ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz. lmn / F / 38 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

H/O transphenoidal subtotal excision of haemorrhagic non-malignant pituitary macroadenoma done on 00.00.00.
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.

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

OBSERVATION :

The pituitary gland appears bulky and measures approximately 13.0 x 15.0 x 8.0 mms. A hyperintense signal is seen in the inferior aspect of the pituitary region. This is seen to turn hypointense on the T2 Weighted images and may represent a fat graft, the result of previous surgery. The superior portion of the lesion is hypointense on the T1 weighted images and turns heterogenously hyperintense on the T2 Weighted images. The optic chiasm is seen separate from this lesion. The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. The pituitary stalk is slightly deviated to the right side. The hypothalamus is unremarkable.



T2 Weighted axial images of the brain do not reveal any significant feature of note. Incidental note is made of a left maxillary polyp.
IMPRESSION :The MRI features are suggestive of :1. Post-operative status.2. There is no significant decrease in the size of the pituitary macroadenoma as compared to the previous MRI (study no:0000) dated 00.00.00.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzn Plmn / F / 48 yrs.
Referred by : Dr. Abc Xyz Apte.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O drooping of the left eyelid 24 days back.
4 days later H/O fall with weakness of right half of body and loss of consciousness for 10 days, from which patient has partially recovered.
C/O speech dysarthria and slight weakness still persists.
H/O headaches since 1-2 months.
To r/o posterior communicating artery aneurysm.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images, 5 mm thick FLAIR coronal images and 5 mm thick T1 Weighted sagittal images.

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

SOME MOTION ARTIFACTS ARE NOTED IN THE NECK MRA.

OBSERVATION :

There is evidence of subdural hematomas in the right posterior parietal region, left temporo-parieto-occipital region and in the posterior interhemispheric fissure. These lesions are hyperintense on all the pulse sequences. The maximum width of the subdural hematoma in the left temporal region is 5.0 mms and in the right posterior parietal region is about 3.0 mms. There is no significant mass effect identified.

There is no focal area of altered signal intensity within the brain parenchyma per se.
Scan-00002


Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. 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.

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 :

Subdural hematomas in the right posterior parietal region (maximum width 3.0 mms), left temporo-parieto-occipital region (maximum width 5.0 mms) and in the posterior interhemispheric fissure.

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

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 67 yrs.
Referred by : Dr. Abc Xyzothari.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

Alleged H/O fall 3 months ago with loss of consciousness.

EXAMINATION :

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

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

OBSERVATION :

Few prominent perivascular spaces are noted in the periventricular region.

There is mild fullness of both the lateral ventricles. There is mild prominence of the cerebral cortical sulci bilaterally.

The 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 right maxillary polyp and inflammatory changes in the ethmoidal air cells and frontal sinus.

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 per se on this study.

sb/bv/nl/nl
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.

CLINICAL PROFILE :

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

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

10 mm thick T1 Weighted and T2 Weighted axial images.

The lumbar and cervical spines were screened with 5 mm thick T1 Weighted sagittal images and 4 mm thick T2 Weighted sagittal images, respectively.

OBSERVATION :

The dorsal spinal cord over the D9 to D11 vertebral levels appears expansile. There is an ill-defined, hyperintense signal in the dorsal spinal cord extending over the D8 to D12 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. The lesion is located more so, centrally and posteriorly within the dorsal spinal cord. Slight effacement of the CSF space over the extent of the lesion is noted.

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.







There is no cord compression.

The conus medullaris terminates at the L1 level.

Screening images of the cervical and lumbar spines do not reveal any significant feature of note.

IMPRESSION :

Altered signal of the dorsal spinal cord over the D8 to D12 levels with slight expansion of the cord over the D9 to D11 levels is not specific for a single etiology. A demyelinating lesion or a granuloma is a likely possibility. The possibility of a neoplasm seems less likely.

A contrast enhanced scan would be worthwhile for evaluating the underlying pathology.

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzta Blmn / F / 47 yrs.
Referred by : Dr. Abc Xyzzare.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O speech disturbances on 00.00.00 from which patient has recovered partially.
C/O fever and headaches since 7 days.
H/O left sided hemiparesis in 0000.

EXAMINATION :

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

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

FEW IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

There is an ill-defined hyperintense area within the right frontal bone (se/im: 102/13, 14). A small extradural/meningeal lesion which measures approximately 2.0 x 0.6 cms is seen in the right frontal region and is hypointense on the T2 Weighted images. Surrounding subcortical white mater edema is noted with mild indentation on the frontal horn of the right lateral ventricle.

A suspicious lesion is seen in the left cerebellar hemisphere.

There is moderate dilatation of the right lateral ventricle and fullness of the left lateral and fourth ventricles. The third ventricle is normal. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

The basal cisternal spaces are unremarkable. There is no shift of the midline structures.


INTRACRANIAL MRA :

SOME IMAGES SHOW PATIENT MOTION.

The left vertebral artery is hypoplastic.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, right vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The left vertebral artery in the neck is also hypoplastic.

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

IMPRESSION :

Lesion in the right frontal bone with a small extradural/meningeal lesion measuring approximately 2.0 x 0.6 cms. is not specific for a single diagnosis. The possibilities to be considered are :

1. Metastasis.

2. Infective process.

A contrast enhanced scan would be worthwhile.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza G. Jalmn / F / 47 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. - Brain (Post-contrast Study).

CLINICAL PROFILE :

H/O insect bite at night with fall from bed 1 month back followed with abnormal behaviour, irrelevant talk and forgetfulness since then.

EXAMINATION :

The brain was screened with 5 mm thick T1 Weighted axial and sagittal images and 5 mm thick FLAIR coronal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is still seen subtle hyperintense signal on the FLAIR images along the gyri in the temporo-parietal and occipital parafalcine regions bilaterally and in the thalami and frontal regions bilaterally. These lesions appear relatively hypointense to normal grey matter on the T1 Weighted images.

After administration of contrast, there is no focal or diffuse area of abnormal enhancement in 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 previously identified altered signal intensity lesions are grossly unchanged on the present study. There is no focal or diffuse area of abnormal enhancement in the brain parenchyma or the meninges after contrast administration.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzDamlmn / F / 42 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O seizures on 00.00.00.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images.

Intracranial MRA was performed with 3D TOF sequence.

Intracranial MRV was performed using 2D TOF sequences in the axial, coronal and sagittal planes.

OBSERVATION :

There is an ill-defined predominant hypointense signal on the T1 Weighted images in the left temporo-parietal and high parietal regions. This lesion remains predominantly hypointense on the T2 Weighted images with focal hyperintense areas within. On the T1 Weighted images faint hyperintense signal is noted in some regions. There is perilesional white matter edema with sulcal space effacement and indentation on the atrium of the left lateral ventricle. The third ventricle is also effaced with shift of the midline structures to the right.

The fourth ventricle is normal. The basal cisternal spaces are unremarkable.






There is loss of normal flow void signal in the dural venous sinuses (superior sagittal, right transverse and sigmoid sinuses) with a hyperintense signal on the T1 Weighted images within these sinuses, which appears relatively hypointense on the T2 Weighted images.

INTRACRANIAL MRV :

On the MRV, there is loss of normal flow signal in the superior sagittal sinus, right transverse sinus and to some extent in the right sigmoid sinus. The normal flow signal is however noted in the straight sinus, torcula, left transverse and sigmoid sinuses and in the internal cerebral veins and vein of Galen.

INTRACRANIAL MRA :

The left middle cerebral artery and its Sylvian branches appear slightly stretched due to the mass effect of the left cerebral hemispheric lesion.

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

1. Lesion in the left temporo-parietal and high parietal regions, most likely represents an haemorrhagic infarct, probably venous, in view of the loss of normal flow signal in the dural sinuses as described.

2. Loss of normal flow signal in the dural venous sinuses as described suggests venous sinus thrombosis.

3. Except for stretched left MCA and its Sylvian branches, no significant abnormality is detected on the intracranial MRA on this study.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Mlmn / M / 20 yrs.
Referred by : Dr. Abc Xyzhru / Dr. Abc Xyzankhla.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O road traffic accident at 4.30 pm on 00.00.00 with injury to the head.

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.

SOME IMAGES SHOW MOTION ARTIFACTS.

OBSERVATION :

There is seen a very thin sliver of hyperintense signal on the proton and T2 Weighted images in the subdural space in the left fronto-temporal region. This lesion follows CSF signal on the T1 Weighted images and may represent a very small, subdural effusion.

There is a small hyperintense focus in the left parietal region (scans 106.8, 106.9) in the cortex best appreciated on the FLAIR images and represents a cortical contusion.

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.






Probable fractures are noted in the lateral wall of the left orbit and the left zygomatic arch.

Fluid level is noted in the sphenoid sinus and left maxillary antrum, which may represent haemorrhage in the given clinical setting.

Susceptibility artifacts are noted in the soft tissues in the left fronto-temporo-parietal region, the result of the accidental injury. Altered signal in the subgaleal soft tissues in the left posterior parietal region, left temporal region and in the left periorbital region represents soft tissue contusions/hematoma.

IMPRESSION :

1. A very small, subdural effusion along the left fronto-temporal convexity.

2. Cortical contusion in the parietal lobe.

3. Subgaleal soft tissue injury as described with probable haemorrhage in the left maxillary antrum and sphenoid sinus.

4. Probable fractures in the lateral wall of the left orbit and left zygomatic arch

A 3D CT would be useful.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 62 yrs.
Referred by : Dr. Abc Xyzraf.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

H/O sudden onset of weakness of the RLE with fall and injury to the back with low back pain and pain in the RLE with bladder involvement since then.
H/O tuberculous spine for which ALD was done on 00.00.00 at D8, D9, D10 and D11 levels. On AKT since then.

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.

Metallic susceptibility artifacts due to Harrington Rod placement are observed.

OBSERVATION :

There is evidence of internal fixation of the dorsal spine with metallic susceptibility artifacts at the D11 and D4 vertebral levels. There is evidence of antero-lateral decompression on the right side.

There is near complete collapse of the D8 vertebral body. The D7, D8 and D9 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The D7-D8 and D8-D9 intervertebral discs are not well identified. Minimal right paravertebral and anterior epidural soft tissue lesion is noted at the D8 and D9 vertebral levels. There is mild thecal sac compression at these levels.






The dorsal spinal cord over the D7 to D9 vertebral levels shows a subtle hyperintense signal on the T2 Weighted images which may suggest cord edema/ischemia/gliosis. Probable atrophy of the cord is noted at the D8-D9 level.

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

The conus medullaris terminates at the L2 level.

IMPRESSION :

1. Post-operative status with susceptibility artifacts due to metallic implant.

2. Near complete collapse of the D8 vertebral body with altered signal of the D7, D8 and D9 vertebrae may suggest residual tuberculous osteitis in the given clinical setting. Minimal right paravertebral and anterior epidural soft tissue extension is noted.

3. Altered cord signal over the D7 to D9 vertebral levels may suggest cord edema/ischemia/gliosis.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyztala Ralmn / F / 63 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 6 months which has increased since 2 1/2 months.
H/O right Ca breast (infiltrating duct carcinoma) for which patient was operated 1 year back. Received 25 sittings of radiotherapy.

EXAMINATION :

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

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

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is an ill-defined, hypointense signal on the T1 Weighted images involving the left iliac, pubic and ischial bones. This lesion appears hyperintense on the T2 Weighted and STIR images. Part of the left iliac bone in the region of the left sacro-iliac joint and the iliac crest seem to be spared. Minimal expansion of the affected bone segments is also noted, with probable minimal periosteal reaction. No significant soft tissue component of the lesion is noted.

Similar signal intensity changes are noted in the right iliac bone, posteriorly adjacent to the right sacro-iliac joint and in the sacral segments as described.



A suspicious lesion is also seen in the mid shaft of the left femur.

A small left hip joint effusion is noted. The femoral heads are otherwise unremarkable on either side. The right acetabulum is unremarkable.

There are no abnormally enlarged pelvic lymph nodes identified.

IMPRESSION :

In a known C/O Ca breast, altered signal in the left iliac, pubic and ischial bones, in the right iliac bone, posteriorly adjacent to the right sacro-iliac joint and in the sacral segments as described most likely represents metastasis.