sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 30 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Right Shoulder.

CLINICAL PROFILE :

H/O traumatic posterior dislocation of the right shoulder on 00.00.00.

EXAMINATION :

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

4 mm thick T1 Weighted and GRASS axial images.

4 mm thick T1 Weighted sagittal images.

4 mm thick T1 Weighted, Proton and T2 Weighted coronal images.

OBSERVATION :

There is seen a depression of the humeral head along its postero-lateral margin which most likely represents a compression fracture (Hill-Sachs lesion) in the given clinical setting. This lesion appears as a hyperintense centre with perilesional hypointense signal on the T1 Weighted images and appears homogeneously hyperintense on the T2 Weighted and GRASS images. Probable avulsion of the inferior gleno-humeral ligament is noted, with blunting of the inferior lip of the labrum. Fluid is noted in the gleno-humeral joint.

The visualized scapula appears normal. The biceps tendon in the biciptical groove shows normal signal intensity.

The articular cartilage of the head of the right humerus appears normal.
Scan-00006



The tendinous insertion of the supraspinatous muscle shows normal signal intensity. There is no evidence of fluid in the subdeltoid bursa. There is no evidence of a tear of the supraspinatous muscle.

The acromio-clavicular joint is normal. The acromion process is seen to be sloping posteriorly.

The visualized axilla is unremarkable.

IMPRESSION :

1. A depression of the humeral head along its postero-lateral margin most likely represents a compression fracture (Hill-Sachs lesion) in the given clinical setting.

2. Probable avulsion of the inferior gleno-humeral ligament with blunting of the inferior lip of the labrum.

3. Fluid in the gleno-humeral joint.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzndra Salmn / M / 55 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Dorsal & Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 2-3 months with weakness of BLE since 2 days.

EXAMINATION :

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

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

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The posterior elements of the D4, D5 and D6 vertebrae and the D3, D6, L1 and L4 vertebral bodies appear hypointense on the T1 Weighted images and are predominantly hypointense on the T2 Weighted images. Minimal extension into the left paravertebral soft tissues is noted at the L4 vertebral level and in the right paravertebral soft tissues at the L1 vertebral level. There is also extension of the soft tissue lesion into the anterior and right lateral epidural space at the D12 vertebral level, the left lateral and posterior epidural space at D5 and D6 vertebral levels and in the anterior epidural space at the D3 vertebral level. There is resultant cord compression at D3, D5 and D6 vertebral levels. The dorsal spinal cord at the D5 and D6 vertebral levels shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia.

Postero-central disc herniations are noted at the L4-L5 and L5-S1 levels and a right postero-lateral disc herniation is noted at the D12-L1 level.


The visualized intervertebral discs show loss of water content.

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

The conus medullaris terminates at the L1 level and thecal sac terminates at the S2 level.

Incidentally noted is a fairly large, lobulated mass lesion in the upper pole of the left kidney and another suspicious lesion in the left iliac bone.

IMPRESSION :

Altered signal involving the posterior elements of the D4, D5 and D6 vertebrae and the D3, D6, L1 and L4 vertebral bodies with paravertebral and epidural soft tissue lesions as described is not specific for a single etiology. In view of the lobulated mass lesion in the upper pole of the left kidney, these lesions may represent metastatic deposits. The possibility of an infective lesion is less likely.

There is cord compression at D3, D5 and D6 vertebral levels with altered cord signal suggesting cord edema/ischemia.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzMalmn / F / 30 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Dorsal spine.

CLINICAL PROFILE :

C/O high grade fever with headaches and altered sensorium since 00.00.00.
H/O delivery of a still born baby on 00.00.00 with bladder continence and loss of vision since then.
CSF s/o Tuberculous meningitis.
Now C/O paraparesis with multiple cranial nerve palsies.

EXAMINATION :

M.R.I of the dorsal 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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

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.

The visualized dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

IMPRESSION :

No significant abnormality is detected on this study.

sb/ke/nl/rg.
Date : 19.0000

Name of the Patient : Abc XyzMalmn / F / 30 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O high grade fever with headaches and altered sensorium since 00.00.00.
H/O delivery of a still born baby on 00.00.00 with bladder continence and loss of vision since then.
CSF s/o Tuberculous meningitis.
Now C/O paraparesis with multiple cranial nerve palsies.

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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is loss of normal cervical lordosis and slight loss of water content of the cervical intervertebral discs.

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

The cervical spinal cord reveals normal signal intensity.

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

IMPRESSION :

No significant abnormality is detected on this study.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzben Mlmn / F / 82 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden loss of speech and subsequent loss of consciousness at 9.00 am on 00.00.00.
H/O seizures at 1.30 pm on 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.

OBSERVATION :

There is seen an approximately 2.2 x 2.0 x 1.8 cms sized well marginated, slightly hyperintense lesion on the T1 Weighted images in the left posterior temporal lobe. This lesion appears slightly hypointense on the T2 Weighted images but turns appreciably more hypointense on the Fast Scan (T2 *) images and represents an acute intraparenchymal hematoma. There is mild perilesional edema with effacement of the sulcal spaces and the left Sylvian cistern. Minimal indentation on the atrium of the left lateral ventricle is noted.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the pons, in the subcortical and deep white matter in the right posterior parietal region, in the subcortical white matter in the fronto-parietal regions bilaterally and in the posterior parietal periventricular white matter and centrum semiovale bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes.


Lacunar infarcts are noted in the lentiform nuclei and thalami bilaterally.

There is mild dilatation of both the lateral ventricles. The third and the fourth ventricles are normal. There is prominence of the cerebral cortical sulci, cerebellar folia and basal cisternal spaces bilaterally.

There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. An acute intraparenchymal hematoma measuring approximately 2.2 x 2.0 x 1.8 cms in the left posterior temporal lobe.

2. Altered signal in the pons, in the subcortical and deep white matter in the right posterior parietal region, in the subcortical white matter in the fronto-parietal regions bilaterally and in the posterior parietal periventricular white matter and centrum semiovale bilaterally most likely represent ischemic changes.

3. Lacunar infarcts in the lentiform nuclei and thalami bilaterally.

4. Age related cerebral and cerebellar atrophy.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzMalmn / F / 30 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O high grade fever with headaches and altered sensorium since 00.00.00.
H/O delivery of a still born baby on 00.00.00 with bladder continence and loss of vision since then.
CSF s/o Tuberculous meningitis.
Now C/O paraparesis with multiple cranial nerve palsies.

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 and 3 mm thick T2 Weighted sagittal images.

OBSERVATION :

There is an ill-defined, hypointense signal on the T1 Weighted images in the genu of the corpus callosum and along the frontal cortex in the parafalcine regions bilaterally. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images.

There is a hyperintense signal, better appreciated on the FLAIR images in the subdural space at the right parietal convexity. This lesion may represent basal exudates, in the given clinical setting. Similar signal is also noted in the anterior interhemispheric fissure.




There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. Fluid levels are noted in the occipital horns bilaterally with increased signal,
in the atrium and occipital horn of the right lateral ventricle which may represent debris.

There is slight effacement of the sulcal spaces in the cerebral hemispheres bilaterally, more on the left side.

Intermediate signal intensity is seen in the suprasellar cistern on the T1 Weighted images and would represent exudates.

The basal cisternal spaces are slightly prominent. 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.

IMPRESSION :

1. Altered signal in the genu of the corpus callosum and along the frontal cortex in the parafalcine regions bilaterally may represent ischemic changes, in the given clinical setting of tuberculous meningitis.

2. Altered signal in the subdural space at the right parietal convexity and in the anterior interhemispheric fissure and suprasellar cistern may represent exudates, in the given clinical setting.

3. Mild dilatation of both the lateral and third ventricles. Fluid levels in the occipital horns bilaterally with increased signal, in the atrium and occipital horn of the right lateral ventricle may represent debris and may suggest ventriculitis.

A contrast enhanced scan is essential.

As compared to the previous CT Scan dated 00.00.00, there is slight increase in the size of ventricles.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Shlmn / F / 55 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the right half of body since 7 days.
H/O hypertension.

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 seen a well-defined, approximately 1.2 cms diameter sized hyperintense lesion on the T1 Weighted images in the left thalamus. This lesion remains hyperintense on the proton, T2 Weighted and FLAIR images and represents extracellular methemoglobin. There is a well-defined hypointense rim seen on the proton and T2 Weighted images. There is mild perilesional edema with minimal indentation on the third ventricle.

Lacunar infarcts are noted in the cerebellar hemispheres bilaterally, in the pons, right thalamus, bilateral lentiform nuclei and in the right corona radiata.

Ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and in the corona radiata and centrum semiovale most likely represent ischemic changes.






Both the lateral and the fourth ventricles appear normal. There is slight prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces 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 sinuses bilaterally.

Incidentally noted is an empty sella.

IMPRESSION :

1. An approximately 1.2 cms diameter sized lesion in the left thalamus represents a subacute hematoma.

2. Lacunar infarcts in the cerebellar hemispheres bilaterally, in the pons, right thalamus, bilateral lentiform nuclei and in the right corona radiata.

3. Altered signal in the periventricular white matter bilaterally and in the corona radiata and centrum semiovale most likely represent ischemic changes.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzgalhalikar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 1 year.

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 reduction in height of the L5-S1 disc and loss of water content of the L4-L5 and L5-S1 intervertebral discs.

There is a posteriorly herniated disc with a posterior peridiscal osteophyte (hard disc) at the L5-S1 level with bilateral neural foraminal narrowing and indentation on the traversing left S1 nerve root. There is also slight facetal and ligamentum flavum hypertrophy at this level. Minimal facet joint effusion is noted at the L5-S1 level.

A small postero-central disc herniation with peridiscal osteophyte is seen at the L4-L5 level, indenting the dural theca anteriorly. Slight facetal hypertrophy is noted at this level.

Anterior disc herniation with anterior peridiscal osteophytes is noted at the L5-S1 level.





Type I degenerative marrow changes are seen adjacent to the L5-S1 disc. An anterior disc herniation is also noted at this level.

The rest of 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 S3 level.

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

21.0 mm at L1-L2
19.0 mm at L2-L3
20.0 mm at L3-L4
16.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. A posteriorly herniated disc with a posterior peridiscal osteophyte (hard disc) at the L5-S1 level indenting the traversing left S1 nerve root.

2. A small postero-central disc herniation with peridiscal osteophyte at the L4-L5 level.

3. Slight facetal hypertrophy at the L4-L5 and L5-S1 levels with mild facet joint effusion at the L5-S1 level.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzh Mlmn / M / 26 yrs.
Referred by : Dr. Abc Xyzunjhunwala.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O pain in the LLE (thigh) with tingling and burning sensation since 2 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.

5 mm thick T1 Weighted coronal images.

OBSERVATION :

There is loss of normal lumbar lordosis.

Small posterior disc bulges are noted at the L4-L5 and L5-S1 levels.

There is seen a fairly large, approximately 3.2 x 4.3 x 4.2 cms sized well-defined intermediate signal intensity mass lesion on the T1 Weighted images in the left psoas muscle, extending over the L2 to L4 vertebral levels. On the T2 Weighted images, the bulk of the lesion appears hyperintense with central hypointense signal. The left psoas muscle is well identified around this lesion. There is also seen a fairly large, similar signal intensity lesion along the left lateral pelvic wall in the left iliac region. This lesion measures approximately 16.0 x 10.0 cms and is seen to indent the lateral margin of the left psoas muscle. The inferior margin of the left kidney is displaced superiorly.
..2/.






There are also seen small, lobulated lesions in both the paravertebral regions at the L5-S1, L4-L5, L3-L4 and L2-L3 levels, which follow signal intensity of the above described lesions. These lesions are noted along the exiting nerve roots at the corresponding disc levels and also within the neural foramina bilaterally.

The lumbar vertebral bodies reveal normal signal intensity. The L2-L3 intervertebral disc shows slight loss of water content. The facet joints 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
18.0 mm at L2-L3
16.0 mm at L3-L4
14.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

A fairly large, approximately 3.2 x 4.3 x 4.2 cms sized mass lesion in the left psoas muscle, extending over the L2 to L4 vertebral levels with signal characteristics as described, is not specific for a single etiology. Similar signal intensity, fairly large lesion is also noted along the left lateral pelvic wall in the left iliac region. Multiple lobulated lesions are noted in the paravertebral regions at the L5-S1, L4-L5, L3-L4 and L2-L3 levels.

Multiple neurofibromas may be considered as a likely possibility.

A contrast enhanced scan and a pelvic study would be worthwhile.

sb/bv/nl/rg.
sw Date : 00.00.00

Name of the Patient : Abc Xyzai S. Klmn / F / 38 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 4-5 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 :

The L5 vertebral body is as marked on the film.

There is loss of water content of the L5-S1 and L1-L2 intervertebral discs.

There is a postero-central disc herniation with peridiscal osteophyte at the L5-S1 level indenting the dural theca anteriorly.

A left postero-lateral and left far lateral disc bulge is noted at the L4-L5 level narrowing the left neural foramen at that level.

The facet joints at the L4-L5 and L5-S1 levels appear slightly hypertrophied.



- 2 - 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 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
14.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

1. A postero-central disc herniation with peridiscal osteophyte at the L5-S1 level.

2. A left postero-lateral and left far lateral disc bulge at the L4-L5 level narrowing the left neural foramen at that level.