sb/bv.
Date : 00.00.00

Name of the Patient : Abc Xyz Khlmn / F / 10 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

H/O fall 4-5 years back.
C/O swelling over the back with weakness of BLE with bladder/bowel involvement since 6 months.

EXAMINATION :

M.R.I of the dorso-lumbar 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.

OBSERVATION :

There is evidence of an acute kypho-scoliotic deformity in the dorso-lumbar region with the apex of the kyphus at the D12-L1 level. Slight wedging of the D12 and L1 vertebral bodies is noted.

There is seen an intraspinal (most likely epidural), intermediate signal intensity mass lesion on the T1 Weighted images extending over the D9-D10 disc level upto the L2 vertebral level. This lesion appears relatively hypointense on the T2 Weighted images and is located in the posterior epidural space. There is resultant compression and anterior displacement of the lower dorsal spinal cord over these levels. The dorsal spinal cord over the affected levels appears to be slightly hyperintense to the normal cord on the T2 Weighted images. Slight widening of the spinal canal is noted at the D9, D10 and D11 vertebral levels, with scalloping of the right postero-lateral margin of these vertebrae. There is extension of the lesion through the left neural foramen at D11-D12, D12-L1 and L1-L2 levels into the left paravertebral soft tissues at these levels.
..2/.






The rest of the visualized lumbar vertebral bodies and the 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-L2 level.

IMPRESSION :

1. An acute kypho-scoliotic deformity in the dorso-lumbar region with the apex of the kyphus at the D12-L1 level.

2. An intraspinal (most likely epidural) mass lesion extending over the D9-D10 disc level upto L2 vertebral level and through the neural foramen as described is not specific for a single etiology. The differential diagnosis would include :

a. A nerve sheath tumor.

b. Meningioma less likely.

c. An organized inflammatory lesion ? of tuberculous etiology less likely.

3. Cord compression with cord signal alteration over the D9-D10 disc level to the L1 vertebral level.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzo Tendulmn / M / 56 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 0000 which is increased since 15 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 L4-L5 and L5-S1 intervertebral discs show loss of water content.

There is slight retrolisthesis of the L5 over the S1 vertebra. A pseudo-posterior disc herniation is seen at the L5-S1 level with anterior indentation of the thecal sac. There is inferior migration of the disc portion posterior to the S1 vertebral body indenting the S1 nerve roots.

There is a posterior disc herniation at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. The L4-L5 facet joints show mild degenerative changes.

A posterior and right postero-lateral disc herniation is seen at the L3-L4 level with anterior indentation of the thecal sac and right neural foraminal narrowing.
scan-00009


Far lateral disc bulges are seen at the L2-L3 and L1-L2 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-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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. Slight retrolisthesis of the L5 over the S1 vertebra.

2. A pseudo-posterior disc herniation at the L5-S1 level with inferior migration of the disc portion, posterior to the S1 vertebral body indenting the S1 nerve roots.

3. A posterior disc herniation at the L4-L5 level with
mild facetal arthropathy at this level.

4. Tight lumbar canal over the L4-L5 and L5-S1 levels.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzumar Glmn / M / 11 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 4 years. On anti-epileptics.
H/O right lens implant 4 years back.

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 hippocampus 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.

Incidental note is made of right maxillary sinusitis, right mastoiditis and enlarged adenoids.

IMPRESSION :

Normal study of the Brain.

hs/ke/nl/nl
Date : 00.00.00
Name of the Patient : Abc XyzShlmn / M / 59 yrs.
Referred by : Dr. Abc Xyzik.
Examination : M.R.I. of the Chest.
CLINICAL PROFILE :
C/O pain in the throat with difficulty in swallowing since 1 month and change in voice.
C/O pain below the left ear radiating to the neck on the left side.
EXAMINATION :
M.R.I. of the chest was performed using the following parameters:
6 mm thick T1 Weighted and T2 Weighted axial images.6 mm thick T1 Weighted and STIR coronal images.5 mm thick T1 Weighted sagittal images.OBSERVATION :
The lung fields appear to be normal. The vascular structures in the mediastinum are normal. The hila bilaterally appear to be normal.No enlarged lymphnodes are identified.There is no evidence of any mass lesion on the scan.

The visualized cervico-dorsal vertebral bodies, the sternum and the costochondral joints do not reveal any area of altered signal intensity.IMPRESSION :Normal study of the Chest.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz V. Bhalmn / F / 16 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O congenital deformity of the RLE with headaches, vomiting and giddiness since 1 month.

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.

5 mm thick T1 Weighted sagittal images.

CT Scan was not available.

OBSERVATION :

There is seen a fairly large, extra-axial, hypointense mass lesion on the T1 Weighted images in the right cerebello-pontine angle cistern. This lesion is slightly hyperintense to CSF on all the pulse sequences. Resultant compression of the brain stem and fourth ventricle is noted, which are displaced slightly to the left of the midline. Cerebellar tonsillar herniation through the foramen magnum is also noted. Septation is noted within this lesion.

There is seen an approximately 1.8 cms diameter sized well marginated, slightly hyperintense lesion on the T1 Weighted images in the right inferior frontal/frontal region. This lesion has a hypointense rim with a slightly hyperintense centre on the proton, T2 Weighted and FLAIR images but is markedly hypointense on the Fast Scan (T2 *) images. Perilesional white matter hyperintense signal on the proton, T2 Weighted and FLAIR images is noted which may represent perilesional edema.
..2/.






There are multiple varying size hypointense lesions on all the pulse sequences in the heads of the caudate nuclei and lentiform nuclei bilaterally, right thalamus and in the posterior parietal periventricular white matter on the right.

There is a diffuse, hyperintense signal on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally. This signal appears hypointense on the T1 Weighted images.

There is mild dilatation of both the lateral and third ventricles. The basal cisternal spaces are unremarkable. There is mild bulge of the midline structures to the left. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the paranasal sinuses bilaterally.

IMPRESSION :

1. A fairly large, extra-axial, mass lesion in the right cerebello-pontine angle cistern with septations may represent an epidermoid cyst or an arachnoid cyst.

2. An approximately 1.8 cms diameter sized lesion in the right inferior frontal/frontal regions as described is most likely a calcified lesion. An oligodendroglioma or a germ cell tumor should be considered as differential diagnosis. Perilesional white matter hyperintense signal may represent edema.

3. Dense calcification in the head of caudate nuclei, lentiform nuclei and in the right posterior parietal deep white matter.

4. Altered signal in the periventricular white matter bilaterally is not specific for a single etiology.

Tuberous sclerosis should be considered.

A contrast enhanced scan would be worthwhile.

The previous CT Scan was not available for review.

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzna I. Chamlmn / F / 32 yrs.
Referred by : Dr. Abc Xyzoctor / Dr. Abc XyzParekh.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O swelling over the right side of face with drooping of the right eyelid since 00.00.00 with headaches.
Known diabetic (recently detected).

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 STIR coronal images.
MR cisternogram was obtained in the coronal plane.

OBSERVATION :

There is an intermediate signal intensity lesion in the region of the right superior orbital fissure and cavernous sinus anteriorly on the T1 Weighted images (se/im 106.5/6). This is seen to turn heterogeneously hyperintense on the STIR images. The cavernous portion of the internal carotid artery shows normal flow-void signal.

Hyperintense signal is seen in the superior opthalmic vein on the right side on the STIR images, ? slow flow/congestion.

The intraorbital muscles on the right side appear bulky as compared to the left. Slight streaking of the retro-orbital fat is also seen.

The optic nerves show normal signal intensity on STIR images bilaterally. The seventh and eighth nerve complex on either side are 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.
..2/.




- 2 - scan-00006


Incidental note is made of inflammatory changes in the right frontal sinus, maxillary sinus, ethmoidal sinus and sphenoid sinus. There is swelling of the face on the right with mild hyperintense signal on the T2 Weighted images may be due to congestion.

Note is also made of a convex superior surface of the pituitary gland.

IMPRESSION :

The MRI features are suggestive of an intermediate signal intensity lesion in the region of the right cavernous sinus and right superior orbital fissure as described. This is not specific for a single diagnosis. The following may be considered :

1. Neoplastic processes.

2. Inflammatory processes.

Also seen is increased muscle bulk within the right orbit, which is most likely the result of compression upon the right superior opthalmic vein by this lesion.

ke/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Agrlmn / M / 30 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the RUE with numbness since June 0000 with headaches.
Alleged H/O vehicular accident prior to this.

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 fracture with anterior wedging of the D2 vertebral body. A Schmorls node is identified on the inferior surface of the D2. This vertebral body however shows normal signal intensity. There is a posterior disc herniation at the D2-D3 level with anterior indentation of the thecal sac.

There are small postero-central disc herniations at the C4-C5 and the C5-C6 levels with anterior indentation of the thecal sac.

The cervical vertebral bodies and the intervertebral discs 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.
..2/.







IMPRESSION :

The MRI features are suggestive of :

1. Fracture with anterior wedging of the D2 vertebral body with a posterior disc herniation at the D2-D3 level.

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

ke/bv/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 0000.
H/O laminectomy at the L5-S1 in 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 :

The lumbar intervertebral discs show loss of water content.

There are post-operative changes in the posterior soft tissues over the L3 to S1 levels with laminectomy of the L4 and L5 vertebrae.

There is a right postero-lateral disc herniation at the L5-S1 level with right neural foraminal narrowing and mild indentation upon the right S1 nerve root and the extraforaminal portion of the right L5 nerve root. A left antero-lateral disc herniation is also noted at this level. The right S1 nerve root appears to be of larger calibre and is ? inflamed, ?? has a baggy nerve root sleeve.

Bilateral far lateral disc herniations are seen at the L4-L5 level with anterior indentation of the thecal sac and neural foraminal narrowing. There is indentation upon the extraforaminal and foraminal portion of the L4 nerve roots bilaterally.
- 2 - Scan-00004


Mild retroplacement of the L3 over the L4 vertebra is noted with a posterior disc herniation at the L3-L4 level with anterior compression upon the thecal sac, bilateral neural foraminal narrowing and a tight canal at this level.

A small posterior disc bulge is noted at the L2-L3 level. Anterior disc herniations are seen at the L2-L3 and L3-L4 levels. The lower lumbar facet joints show mild degenerative changes.

The intrathecal nerve roots appear slightly thick over the L3-L4 to the L5-S1 levels suggestive of Group I arachnoiditis.

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 S1 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

14.0 mm at L2-L3

8.0 mm at L3-L4.

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.
..3/.










- 3 - Scan-00004


2. A right postero-lateral disc herniation at the L5-S1 level with mild indentation upon the right S1 nerve root and the extraforaminal portion of the right L5 nerve root.

3. Bilateral far lateral disc herniations at the L4-L5 level with indentation upon the extraforaminal and foraminal portion of the L4 nerve roots bilaterally.

4. Mild retroplacement of the L3 over the L4 vertebra with a posterior disc herniation at the L3-L4 level and a tight canal at this level.

5. Group I arachnoiditis over the L3-L4 to the L5-S1 levels.

ke/hs/rg.
Date : 00.00.00

Name of the Patient : Abc XyzShlmn / M / 59 yrs.
Referred by : Dr. Abc Xyz Naik.
Examination : M.R.I. of the Neck.

CLINICAL PROFILE :

C/O pain in the throat with difficulty in swallowing since 1 month with pain below the left ear and change in voice.

EXAMINATION :

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

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

4 mm thick T1 Weighted and STIR coronal images.

4 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is an intermediate signal intensity mass lesion having its epicentre in the left pyriform sinus. Anteriorly this is seen to extend into the left paralaryngeal space with involvement of the left aryepiglottic fold. The anterior junction however appears to be spared. This lesion is slightly hyperintense to normal muscle on the T1 Weighted images and turns hyperintense on the T2 Weighted and STIR images. There is slight extension along the posterior aspect to the right of the midline with mild encroachment into the right pyriform sinus.

The right aryepiglottic fold is unremarkable.

The carotid sheaths bilaterally appear to be normal.

The thyroid shows normal configuration and signal characteristics. The visualized muscles are unremarkable. The visualized bones show normal signal intensity and no obvious bone destruction is evident.
..2/.





- 2 - scan-00003

The visualized salivary glands are unremarkable.

Enlarged lymphnodes are noted on the left side.

IMPRESSION :

In a known C/O Ca larynx the MRI features are suggestive of a
mass lesion having its epicentre in the left pyriform sinus with extensions as described.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzumar Mlmn / M / 65 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided weakness with slurred speech and high blood pressure on 00.00.00 which has slightly improved.
Known 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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is a hyperintense area in the left thalamus on the T1 Weighted images which is seen to remain hyperintense on the proton, T2 Weighted and FLAIR images and represents extracellular methaemoglobin. There is slight extension into the left subthalamus with mild mass effect and indentation upon the body of the left lateral and the third ventricles.

An area of cystic encephalomalacia which is isointense to CSF on all the pulse sequences is seen in the left lentiform nucleus. The medial part of this lesion is seen to bloom on the Fast Scan (T2 *) images and is suggestive of deposition of paramagnetic substances.

There is fullness of both the lateral ventricles. The fourth ventricle is normal. Prominence of the cerebral cortical sulcal spaces is noted. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. The vertebro-basilar system is ectatic. Calcification of the globus pallidus is noted bilaterally.


IMPRESSION :

The MRI features are suggestive of :

1. A subacute haematoma in the left thalamus with mass effect as described, probably represents a primary hypertensive bleed.

2. An area of cystic encephalomalacia in the left lentiform nucleus.