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Sunday, 27 December 2015 16:48

12669

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyza R. Klmn / F / 48 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache 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 a postero-central and right paracentral disc extrusion at the L5-S1 level with anterior indentation of the thecal sac. There is inferior migration of the disc fragment which is seen to lie in the right lateral recess of the S1 vertebra with mild indentation upon the right S1 nerve root.

A small, postero-central and bilateral far lateral disc herniation is seen at the L4-L5 level.

Mild ligamentum flavum and facetal hypertrophy is seen at the L5 and S1 levels. The L4-L5 and L5-S1 intervertebral discs show loss of water content.

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.
- 2 - Scan-00009

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

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

IMPRESSION :

The MRI features are suggestive of :

1. A postero-central and right paracentral disc extrusion at the L5-S1 level with inferior migration of the disc fragment which is seen to lie in the right lateral recess of the S1 vertebra, with mild indentation upon the right S1 nerve root.

2. A small, postero-central and bilateral far lateral disc herniations at the L4-L5 level.

3. Mild ligamentum flavum and facetal hypertrophy at the L5 and S1 levels.







Sunday, 27 December 2015 16:48

12668

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz. Ralmn / F / 15 yrs.
Referred by : Dr. Abc XyzShah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache since 2-3 months with fever and loss of appetite and weight since then.
C/O weakness of BLE since 3 days.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is slight anterior wedging of the D8 vertebral body with forward translation of the D7 over the D8 vertebra with a resultant kyphus at that level.

There is replacement of the normal marrow of the D5, D6, D7, D8 and D9 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The pedicles of these vertebrae and the posterior appendages of the D7 and D8 vertebrae are involved by the pathology. The superior and inferior cortical endplates of the D8 and D7 vertebrae are breached with involvement of the D7-D8 intervertebral disc. There is pre and paravertebral soft tissue extension over the D5 to D9 vertebral levels which is hypointense with a hyperintense periphery on the T1 Weighted images and turns hyperintense on the T2 Weighted images and would





represent abscess formation. The costo-vertebral and costo-transverse joints at the D7-D8 and D8-D9 levels are involved. There is slight extension into the posterior paraspinal soft tissues at the D7 and D9 vertebral levels. There is circumferential epidural extension of the soft tissue lesion over the D7 and D8 levels with severe compression of the spinal cord at the D7-D8 and D8 levels. The spinal cord at these levels shows a subtle hyperintense signal on the T2 Weighted images (isointense to normal cord on the T1 Weighted images) suggestive of cord edema/ischemia/myelitis.

The aorta and IVC are displaced anteriorly by the pre and paravertebral soft tisse lesion.

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

The conus medullaris terminates at the D12-L1 level.

The cervico-dorsal and the dorso-lumbar spines were screened with 5 mm thick T1 Weighted sagittal images and do not reveal any diagnostic feature of note.

IMPRESSION :

Altered signal of the D5, D6, D7, D8 and D9 vertebral bodies and the D7-D8 intervertebral disc suggests osteitis discitis, most likely tuberculous in etiology. Pre and paravertebral soft tissue lesion over the D5 to D9 vertebral levels may suggest an abscess formation. There is cord compression and cord signal alteration over the D7-D8 to D8 levels suggestive of cord edema/ischemia/myelitis.

The possibility of a round cell tumor seems less likely.

Sunday, 27 December 2015 16:48

12667

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 34 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with diplopia, diminished vision and squint in the right eye since March 0000.

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.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

The optic nerves show normal signal intensity on the STIR images bilaterally. The cavernous sinuses and the suprasellar cistern 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. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

No other significant abnormality is detected within the brain on this study.

Sunday, 27 December 2015 16:48

12666

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzapilmn / F / 15 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with tingling in BLE since 4-5 months.
H/O TB at the age of 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 vertebra on the left.

There is mild posterior subluxation of the L4 over the L5 vertebra.

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

Transepiphyseal herniation of the D12-L1 and L2-L3 discs is seen at the antero-superior margin of the L1 and L3 vertebral bodies, respectively, with adjacent Type II degenerative marrow changes. These discs are reduced in height.

The rest of 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 D12-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 :

18.0 mm at L1-L2
17.0 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. Partial sacralization of the L5 vertebra on the left.

2. A small posterior disc bulge with peridiscal osteophytes at the L4-L5 level.







Sunday, 27 December 2015 16:48

12665

Date : 00.00.00

Name of the Patient : Abc Xyza G. Jalmn / F / 47 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O insect bite at night with fall from bed 1 month back followed with abnormal behaviour, irrelevant talk and forgetfulness since then.

EXAMINATION :




OBSERVATION :

There is a subtle hyperintense signal on the FLAIR images along the gyri in the temporo-parietal and occipital parafalcine regions bilaterally and in the thalami and frontal regions bilaterally, better appreciated on the FLAIR images.

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 mild bilateral maxillary sinusitis.

IMPRESSION :

The MRI features are suggestive of altered signal along the gyri in the temporo-parietal and occipital parafalcine regions bilaterally and in the thalami and frontal regions bilaterally. These changes are not specific for a single etiology.

Hypoxic-ischemic etiology is a likely possibility.

The possibility of encephalitis is less likely.


Sunday, 27 December 2015 16:48

12664

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzN. Amlmn / F / 59 yrs.
Referred by : Dr. Abc Xyzadkat.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the LUE and tingling with swelling in the left axillary region and a lump in the left arm distally, since 1 month.
H/O left mastectomy 6 years back. Received chemotherapy.

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 :

Small posterior disc herniations with peridiscal osteophytes are noted at the C3-C4, C4-C5 and C5-C6 levels with anterior indentation of the thecal sac.

A small postero-central disc protrusion is noted at the C2-C3 level.

The cervical intervertebral discs show loss of water content.

The cervical vertebral bodies show fatty marrow changes suggesting osteoporosis. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
scan-00004

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. Small posterior disc herniations with peridiscal osteophytes at the C3-C4, C4-C5 and C5-C6 levels.

2. A small postero-central disc protrusion at the C2-C3 level.

Sunday, 27 December 2015 16:48

12663

ke/sb/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O squint in the left eye since 15 days with diplopia.
H/O fever prior to this.

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 are ill-defined, hypointense areas within the medulla, posterior aspect of the pons, bilateral cerebellar hemispheres, right temporal lobe, right frontal region and in bilateral high frontal and right high parietal regions on the T2 Weighted images. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images. Few of these lesions show a hyperintense signal on the T2 Weighted images. There is mild surrounding edema with mass effect and effacement of the adjacent sulci in the frontal region. There is mild indentation upon the frontal horn of the right lateral ventricle.

The left 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 :

The MRI features are suggestive of areas of altered signal within the medulla, posterior aspect of the pons, bilateral cerebellar hemispheres, right temporal lobe, right frontal region and bilateral high frontal and right high parietal regions. These may represent granulomatous infective lesions like tuberculomas.

A contrast enhanced scan would be mandatory.
Sunday, 27 December 2015 16:48

12662

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzN. Amlmn / F / 59 yrs.
Referred by : Dr. Abc Xyzadkat.
Examination : M.R.I. of the Neck.

CLINICAL PROFILE :

C/O neck pain radiating to the LUE and tingling with swelling in the left axillary region and a lump in the left arm distally, since 1 month.
H/O left mastectomy 6 years back. Received chemotherapy.

EXAMINATION :

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

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

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

The visualized spaces of the neck and the carotid sheaths bilaterally appear to be normal. No obviously enlarged lymphnodes are evident on this scan.

The thyroid and salivary glands show normal configuration and signal characteristics. The visualized cervical vertebrae show spotty fatty marrow changes and no obvious bone destruction is evident.

IMPRESSION :

No significant abnormality is detected on this study.


Sunday, 27 December 2015 16:48

12661

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzN. Amlmn / F / 59 yrs.
Referred by : Dr. Abc Xyzadkat.
Examination : M.R.I. of the Upper Thorax & Axillae.

CLINICAL PROFILE :

C/O neck pain radiating to the LUE and tingling with swelling in the left axillary region and a lump in the left arm distally, since 1 month.
H/O left mastectomy 6 years back. Received chemotherapy.

EXAMINATION :

M.R.I of the upper thorax and axillae was performed using the following parameters :

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

5 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

The left breast is not visualized the result of previous surgery.

No obvious mass lesion is identified in the visualized anterior chest wall.
No enlarged lymphnodes are identified in the axillae on either side or in the visualized mediastinum. No obvious vascular anomaly is noted.
IMPRESSION :

Status left mastectomy with no obvious anomaly detected in the visualized upper thorax and axillae on either side.

Sunday, 27 December 2015 16:48

12660

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz V. Banalmn / F / 76 yrs.
Referred by : Dr. Abc Xyzorude.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness since several years.
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 coronal images.

OBSERVATION :

Ill-defined, hyperintense signal on the T2 Weighted and FLAIR images in the right posterior parietal-periventricular white matter may represent ischemic changes.

There is mild dilatation of both the lateral ventricles.

The 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.

Incidentally noted is a mega cisterna magna.

IMPRESSION :

Altered signal in the right posterior parietal-periventricular white matter may represent ischemic changes.

No other significant abnormality is detected on this study.