse sequences and would represent a lipoma. The spinal cord is compressed and thinned out and displaced anteriorly and shows a hyperintense signal on the STIR images at few levels suggestive of edema/gliosis/ischemia.








The visualized dorso-lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

IMPRESSION :

The MRI features are suggestive of congenital kyphoscoliosis of the dorso-lumbar spine and presence of a lipoma within the spinal canal and which is extradural in the visualized lumbar and dorsal region.

sb/ke/nl/nl
/00006 Date : 27/00.00.00

Name of the Patient : Abc Xyz Nallmn / F / 41 yrs.
Referred by : Dr. Abc Xyz. Kapadia.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O numbness in BLE (right more than left) with difficulty in walking since 6 months.
Now C/O progressive weakness of BLE.

EXAMINATION :

M.R.I of the dorso-lumbar 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.

OBSERVATION :

There is reduction in height of the D10-D11, D11-D12 and D12-L1 intervertebral discs and loss of water content of the visualized dorso-lumbar intervertebral discs.

There is a postero-central disc herniation with posterior peridiscal osteophytes at the D10-D11 level, more to the right of the midline, with cord compression. The dorsal spinal cord at this level shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia.













Small, postero-central protruded discs with peridiscal osteophytes are also noted at the D9-D10, D11-D12 and D12-L1 levels. Slight facetal hypertrophy is noted at the D9-D10 and D10-D11 levels.

The D11 and D12 vertebral bodies are slightly wedged anteriorly, without change in signal intensity.

The visualized dorso-lumbar vertebral bodies 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.

Screening, T2 Weighted sagittal images of the upper dorsal spine do not reveal any significant feature of note.

A small postero-central protruded disc is also noted at the L4-L5 level.

After administration of contrast, there is no area of abnormal enhancement within the spinal canal or along the meninges.

IMPRESSION :

1. A postero-central disc herniation with posterior peridiscal osteophytes at the D10-D11 level, more to the right of the midline, with cord compression and cord signal alteration at this level suggesting cord edema/ischemia.

2. Small, postero-central protruded disc with peridiscal osteophytes at the D9-D10, D11-D12 and D12-L1 levels.

3. Slight facetal hypertrophy at the D9-D10 and D10-D11 levels.

sb/ke/nl/nl
/00006 Date : 27/00.00.00

Name of the Patient : Abc Xyz Nallmn / F / 41 yrs.
Referred by : Dr. Abc Xyz. Kapadia.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O numbness in BLE (right more than left) with difficulty in walking since 6 months.
Now C/O progressive weakness of BLE.

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.

3 mm thick T2 Weighted coronal images.

After administration of contrast, the following parameters were used :

4 mm thick T1 Weighted sagittal and axial images.

4 mm thick T1 Weighted coronal images.

OBSERVATION :

There is loss of water content of the cervical intervertebral discs.

There is seen a well marginated approximately 1.4 x 1.0 x 3.0 cms sized intradural-extramedullary mass lesion in the cervical spinal canal, extending over the C5 and C6 vertebral levels, anterior to the spinal cord and to the




right of the midline. This lesion is relatively hypointense when compared to the normal cord on the T1 Weighted images and appears hyperintense on the T2 Weighted and Fast Scan (T2 *) images with focal hypointense signal within. There is resultant cord compression and cord displacement posteriorly and to the left at these levels. It is difficult to assess the cord signal at the C5 and C6 vertebral levels.

After administration of contrast, there is fairly homogeneous enhancement of the lesion at the C5 and C6 vertebral levels with enhancement of the nerve roots on the right side at the C4-C5 level.

Posterior disc bulges with posterior peridiscal osteophytes are noted at the C4-C5, C5-C6 and C6-C7 levels.

Degenerative changes of the joints of Luschka are noted at the C5-C6 level on the right and C6-C7 level on the left. Slight facetal hypertrophy is noted at the C4-C5 and C5-C6 levels.

The cervical vertebral bodies show normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

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

IMPRESSION :

An approximately 1.4 x 1.0 x 3.0 cms sized intradural- extramedullary mass lesion in the cervical spinal canal, extending over the C5 and C6 vertebral levels, anterior to the spinal cord and to the right of the midline with enhancement as described. This most probably represents a nerve sheath tumor.

Degenerative changes are noted in the cervical spine at the C4-C5, C5-C6 and C6-C7 levels as described.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzhan Anlmn / F / 39 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (left more than right) with paresthesias since 3 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 :

A small posterior disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac and mild bilateral neural foraminal narrowing. The L4-L5 facet joints show hypertrophic degenerative changes with resultant canal stenosis.

Small right paracentral disc herniations are seen at the L2-L3 and L3-L4 levels and a posterior disc bulge at the L5-S1 level. The lumbar intervertebral discs show loss of water content.

The lumbar facet joints show degenerative changes.

Far lateral (extraforaminal) disc bulges are seen bilaterally at the L4-L5 level and on the right side at the L2-L3, L3-L4 and L5-S1 levels.

The lumbar vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.



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 :

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

IMPRESSION :

1. A small posterior disc herniation at the L4-L5 level with hypertrophic degenerative changes of the L4-L5 facet joints with resultant canal stenosis.

2. Small right paracentral disc herniations at the L2-L3 and L3-L4 levels and a posterior disc bulge at the L5-S1 level.

3. Degenerative changes of the lumbar facet joints.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Chlmn / F / 10 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with gradual progressive paraparesis since 6-7 months.
H/O fall while playing 1 year back.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and 4 mm thick T2 Weighted sagittal images.

4 mm thick T1 Weighted and 7 mm thick T2 Weighted axial images.

OBSERVATION :

The visualized dorso-lumbo-sacral vertebral bodies appear relatively hypointense to normal fatty marrow on the T1 Weighted images but appear isointense on the T2 Weighted images. This suggest predominance of red marrow.

The intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The visualized lower dorsal spinal cord upto the D8 vertebral level shows normal signal. There is no cord compression.







The conus medullaris terminates at the 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 :

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

Incidentally noted is mild bilateral hydronephrosis with hydroureter and a distended urinary bladder.

IMPRESSION :

1. No significant abnormality is detected in the lumbo-sacral spine or the visualized lower dorsal spinal cord upto the D8 vertebral level.

2. Mild bilateral hydronephrosis with hydroureter and a distended urinary bladder which requires further evaluation.

3. Preponderance of hematopoeitic marrow.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzk Barmlmn / M / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O gait ataxia with involuntary movements of body since 4-5 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 are prominent perivascular spaces in the bilateral lentiform nuclei.

There is mild fullness of both the lateral ventricles. The third and fourth ventricles are normal.

There is prominence of the cerebral cortical sulci and 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.

IMPRESSION :

The MRI features are suggestive of mild cerebral and cerebellar atrophy.

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzRlmn / F / 30 yrs.
Referred by : Dr. Abc Xyzrekh
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE.

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 forward subluxation of the L5 vertebra over the S1 vertebra. Also seen is mild retroplacement of the L4 vertebra over the L5 vertebra.

A large postero-central disc herniation is seen at the L5-S1 level with anterior indentation of the thecal sac. There is superior migration of the disc which is seen to lie posterior to the L5 vertebral body. This disc shows loss of water content.

A small postero-central disc herniation is noted at the L4-L5 level.

There is a suspicious break of the pars interarticularis of the L5 vertebra. Please correlate with plain radiographs.

There appears to be a small Tarlovs perineurial cyst within the spinal canal at the S1/S2 level.
Scan-00006


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 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
17.0 mm at L2-L3
16.0 mm at L3-L4
15.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. Forward subluxation of the L5 vertebra over the S1 vertebra.

2. Probable spondylolysis of the L5 vertebra. Please correlate with plain radiographs.

3. A large postero-central disc herniation at the L5-S1 level with superior migration of the disc and lying posterior to the L5 vertebral body.

4. A small postero-central disc herniation at the L4-L5 level.

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzdali H. Telmn / M / 74 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : Intracranial 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 brain was screened with 5 mm thick T2 Weighted axial images.

Intracranial was performed with 3D TOF sequence.

OBSERVATION :

Diffuse areas of hyperintensity on the T2 Weighted images are seen within the periventricular white matter, corona radiata and centrum semiovale bilaterally and these are most likely ischemic in etiology.

Lacunar infarcts (iso to hyperintense to CSF) are seen within the thalamus and lentiform nuclei bilaterally.

There is mild to moderate dilatation of the third and both the lateral ventricles. There is mild prominence of the cerebral cortical sulci bilaterally.

The fourth ventricle is normal. There is no shift of the midline structures.








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.

IMPRESSION :

The MRA features are suggestive of :

1. Areas of altered signal within the periventricular white matter, corona radiata and centrum semiovale bilaterally are most likely ischemic in etiology.

2. Lacunar infarcts within the thalamus and lentiform nuclei bilaterally.

3. Mild to moderate dilatation of the third and both the lateral ventricles which is disproportionate to the degree of the cerebral cortical atrophy. Normal pressure hydrocephalus should be excluded.

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

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzBhlmn / F / 50 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

C/O pain with mild swelling over the right knee joint since 2 months.

EXAMINATION :

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

4 mm thick T1 Weighted, proton and GRASS sagittal images.

4 mm thick T1 Weighted and T2 Weighted coronal images.

4 mm thick GRASS axial images.

OBSERVATION :

Menisci

There is a hyperintense signal in the posterior horn of the medial meniscus reaching upto the inferior articular surface and represents Grade III meniscal signal (meniscal tear).

Linear hyperintense signal is seen in the anterior horn of the medial meniscus and the anterior and posterior horns of the lateral meniscus not reaching upto the articular surface and would represent Grade II meniscal signal (meniscal degeneration).









Cruciate Ligaments :

The anterior and posterior cruciate ligaments show normal contour and signal characteristics.

Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.

Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

The articular cartilage overlying the patella, tibia and femur appears normal.

Effusion is seen in the suprapatellar bursa and in the right knee joint.

IMPRESSION :

1. Grade III meniscal signal (meniscal tear) in the posterior horn of the medial meniscus of the right knee joint.

2. Grade II meniscal signal (meniscal degeneration) in the anterior horn of the medial meniscus and the anterior and posterior horns of the lateral meniscus of the right knee joint.

3. Effusion in the suprapatellar bursa and in the right knee joint.