ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzAklmn / M / 55 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O sudden onset of weakness of the RLE since 4 days.
H/O fever with chills since 10 days.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The dorsal intervertebral discs show loss of water content.

The visualized dorsal vertebral bodies 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.

Incidental note is made of a left pleural effusion.

The lumbo-sacral spine was screened with 5 mm T1 Weighted sagittal images and reveals a small posterior disc herniation at the L5-S1 level.
Scan-00009


The cervico-dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and 5 mm thick Fast Scan (T2 *) axial images and shows small posterior disc bulge with peridiscal osteophytes at the C5-C6 and C6-C7 levels and hyperintense signal in the cervical cord on the T2 Weighted images at the C6-C7 level suggesting cord edema/ischemia/contusion.

IMPRESSION :

1. No significant abnormality is detected within the dorsal spine on this study.

2. Small posterior disc bulge with peridiscal osteophytes at the C5-C6 and C6-C7 levels with altered signal
at the C6-C7 level suggestive of cord edema/ischemia/contusion.

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

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzAmbelmn / M / 55 yrs.
Referred by : Dr. Abc Xyzan.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

H/O fall from bed 8 days back.
C/O inability to sit and stand since then.

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 posterior disc herniation at the C3-C4 level with anterior indentation of the cord and bilateral neural foraminal narrowing.

A left postero-lateral disc herniation is seen at the C5-C6 level with antero-lateral indentation of the cord.

Small posterior disc bulge is noted at the C4-C5 level. Anterior disc herniation is seen at the C4-C5 level with peridiscal osteophytes. Posterior peridiscal osteophytes are seen over the C3-C4 to the C5-C6 levels. The cervical intervertebral discs show loss of water content.

The cervical spinal cord at the C5 level appears swollen and shows a hypointense signal on the T1 Weighted images. This is seen to turn hyperintense on the T2 Weighted and Fast Scan (T2 *) images.

Hyperintense signal is seen in the cervical spinal cord at the C3-C4 and C4-C5 levels on the T2 Weighted and Fast Scan (T2 *) images.
..2/.




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

Facetal hypertrophy is noted at the C3-C4 and C5-C6 levels.

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

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and does not reveal any diagnostic feature of note.

IMPRESSION :

The MRI features are suggestive of :

1. A posterior disc herniation at the C3-C4 level.

2. A left postero-lateral disc herniation at the C5-C6 level.

3. Altered signal of the cervical spinal cord at the C5 level would represent cord contusion in the given clinical setting.

4. Cord signal alteration at the C3-C4 and C4-C5 levels most likely represents cord edema/ischemia.

Scan No : Date :

Name of the Patient : .
Referred by :
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

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 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 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 :

.0 mm at L1-L2
.0 mm at L2-L3
.0 mm at L3-L4
.0 mm at L4-L5
.0 mm at L5-S1.

IMPRESSION :

Normal study of the Lumbo-sacral Spine.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Salmn / M / 45 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backpain radiating to BLE with fever since 2 months.
H/O fall prior to this.

EXAMINATION :

M.R.I of the dorso-lumbar 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 which is as marked on the film. Spina bifida is also noted at this level.

There is replacement of the normal marrow of the D12, L1, L2, L3 and L4 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The cortical endplates adjacent to the D12-L1, L1-L2, L2-L3 and L3-L4 intervertebral discs are breached with involvement of the respective discs. There is anterior epidural extension to the right of the midline over the L1 to the L3 levels with mild encroachment into L2-L3 neural foramina on the right side and encasement of the right L2 nerve root.

Small posterior disc bulges are seen at the L3-L4 and L4-L5 levels.

The rest of the visualized dorso-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.
..2/.






The visualized dorso-lumbar spinal cord reveals normal signal intensity.

The conus medullaris terminates at the D12 level.

The cervico-dorsal spine was screened with 4 mm thick T1 Weighted sagittal images, which reveals altered signal of C5 and C6 vertebrae. There is no significant cord compression.

IMPRESSION :

The MRI features are suggestive of altered signal of the D12, L1, L2, L3 and L4 vertebral bodies and the intervening intervertebral
discs with epidural extensions as described. This most probably represents a infective process like tuberculosis.

The possibility of this being a round cell tumor is less likely.

The C5 and C6 vertebral bodies also show altered signal.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Slmn / M / 21 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

Known C/O TBM with TB arachnoiditis. On AKT.
C/O numbness in BLE since June 0000.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

After administration of contrast 5 mm thick T1 Weighted sagittal, 7 mm thick T1 Weighted axial and 4 mm thick T1 Weighted coronal images were obtained. The cervico-dorsal and lumbar spines were screened with 4 mm and 5 mm thick T1 Weighted sagittal images.

The brain was screened with 5 mm thick T1 Weighted axial images.

OBSERVATION :

There is still seen an ill-defined, intermediate signal intensity mass lesion on the T1 Weighted images in the spinal canal at D4, D5 and D8 and D9 vertebral levels. This lesion is most likely intradural in location and appears hyperintense on the T2 Weighted images. The lesion is located posterior and more to the right of the dorsal spinal cord at these levels. The posterior margin of the dorsal spinal cord is not well-defined separately from the lesion on the T1 Weighted images. The surrounding CSF space appears effaced. The dorsal spinal cord over the D3 to D9 vertebral levels appears slightly hyperintense on the T2 Weighted images suggesting cord edema/ischemia. The CSF in the dorsal region appears slightly more hyperintense as compared to the normal.
..2/.






After administration of contrast, there is peripheral enhancement of the above described intradural lesions at D4, D5, D8 and D9 vertebral levels with enhancement of the posterior meninges over D2 to D11 vertebral levels.

A small, right paracentral protruded disc with peridiscal osteophyte is noted at the D2-D3 level.

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 D12 vertebral level.

Screening images of the cervical and lumbar spines are unremarkable except for slightly hyperintense signal of the CSF in the lumbar region.

Screening images of the brain reveal an approximately 4.0 mm diameter sized disc-enhancing lesion in the left parieto-occipital parafalcine cortex (scans 114.10). Suspicious patchy enhancement is noted in the region of the left cerebral peduncle.

The ventricular system is unremarkable. There is no midline shift. No basal enhancement is noted.

IMPRESSION :

Intradural-extramedullary, peripherally enhancing mass lesion in the dorsal region, posterior to the dorsal spinal cord at the D4, D5, D8 and D9 vertebral levels as described most likely represents granulation tissue/abscess, in the given clinical setting. Enhancement of the posterior meninges over D2 to D11 levels is noted. Altered cord signal over D3 to D9 vertebral levels may represent cord edema/ischemia.

Focal, disc enhancing lesion in the left parieto-occipital parafalcine cortex would represent a granuloma, in the given clinical setting.
..3/.




- 3 - Scan-00005


As compared to the previous MRI dated 00.00.00 (Study No.00006), there seems to be a decrease in the size of the intradural granulation tissue/abscess on the present study (the previous study was a non-contrast study).

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Gailmn / F / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O cervical lymphadenopathy. Operated in 0000 for the same. Received AKT.
C/O neck pain and severe pain in the right shoulder with restricted movements of the RUE.

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.

4 mm thick T1 Weighted and T2 Weighted coronal (with fat saturation) images.

OBSERVATION :

There are small postero-central disc protrusions at the C3-C4 and C4-C5 levels with anterior indentation of the thecal sac.

A small posterior disc bulge is seen at the C5-C6 level. The cervical intervertebral discs show loss of water content.

No obvious lesion is seen along the brachial plexus.

A subtle mixed signal characteristics lesion is seen on the T1 Weighted images in the D3 vertebral body on the right side. This is seen to turn hyperintense on the T2 Weighted images. There is no bony erosion or destruction seen (scans 105.6, 104.6).

No abnormally enlarged cervical lymphnodes are noted on this study.
..2/.





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.

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and the visualized dorsal spinal cord shows normal signal intensity.

IMPRESSION :

The MRI features are suggestive of :

1. Small postero-central disc protrusions at the C3-C4 and C4-C5 levels.

2. A small posterior disc bulge at the C5-C6 level.

3. Altered signal in the D3 vertebral body on the right side most probably represents a hemangioma.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 30 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE with paresthesias 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 partial sacralization of the L5 vertebral body on the left side.

There is a large posterior disc extrusion at the L4-L5 level with severe compression of the thecal sac and canal stenosis. There is slight inferior migration of the disc with impingement of the L5 nerve roots.

Small postero-central disc herniations are noted at the L1-L2, L2-L3 and L3-L4 levels. The L2-L3 and L4-L5 intervertebral discs show loss of water content.

The L4-L5 facet joints show 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 D12 level and the thecal sac terminates at the S2 level.
..2/.




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

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

IMPRESSION :

The MRI features are suggestive of :

1. Partial sacralization of the L5 vertebral body on the left side.

2. A large posterior disc extrusion at the L4-L5 level with slight inferior migration of the disc impinging the L5 nerve roots and canal stenosis at this level.

3. Small postero-central disc herniations at the L1-L2, L2-L3 and L3-L4 levels.

4. Facetal arthropathy at the L4-L5 level.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzh lmn / M / 32 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 2 years which has increased since 1 1/2 months.
H/O being operated for pelvis with sacro-iliac joints disruption on 00.00.00.

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 sacralization of the L5 vertebra and the L1 vertebra is as marked on the film.

There is retrolisthesis of the L4 over the L5 vertebral body. A pseudo-posterior disc herniation with peridiscal osteophytes is noted at the L4-L5 level with inferior migration of the disc posterior to the L5 vertebral body. The L4-L5 intervertebral disc shows slight loss of water content. A probable, small, sequestered disc fragment is noted at the L5 vertebral level, more to the right of the midline.

A Schmorls node is seen in the superior aspect of the D12 vertebral body with apparent wedging of the D12 vertebra.

Type II degenerative changes are noted in the L4 and L5 vertebral bodies adjacent to the L4-L5 intervertebral disc.


The facet joints in the lower lumbar region appear slightly hypertrophied.

The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. Sacralization of the L5 vertebra.

2. Retrolisthesis of the L4 over the L5 vertebral body.

3. A pseudo-posterior disc herniation with peridiscal osteophytes at the L4-L5 level with inferior migration of the disc posterior to the L5 vertebral body. A probable, small, sequestered disc fragment is noted, at L5 vertebral level, to the right.

4. Slight anterior wedging of D12 body.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyznt Kangulmn / M / 60 yrs.
Referred by : Dr. Abc Xyzmpat / Dr. Abc Xyzat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches with nausea and giddiness since 00.00.00.
Known hypertensive. On Rx.

EXAMINATION :

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

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

Small hyperintense areas on the T2 Weighted images are seen in the right cerebral peduncle (scan 105.8) and are probably ischemic in etiology.

There is mild dilatation of both the lateral ventricles. The third and the fourth ventricles are normal. Slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally is noted. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidental note is made of left maxillary sinusitis and inflammatory changes in the right mastoid air cells.

INTRACRANIAL MRA :

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.


NECK MRA :

There are small filling defect in the proximal internal carotid artery on the left side just after the left common carotid bifurcation which may be due to atherosclerotic plaques.

The common carotid arteries and their extracranial branches appear normal bilaterally.

IMPRESSION :

1. Altered signal in the right cerebral peduncle is
probably ischemic in etiology.

2. Small filling defect in the proximal internal carotid artery on the left side just after the left common carotid
bifurcation may be due to atherosclerotic plaques.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzh Glmn / M / 18 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 3-4 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.

6 mm thick T1 Weighted coronal images.

OBSERVATION :

There are areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images within the right inferior articular facet of the L3 vertebra and the right superior articular facet of the L4 vertebra with involvement of the right L3-L4 facet joint. Areas of hyperintensity on the T2 Weighted images are seen within the paraspinal muscles bilaterally (right more than left) over the L3 to the L5-S1 levels.

The L4-L5 facet joints show degenerative changes.

There is a mild posterior disc bulge at the L5-S1 level.

Hypointense areas on the T1 Weighted images are noted within the sacral ala and iliac wings adjacent to both the sacro-iliac joints.








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.

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
14.0 mm at L3-L4
12.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the L3-L4 facet joints and the adjacent articular facets as described and this most likely is inflammatory/infective (? tuberculosis) in etiology. There is probable involvement of the sacro-iliac joints bilaterally and a dedicated study of the same may be performed if clinically indicated.

The possibility of this being a neoplastic process is less likely.