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Sunday, 27 December 2015 16:48

12775

sb/hs/nl/nl
/00005 Date : 17/00.00.00

Name of the Patient : Abc Xyz Kalmn / F / 30 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Left Thigh with MRV &
MRA.

CLINICAL PROFILE :

C/O pain with swelling in the lower left 1/3 rd femur since 6 months.
Operated for a ? removal of lipoma from the same region in 0000.

EXAMINATION :

M.R.I. of the left thigh with MRV and MRA was performed using the following parameters :

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

5 mm thick T1 Weighted and STIR coronal images.

7 mm thick GRASS sagittal images.

MRV and MRA were performed using 2D TOF sequences.

OBSERVATION :

There is seen fatty replacement in the bulk of the left vastus lateralis muscle and the biceps femoris muscle, distally. These changes are seen over a distance of about 18.0 cms cephalad to the left knee joint.

There are multiple, serpingenous lesions in the bulk of the left vastus lateralis muscle, biceps femoris muscles and in the intermuscular fat plane between these muscles in the anterior and posterior compartments of the distal left



thigh, laterally. These lesions are of intermediate signal intensity on the T1 Weighted images and appear hyperintense on the T2 Weighted and STIR images and extend about 18.0 cms supero-inferiorly, proximal to the left knee joint. There is no bone erosion or destruction noted. The subcutaneous tissue around this lesion are unremarkable. There is no extension of this lesion into the left knee joint space per se.

The rest of the visualized muscles in the distal left thigh are unremarkable.

Scar of previous surgery along the antero-lateral margin of the distal left thigh is noted.

MRV/MRA of the distal left thigh and proximal left leg does not reveal any abnormal vascularity at the site of the lesion. There are no obvious arterial feeder vessels or enlarged draining veins into the venous system identified on this study.

IMPRESSION :

1. Post-operative/post-biopsy status.

2. Serpingenous lesions in the bulk of the left vastus lateralis muscle, left biceps femoris muscle and in the intermuscular fat plane between these muscles in the anterior and posterior compartments of the distal left thigh, laterally, as described, are not specific for a single etiology. This lesion most likely represents an intermuscular/intramuscular hemangioma.

3. No obvious arterial feeder vessels or enlarged draining veins into the venous system are identified on this study.

As compared to the previous MRI dated 00.00.00, there is no significant change noted.



Sunday, 27 December 2015 16:48

12774

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzet Powlmn / M / 23 yrs.
Referred by : Dr. Abc Xyzmat.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache (off and on) 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 :

There is mild retroplacement of the L4 vertebra over the L5 vertebra.

A postero-central disc herniation with peridiscal osteophytes is seen to indent the thecal sac and both the traversing L5 nerve roots at the L4-L5 level. Slight inferior migration of this disc is also noted. This intervertebral disc shows loss of water content.

A small posterior disc herniation is seen to indent both the traversing S1 nerve roots at the L5-S1 level. This intervertebral disc shows mild loss of water content.

Mild far lateral (extraforaminal) disc bulges are seen bilaterally at the L3-L4, L4-L5 and L5-S1 levels.

There is mild facetal hypertrophy at the L4-L5 and L5-S1 levels.







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-S2 level.

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

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

IMPRESSION :

1. A postero-central disc herniation with peridiscal osteophytes at the L4-L5 level.

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





Sunday, 27 December 2015 16:48

12773

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzam Jalmn / M / 56 yrs.
Referred by : Dr. Abc Xyzacker.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the LUE and LLE since 00.00.00.
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 FLAIR and 4 mm thick Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a small, approximately 1.3 cm diameter sized hyperintense lesion on the T1 Weighted images in the right lentiform nucleus extending into the right corona radiata and right posterior capsular region. This lesion appears relatively hypointense on the proton and T2 Weighted images and blooms on the Fast Scan (T2 *) images. There is mild perilesional edema.

There is a linear hypointense signal on the T1 Weighted images in the right external capsular region. This lesion appears hyperintense on the proton and T2 Weighted images and shows a peripheral hypointense rim, better appreciated on the T2 Weighted and Fast Scan (T2 *) images.

There are ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and in bilateral fronto-parietal deep white matter. These lesions appear hypointense to normal white matter on the T1 Weighted images.



There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci and basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Incidentally noted is a subgaleal lipoma in the left occipital region.

IMPRESSION :

1. An approximately 1.3 cm diameter sized lesion in the right lentiform nucleus extending into the right corona radiata represents an early subacute hematoma.

2. Altered signal in the right external capsular region most likely is the sequelae of a previous hematoma in that region, which has now resolved.

3. Altered signal in the periventricular white matter bilaterally and in bilateral fronto-parietal white matter most likely represent ischemic changes.

4. Cerebral cortical atrophy.


Sunday, 27 December 2015 16:48

12772

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 20 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O acute onset paraplegia, since 1 day.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

8 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The D12 vertebral body is as marked on the film.

There is seen a fairly large intermediate signal intensity lesion on the T1 Weighted images in the posterior epidural space extending over the D9 to D11 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. There is resultant anterior displacement and compression of the dorsal spinal cord over these levels. The dorsal spinal cord over these levels shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia.

The rest of 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 conus medullaris terminates at the L1 level.

IMPRESSION :

A posterior epidural lesion extending over the D9 to D11 vertebral levels as described is not specific for a single etiology. This may represent granulation tissue (? tuberculous etiology) or round cell tumors. Epidural hematoma seems less likely. There is resultant cord compression and cord signal alteration suggesting cord edema/ischemia.




Sunday, 27 December 2015 16:48

12771

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza lmn / F / 31 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 6 months.
H/O laminectomy at L4-L5 with discectomy.

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 minimal retroplacement of the L4 over the L5 vertebra. The L4-L5 intervertebral disc shows loss of water content.

There is evidence of laminectomy at the L4 and L5 vertebral levels with post-operative changes in the soft tissues in the posterior lumbar region at these levels.

There is an apparent posterior disc bulge at the L4-L5 level.

Slight facetal hypertrophy is noted at the L4-L5 and L5-S1 levels.

There is clumping of the nerve roots within the thecal sac centrally suggesting Type II arachnoiditis over the L4 and L5 vertebral levels (scans 106.6 - 106.8, 103.4).
Scan-00001

Slight herniation of the L4-L5 disc into the body of L4 is noted with adjacent Type I degenerative changes.

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 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 :

18.0 mm at L1-L2
19.0 mm at L2-L3
19.0 mm at L3-L4.

IMPRESSION :

1. Post-operative changes.

2. Minimal retroplacement of the L4 over the L5 vertebra with an apparent posterior disc bulge at the L4-L5 level.

3. Clumping of the nerve roots within the thecal sac centrally over the L4 and L5 vertebral levels suggestive of Type II arachnoiditis.









Sunday, 27 December 2015 16:48

12770

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Jalgaonlmn / F / 45 yrs.
Referred by : Dr. Abc Xyzoshipura.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias.

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 loss of water content of the L4-L5 intervertebral disc.

There appears to be sacralization of the L5 vertebra and it is as marked on the film.

There is a small posterior disc herniation with peridiscal osteophytes at the L4-L5 level with resultant indentation on the anterior dural theca and mild left neural foraminal narrowing. Slight facetal hypertrophy is noted at the L4-L5 level. A left far lateral (extraforaminal) disc bulge is seen to indent the extraforaminal portion of the exiting left L4 nerve root at the L4-L5 level.

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.
Scan-00000


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 :

17.0 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 :

1. Sacralized L5 vertebra.

2. Degenerated L4-L5 disc with a small posterior disc herniation with peridiscal osteophytes.

3. Facetal hypertrophy at the L4-L5 level.

4. A left far lateral (extraforaminal) disc bulge at the L4-L5 level.








Sunday, 27 December 2015 16:48

12769

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzla Tulapulmn / F / 27 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures.

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.

5 mm thick T1 Weighted coronal images.

OBSERVATION :

There is no focal area of altered signal intensity within the brain parenchyma.

The hippocampal complex on either side is unremarkable.

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 :

Normal study of the Brain.

Sunday, 27 December 2015 16:48

12768

hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzA. Salmn / F / 14 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 6 months with LOC.

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 no focal area of altered signal intensity within the brain parenchyma.

The hippocampal complex on either side is unremarkable.

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.

Inflammatory changes are noted in the ethmoidal air cells and maxillary sinus on the left side.

IMPRESSION :

No abnormality is detected within the brain per se on this study.

Sunday, 27 December 2015 16:48

12767

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzrajilmn / M / 36 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O neckpain radiating to the mid back since 6-7 months.

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.

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

OBSERVATION :

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

There is seen a well marginated, intramedullary lesion within the upper dorsal spinal cord at the D2 and D3 vertebral levels. This lesion is of intermediate signal on the T1 Weighted images but appears hypointense on the T2 Weighted images.

There is a hypointense lesion on the T1 Weighted images within the cervical spinal cord extending over the C2 to D1 and D4 to D8 vertebral levels. This lesion appears hyperintense on the T2 Weighted images and represents a syrinx/tumor related cyst. The cervico-dorsal spinal cord over the C2 to D8 vertebral levels appears increased in its transverse dimensions. Multiple septae are noted in the proximal syrinx/cyst.

Small posterior disc bulges with posterior peridiscal osteophytes are noted in the cervical region.


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

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

IMPRESSION :

An intramedullary mass lesion within the upper dorsal spinal cord at the D2 and D3 vertebral levels as described is not specific for a single etiology. An intramedullary neoplasm (astrocytoma/ependymoma) may be considered in the differential diagnosis (less likely to be infective in etiology). A tumor related cyst/syrinx is noted proximal and distal to the lesion as described.

A contrast enhanced scan would be worthwhile.

Sunday, 27 December 2015 16:48

12766

hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzGovlmn / M / 76 yrs.
Referred by : Dr. Abc Xyzichgar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided hemiparesis with slurred speech since 1 week.

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 irregularly defined areas of hyperintensity on the proton, T2 Weighted and FLAIR images within the periventricular white matter and white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

Lacunar infarcts (iso to hyperintense to CSF) are seen within the lentiform nuclei, corona radiata and posterior limbs of the internal capsules bilaterally.

There is fullness of the third and both the lateral ventricles. The fourth ventricle is normal. Also seen is prominence of the basal cisternal spaces, cerebral cortical sulci and cerebellar folia bilaterally.

There is an increased signal on the T1 Weighted images within the head of the left caudate nucleus. This may represent deposition of paramagnetic substances.

There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
..2/.





- 2 - scan-00006


IMPRESSION :

The MRI features are suggestive of :

1. Irregularly defined areas of altered signal intensity within the periventricular white matter and white matter in the fronto-parietal lobes bilaterally are most likely ischemic in etiology.

2. Lacunar infarcts in the lentiform nuclei, corona radiata and posterior limbs of the internal capsules bilaterally.

3. Altered signal within the head of the left caudate nucleus may represent deposition of paramagnetic substances.