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Sunday, 27 December 2015 16:48

12838

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzwar P. Trilmn / M / 62 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to BUE (left more than right) with tingling and weakness of BUE and 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.

OBSERVATION :

There is a large posterior disc herniation with peridiscal osteophytes at the C3-C4 level with compression of the spinal cord. Ligamentum flavum hypertrophy is noted at this level with resultant canal stenosis. The spinal cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images which is isointense to normal cord on the T1 Weighted images suggestive of cord edema/ischemia.

Small posterior disc bulge with peridiscal osteophyte is seen at the C5-C6 level. The joints of Luschka at this level also shows degenerative changes with bilateral neural foraminal narrowing. Mild ligamentum flavum hypertrophy is noted.

A small posterior disc herniation is noted at the C6-C7 level. The cervical intervertebral discs show loss of water content.
Scan-00008


The cervical vertebral bodies show normal signal intensity. The remaining joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The facet joints at the C4-C5 and C5-C6 levels show hypertrophic degenerative changes.

The C1 is occipitalized.

The cervico-medullary junction is unremarkable.

IMPRESSION :

1. A large posterior disc herniation with peridiscal osteophytes at the C3-C4 level with ligamentum flavum hypertrophy and resultant canal stenosis. Altered cord signal at this level suggests cord edema/ischemia.

2. Small posterior disc bulge with peridiscal osteophyte at the C5-C6 level with degenerative changes of the joints of Luschka and bilateral neural foraminal narrowing.

3. A small posterior disc herniation at the C6-C7 level.

4. Hypertrophic degenerative changes of the facet joints at the C4-C5 and C5-C6 levels.

5. Occipitalized C1.

Sunday, 27 December 2015 16:48

12837

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzshore Pabrlmn / M / 36 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O neckpain and neck stiffness with inability to move the neck to the right and bend forwards since 3-4 months.
C/O radicular pain with paresthesias in the RUE.
H/O lifting heavy weights.

EXAMINATION :

M.R.I of the cervico-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.

OBSERVATION :

There is a right postero-lateral disc herniation at the C5-C6 level with antero-lateral indentation of the cord and right neural foraminal narrowing. There is indentation upon the right C6 nerve root.

Small right paracentral disc herniation is noted at the C3-C4 level.

Small postero-central disc protrusions are seen at the C4-C5 and C6-C7 levels. The cervical and visualized upper dorsal intervertebral discs show loss of water content.

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






The visualized cervico-dorsal spinal cord reveals normal signal intensity.

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

IMPRESSION :

1. A right postero-lateral disc herniation at the C5-C6 level with indentation upon the right C6 nerve root.

2. Small postero-central disc protrusions at the C4-C5 and C6-C7 levels.

3. Small, right paracentral disc herniation at the C3-C4 level.

Sunday, 27 December 2015 16:48

12835

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Glmn / F / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 0000. On anti-epileptics.

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 bright focus on the proton and T2 Weighted images in the right thalamus, anteriorly. This lesion appears isointense to normal grey matter on the T1 Weighted images.

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

Inflammatory changes are noted in the maxillary antra bilaterally.

Incidentally noted is atlanto-dens subluxation with the atlanto-dens interval measuring 5.0 mms.

IMPRESSION :

1. Small bright focus on the proton and T2 Weighted images in the right thalamus, anteriorly is of ? etiology, (? ischemic focus).
2. Atlanto-dens subluxation with the atlanto-dens interval measuring 5.0 mms.



Sunday, 27 December 2015 16:48

12834

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzBlmn / F / 31 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

H/O fall in 0000 with pain in the right knee joint, locking on climbing down stairs, click and knee giving way since then.
H/O fall 1 week back, since then pain has increased.

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 STIR coronal images.

5 mm thick Fast Scan (T2 *) axial images.

OBSERVATION :

Menisci

There is a linear hyperintense signal on all the pulse sequences in the posterior horn of the medial meniscus not reaching upto the articular surface and this would represent Grade II meniscal signal.

The anterior and posterior horns of the lateral menisci and the anterior horn of the medial meniscus reveal normal configuration and signal characteristics.

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.

Minimal effusion is noted in the right knee joint.

IMPRESSION :

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

2. Minimal effusion in the right knee joint.


Sunday, 27 December 2015 16:48

12833

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzPlmn / M / 67 yrs.
Referred by : Dr. Abc Xyzikhalikar.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O sudden onset of loss of vision bilaterally since 4 days.
H/O fever since 6 days.

EXAMINATION :

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

3 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

There is a mass lesion in the region of the pituitary fossa which measures approximately 3.1 x 2.8 x 2.1 cms. This lesion shows mixed signal intensity with a predominant hyperintense signal on the T1 Weighted images which turns relatively hypointense on the T2 Weighted images with few hyperintense areas. There is extension of the lesion superiorly with indentation upon the optic nerves and the optic chiasma. Laterally there is indentation on the cavernous sinuses. The cavernous portion of the internal carotid arteries bilaterally show normal flow void signal on all the pulse sequences. Inferiorly the floor of the sella is ballooned with a suspicious break of the sellar floor anteriorly. The pituitary gland and the pituitary stalk cannot be identified separately from the lesion.





There is mild fullness of both the lateral ventricles. The 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 bilateral maxillary and ethmoidal sinusitis.

IMPRESSION :

The MRI features are suggestive of a mass lesion in the region of the pituitary fossa measuring approximately 3.1 x 2.8 x 2.1 cms. with extensions as described. The differential diagnosis would include :

1. Pituitary macroadenoma with haemorrhage.

2. Craniopharyngioma.

Sunday, 27 December 2015 16:48

12832

ke/sb/nl/nl
/66 Date : 22/00.00.00

Name of the Patient : Abc Xyzam Dlmn / M / 65 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O pain in the right eye with minimal ptosis and decreased sensation on the right side since 00.00.00.
Known hypertensive/diabetic.

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 T2 Weighted coronal images.

5 mm thick FLAIR coronal images.

4 mm thick Fast Scan (T2 *) axial images.

OBSERVATION :

There is a hypointense area on the T1 Weighted images in the right middle cerebellar peduncle. There is slight inferior extension to the ponto-medullary junction on the right side posteriorly. This is seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images. There is no perilesional edema.

Ill-defined, hyperintense areas are seen on the proton, T2 Weighted and FLAIR images in the periventricular deep white matter and bilateral centrum semiovale. These are iso to hypointense to normal white matter on the T1 Weighted images.

There is mild to moderate dilatation of both the lateral and third ventricles with fullness of the fourth ventricle. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
BR>


The basal cisternal spaces are unremarkable. There is no shift of the midline structures. The vertebro-basilar system is ectatic.

IMPRESSION :

1. A lesion in the right middle cerebellar peduncle with slight inferior extension to the ponto-medullary junction on the right side posteriorly, most likely represents an ischemic lesion.

2. Altered signal in the periventricular deep white matter and bilateral centrum semiovale are suggestive of areas of ischemia/infarction.

Sunday, 27 December 2015 16:48

12831

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzHathlmn / F / 55 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness with fall 3-4 episodes since 1 month.
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 T1 Weighted and FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a hypointense area in the left thalamus on the T1 Weighted images which is seen to turn hyperintense on the proton and T2 Weighted images and would represent an area of infarct. Similar, smaller areas are noted in the right thalamus, the left corona radiata posteriorly and in the left cerebellar hemisphere.

Lacunar infarcts which are slightly hyperintense to CSF on all the pulse sequences are seen in the right cerebellar hemisphere, right external capsule and the left lentiform nucleus.

There is agenesis of the corpus callosum.

The lateral ventricles, appear slightly full especially the atrium and occipital horns (colpocephaly) and appear parallel to each other. An interhemispheric cyst is noted. The third ventricle is placed between the lateral ventricles. There is beaking of the tectal plate. There is slight prominence of the cerebral cortical sulci.
Scan-00001


The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. The vertebro-basilar system is ectatic.

IMPRESSION :

1. Infarcts in the left thalamus, in the right thalamus, the left corona radiata posteriorly and in the left cerebellar hemisphere.

2. Lacunar infarcts in the right external capsule, the left lentiform nucleus and in the right cerebellar hemisphere, inferiorly.

3. Agenesis of the corpus callosum with an interhemispheric cyst.


Sunday, 27 December 2015 16:48

12830

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 28 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (left more than right) with paresthesias since January 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 scoliosis of the lumbar spine with convexity to the left.

There is a left paracentral disc herniation at the L5-S1 level with indentation upon the left S1 nerve root. There is inferior migration of the disc portion posterior to the S1 vertebral body.

A small posterior disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac. The L4-L5 and L5-S1 intervertebral discs show loss of water content.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints and 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-S2 level.
Scan-00000



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

19.0 mm at L1-L2
18.0 mm at L2-L3
18.0 mm at L3-L4
13.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. Scoliosis of the lumbar spine with convexity to the left.

2. A left paracentral disc herniation at the L5-S1 level with indentation upon the left S1 nerve root. There is inferior migration of the disc portion posterior to the S1 vertebral body.

3. A small posterior disc herniation at the L4-L5 level.

As compared to the previous MRI dated 00.00.00, there is increase in the degree of the L5-S1 disc herniation.
Sunday, 27 December 2015 16:48

12829

Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 72 yrs.
Referred by : Dr. Abc Xyztchha.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 15-20 days.

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 a postero-central disc herniation at the L3-L4 level with anterior compression of the thecal sac and canal stenosis. There is inferior migration of the extruded disc portion which is seen to impinge the right L4 nerve root. The portion of the disc is also seen to migrate superiorly.

Schmorls nodes are seen in the dorso-lumbar region. The L4-L5 and L5-S1 discs are reduced in their height and the lumbar intervertebral discs show loss of water content. Hyperintense areas in the L5-S1 disc on the T1 Weighted images would represent calcification/paramagnetic substances.

The lumbar vertebrae show diffuse fatty change suggestive of osteoporosis.

The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
Scan-00009


The conus medullaris terminates at the D12 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
8.0 mm at L3-L4
12.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

A postero-central disc herniation at the L3-L4 level with canal stenosis and inferior migration of the extruded disc portion impinging the right L4 nerve root.


Sunday, 27 December 2015 16:48

12828

ke/sb/nl/nl

Date : 00.00.00

Name of the Patient : Abc Xyz Chalmn / F / 50 yrs.
Referred by : Dr. Abc XyzR> Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache since 2 years.
H/O swelling over the back since birth.

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.

OBSERVATION :

There appears to be fusion of the D12, L1 and L2 vertebral bodies with obliteration of the intervening disc spaces and an angular kyphus at that level.

The spinal cord appears to be stretched over these levels and the conus medullaris terminates at the L2 level.

The spinal cord at the D11-D12 and at the L1 level shows a subtle hyperintense signal on the T2 Weighted images which is isointense to normal cord on the T1 Weighted images and is suggestive of cord edema/ischemia.










The visualized lower dorsal vertebral bodies show diffuse fatty marrow changes. The intervertebral discs reveal loss of water content. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

IMPRESSION :

The MRI features are suggestive of fusion of the D12, L1 and L2 vertebral bodies with obliteration of the intervening disc spaces and an angular kyphus at that level and stretching of the cord at these levels. These changes may be due to past healed infection. Cord signal alteration at the D11-D12 and L1 levels may suggest cord edema/ischemia.