hs/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Pilmn / F / 58 yrs.
Referred by : Dr. Abc Xyzlkarni.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE since 4 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 :

The lumbar intervertebral discs show loss of water content and the L5-S1 intervertebral disc is decreased in height.

A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina (left more than right) at the L4-L5 level.

A smaller, posterior disc herniation is seen to narrow both the neural foramina at the L5-S1 level.

Small posterior peridiscal osteophytes are seen at the L4-L5 and L5-S1 levels.

Bilateral far lateral (extraforaminal) disc herniations are seen at the L4-L5 and L5-S1 levels.

Posteriorly bulging discs are noted at the D11-D12 and D12-L1 levels.

The lumbar facet joints over the L4-L5 and L5-S1 levels show mild degenerative changes.
..2/.





R>

The lumbar vertebral bodies show areas of fatty replacement of normal marrow and Type II degenerative changes.

Schmorls nodes are noted in the antero-superior aspect of the L3 and L4 vertebral bodies.

The visualized pre and paravertebral soft tissues are unremarkable.

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
16.0 mm at L2-L3
15.0 mm at L3-L4
11.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A posterior disc herniation at the L4-L5 level.

2. A smaller, posterior disc herniation at the L5-S1 level.

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

4. Bilateral far lateral (extraforaminal) disc herniations at the L4-L5 and L5-S1 levels.

hs/bv/rg
Date : 00.00.00

Name of the Patient : Abc Xyztar Llmn / M / 34 yrs.
Referred by : Dr. Abc XyzJain.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain and giddiness.

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 :

The cervical intervertebral discs show loss of water content.

A posterior disc herniation with large posterior peridiscal osteophytes is seen to indent the thecal sac at the C5-C6 level.

A postero-central disc herniation is seen to indent the thecal sac at the C4-C5 level.

A posterior disc bulge is noted at the C3-C4 level.

Small posterior peridiscal osteophytes are noted at the C3-C4 and C4-C5 levels.

The facet joints at the C4-C5 level show degenerative changes.

The cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
..2/.





R>
The cervical spinal cord reveals normal signal intensity.

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

IMPRESSION :

The MRI features are suggestive of :

1. A posterior disc herniation with large posterior peridiscal osteophytes at the C5-C6 level.

2. A postero-central disc herniation with facetal arthropathy at the C4-C5 level.

3. Small posterior peridiscal osteophytes at the C3-C4 and C4-C5 levels.

Hs/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzslmn / M / 53 yrs.
Referred by : Dr. Abc Xyzykar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE with paresthesias since 4 months.

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 :

The lumbar intervertebral discs show loss of water content.

There is a break of the pars interarticularis of the L5 vertebra bilaterally.

Posterior disc herniations with peridiscal osteophytes are seen to indent the thecal sac and narrow both neural foramina at the L4-L5 and L5-S1 levels.

A postero-central disc herniation with peridiscal osteophytes, more to the left of the midline is seen to indent the thecal sac at the L1-L2 level.

The L4-L5 and L5-S1 facet joints show mild degenerative changes. The left L3-L4 facet joint shows hypertrophic degenerative changes.

A right far lateral (extraforaminal) disc herniation is seen to indent the extraforaminal portion of the exiting right L5 nerve root at the L5-S1 level.


An anterior disc herniation is noted at the L5-S1 level. Type I degenerative changes (hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images) are seen within the L5 and S1 vertebral bodies adjacent to the L5-S1 intervertebral disc. Hypointense areas on all the pulse sequences suggestive of calcium/vacuum phenomena are seen within the L5-S1 intervertebral disc.

Fat is noted within the filum from the L2-L3 level downwards.

The rest of the 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 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 :

16.0 mm at L1-L2
17.0 mm at L2-L3
17.0 mm at L3-L4
15.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Spondylolysis of the L5 vertebra.

2. Posterior disc herniations with peridiscal osteophytes and mild facetal arthropathy at the L4-L5 and L5-S1 levels.
..3/.






- 3 - Scan-00007


3. A postero-central disc herniation with peridiscal osteophytes, more to the left of the midline at the L1-L2 level.

4. Hypertrophic facetal arthropathy on the left side at the L3-L4 level.

5. A right far lateral (extraforaminal) disc herniation
at the L5-S1 level.

ke/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzh Plmn / M / 40 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the LUE since 3 months.

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 :

The cervical intervertebral discs show loss of water content.

There is a fairly large left postero-lateral disc herniation with small peridiscal osteophytes at the C5-C6 level with antero-lateral indentation of the cord, left neural foraminal narrowing and indentation on the left C6 nerve root (scans 105.16, 104.15-16). The disc material is also seen to migrate superiorly and is noted posterior to the C5 vertebra.

Small posterior disc protrusions are seen at the C3-C4 and C4-C5 levels.

The facet joints at the C4-C5, C5-C6 and C6-C7 levels appear hypertrophied.

The cervical vertebral bodies appear more hypointense than normal and this may suggest a preponderance of haematopoeitic marrow. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
..2/.






The cervical spinal cord reveals normal signal intensity.

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

IMPRESSION :

The MRI features are suggestive of :

1. A fairly large left postero-lateral disc herniation at the C5-C6 level with indentation on the spinal cord and left C6 nerve root.

2. Small posterior disc protrusions at the C3-C4 and C4-C5 levels.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzA. Hlmn / F / 27 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache and pain in the left upper dorsal region since 5 months.
H/O fever since 2 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 partial sacralization of the L5 vertebral body on the left side and the L2 vertebral body is as marked on the film.

A small posterior disc bulge is seen at the L4-L5 level with anterior indentation of the thecal sac.

The L4-L5 facet joints show degenerative changes.

The lumbar vertebral bodies and the 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 D12-L1 level and the thecal sac terminates at the S1 level.
Scan-00005



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

13.0 mm at L1-L2
12.0 mm at L2-L3
12.0 mm at L3-L4
8.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Partial sacralization of the L5 vertebral body on the left side and the L2 vertebral body is as marked on the film.

2. A small posterior disc bulge at the L4-L5 level with facetal arthropathy.























sb/ke/nl/nl

Date : 00.00.00

Name of the Patient : Abc XyzA. Hlmn / F / 27 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Screening of the Cervico-dorsal spine.



Screening MRI of the cervico-dorsal spine was performed using 4 mm thick T1 Weighted sagittal images and 6 mm thick T1 Weighted coronal images. Altered signal of the D5, D6 and D7 vertebral bodies is noted with a prevertebral, left paravertebral and anterior epidural soft tissue lesions at these levels.

The above described features most likely suggest tuberculous osteitis with a prevertebral and left paravertebral abscess/granulation tissue and anterior epidural granulation tissue at the D6 vertebral level.

The possibility of a neoplasm seems less likely.

hs/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Tlmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias 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.

OBSERVATION :

The lumbar intervertebral discs show loss of water content.

There is evidence of a large postero-central disc extrusion compressing the thecal sac at the L4-L5 level with canal stenosis.

Small postero-central disc protrusions are seen at the L3-L4 and L5-S1 levels.

There is mild facetal hypertrophy at the L3-L4 and L4-L5 levels. Also seen is ligamentum flavum hypertrophy at the L4-L5 level.

The 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 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 :

16.0 mm at L1-L2
16.0 mm at L2-L3
16.0 mm at L3-L4
11.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A large postero-central disc extrusion with ligamentum flavum hypertrophy and canal stenosis at the L4-L5 level.

2. Small postero-central disc protrusions at the L3-L4 and L5-S1 levels.

3. Mild facetal hypertrophy at the L3-L4 and L4-L5 levels.

ke/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz V. lmn / M / 36 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O severe backache since 6 months.

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 are Schmorls nodes in the inferior aspect of the D9 vertebral body and the superior aspect of the D12 vertebra with adjacent Type I degenerative change.

Smaller Schmorls node is also noted at the D10-D11 level.

The dorsal intervertebral discs show slight loss of water content.

The D9-D10 and D10-D11 facet joints show mild degenerative changes.

The rest of the visualized dorsal vertebral bodies reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The visualized dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the D12 level.
- 2 - Scan-00003

The lumbo-sacral spine was screened with 5 mm thick T1 Weighted sagittal images which show sacralization of the L5 vertebral body.

The sacro-iliac joints were screened with 5 mm T1 Weighted coronal images and which do not reveal any diagnostic feature of note.

IMPRESSION :

The MRI features are suggestive of :

1. Schmorls nodes in the inferior aspect of the D9 vertebral body and the superior aspect of the D12 vertebra with adjacent Type I degenerative change.

2. Mild facetal arthropathy at the D9-D10 and D10-D11 levels.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzhai lmn / M / 74 yrs.
Referred by : Dr. Abc Xyzhacker / Dr. Abc Xyzmpat /
Dr. Abc Xyzapadia.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided weakness.
H/O fever since 3 days.
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.
3 mm thick T2 Weighted coronal images.
5 mm thick FLAIR coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular deep white matter and the centrum semiovale bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are probably ischemic in etiology.

A lacunar infarct (isointense to CSF on all the pulse sequences) is noted in the left thalamus.

The hippocampal complex on either side is unremarkable.

There is mild fullness of both the lateral and the third ventricles. The fourth ventricle is normal. Mild prominence of the cerebral cortical sulci and cerebellar folia is noted. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. The right MCA is ectatic. The internal carotid artery on the right side and the right MCA appear slightly prominent as compared to the left.
..2/.







Incidental note is made of inflammatory changes in the sphenoid sinus and the right frontal sinus.

IMPRESSION :

The MRI features are suggestive of :

1. Areas of altered signal in the periventricular deep white matter and the centrum semiovale bilaterally are probably ischemic in etiology.

2. A lacunar infarct in the left thalamus.

ke/sb/rg
Date : 00.00.00

Name of the Patient : Abc Xyznt Bhlmn / M / 57 yrs.
Referred by : Dr. Abc Xyzmat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever (on & off) since 1 1/2 months.
C/O altered behaviour with bladder/bowel incontinence since 00.00.00.
Known diabetic/hypertensive. On Rx.

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.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is an ill-defined mass lesion in the left frontal lobe which is hypointense to the gray matter on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images. A streak of hyperintense signal on the T1 Weighted images is seen at the periphery of the lesion, anteriorly, (scan 104.14) which is seen to remain so on the proton and T2 Weighted images and may represent altered blood/paramagnetic substances. There is surrounding edema with mass effect and effacement of the adjacent sulci. There is slight encroachment into the genu of the corpus callosum on the left side. Mild indentation upon the frontal horn of the left lateral ventricle is noted with slight shift of the anterior falx to the right.

Prominent perivascular spaces are seen in the lentiform nuclei and the thalamus bilaterally.

A ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images is seen in the right high posterior parietal region and in the left frontal region, superior to the left Sylvian fissure which is hypointense to white matter on the T1 Weighted images.
..2/.




A hyperintense speck on FLAIR images is seen in the subcortical white matter in the right occipital region.

There is mild fullness of the ventricular system with slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of :

1. A mass lesion in the left frontal lobe with signal characteristics as described is not specific for a single etiology. The differential diagnosis would include,

a. Tuberculoma/Tubercular abscess.

b. Neoplasm like a glial cell tumor.

2. Altered signal in the right high posterior parietal region and in the left frontal region, superior to the left Sylvian fissure may represent another lesion of same pathology (multicentric distribution).

Patient refused contrast enhanced study.

sb/ke/rg.
Date : 00.00.00

Name of Patient : Ms. Deepa Subramalmn / F / 27 yrs.
Referred by : Dr. Abc Xyzwala.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain with (occasional) paresthesias in BUE since 1 month.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

SOME IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

The C6 and C7 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. There is erosion of the superior cortical endplate of the C7 vertebral body with probable involvement of the C6-C7 intervertebral disc. The spinous processes of C6 and C7 vertebrae also seem to be involved. Destruction of the right sided pedicle, lamina and the facetal articulation of C6 and C7 vertebrae on the right is noted.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the prevertebral space, right paravertebral region and in the right posterior paraspinal muscles extending over C6 and C7 vertebral levels. This lesion appears hyperintense on the T2 Weighted and Fast Scan (T2 *) images. Extension into the anterior and right lateral epidural space at these levels is also noted with cord compression. The cervical spinal cord at this level shows a subtle hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images which may represent cord edema/ischemia.
..2/.


- 2 -


Small posterior disc bulges are noted at the C4-C5 and C5-C6 levels.

The rest of the cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.

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

IMPRESSION :

Altered signal of the C6 and C7 vertebrae with probable involvement of the C6-C7 intervertebral disc as described most likely represents osteitis with discitis probably tuberculous in etiology. Prevertebral, paravertebral, posterior paraspinal and epidural soft tissue lesion on the right would represent granulation tissue/abscess. There is resultant cord compression and subtle cord signal alteration at C6 and C7 levels which may suggests cord edema/ischemia.

The possibility of this lesion representing a neoplasm seems less likely.