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Sunday, 27 December 2015 16:48

12648

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzini Vadlmn / F / 36 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backpain radiating to BLE with paresthesias since 10 years.

EXAMINATION :

M.R.I of the dorsal 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 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 :

Normal study of the Dorsal spine.

Sunday, 27 December 2015 16:48

12647

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Zatlmn / F / 72 yrs.
Referred by : Dr. Abc Xyzcha.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias 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 loss of water content of all the lumbar intervertebral discs, except the L1-L2 disc.

A small, posterior and left far lateral disc bulge with peridiscal osteophytes is noted at the L5-S1 level with mild indentation upon the extraforaminal portion of the left L5 nerve root.

A posteriorly herniated disc with peridiscal osteophytes is noted at the L4-L5 level with bilateral neural foraminal narrowing. Mild ligamentum flavum hypertrophy is also seen at this level. The facet joints at the L4-L5 level show slight degenerative changes bilaterally with resultant canal stenosis.

Small posterior peridiscal osteophytes are at the L2-L3 and L3-L4 levels.





Anterior disc herniations with anterior peridiscal osteophytes are noted in the lumbar region.

The lumbar vertebral bodies show spotty fatty marrow changes. 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 :

15.0 mm at L1-L2
15.0 mm at L2-L3
15.0 mm at L3-L4
8.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

1. A small, posterior and left far lateral disc bulge with peridiscal osteophytes at the L5-S1 level with mild indentation upon the extraforaminal portion of the left L5 nerve root.

2. A posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level with slight facetal arthropathy at this level and canal stenosis.

3. Small posterior peridiscal osteophytes at the L2-L3 and L3-L4 levels.







Sunday, 27 December 2015 16:48

12646

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzMerclmn / F / 79 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache with difficulty in walking since 1 month. H/O spinal surgery on 00.00.00 with weakness of BLE and bladder/bowel involvement since then.

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.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There are post-operative changes in the right paravertebral region over atleast the D7 to D11 levels.

Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the D10 and D11 vertebral bodies and pedicles. The D10-D11 intervertebral disc is seen to be involved with erosion of the adjacent cortical endplates.

There is extension of this pathologic process into the anterior epidural space at the D10 and D11 vertebral levels with resultant cord compression. There is slight extension of the soft tissue into the prevertebral region over these levels. There is a large right paravertebral soft tissue lesion seen over the D7 to the D11 levels with absence of the posterior segments of the D10, D9, D8 and the D7 ribs on the right side and probably the right transverse processes over these levels. This lesion shows hypointense signal as compared to fat on the T1 Weighted images and is heterogeneously hyperintense on the T2 Weighted images posteriorly and is hyperintense in the anterior portion.
- 2 - scan-00006


The spinal cord over D10 to the tip of the conus medullaris shows a hyperintense signal on the T2 Weighted images which is iso to hypointense to normal marrow on the T1 Weighted images, suggestive of cord edema/ischemia/myelitis.

Left pleural collection is also noted.

A small well-defined area of hyperintensity on all the pulse sequences is seen within the postero-superior aspect of the D9 vertebral body and this would represent a hemangioma. The rest of the visualized dorsal vertebral bodies show areas of fatty replacement of normal marrow suggestive of osteoporosis.

A Schmorls node is seen in the superior surface of the D9 vertebral body.

The rest of the dorsal intervertebral discs show loss of water content.

IMPRESSION :

The MRI features are suggestive of

1. Post-operative status.

2. Altered cord signal over the D10 to the tip of the conus medullaris most likely represents cord edema/ischemia.

3. Reduction in the anterior epidural collection as compared to the previous MRI study (scan no.00007A).

4. Right paravertebral soft tissue lesion over the D7 to the D11 levels with left pleural collection as described is the sequelae of previous surgery.







Sunday, 27 December 2015 16:48

12645

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzisha Ilmn / F / 30 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O loss of vision of both eyes since 1 1/2 months.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted, T2 Weighted and STIR coronal images.

3 mm thick T1 Weighted sagittal images.

MR cisternogram was obtained in the sagittal plane.

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

OBSERVATION :

There is seen an approximately 2.0 x 1.7 x 2.3 cms sized well marginated, lobulated, intermediate signal intensity mass lesion on the T1 Weighted images in the sella and suprasellar region. This lesion appears relatively hypointense on the T2 Weighted images. The pituitary stalk is not well identified on this study. The optic chiasma and the proximal optic nerves are not well identified separately from the lesion. Effacement of the suprasellar cistern is noted. Probable extension of the lesion into the right cavernous sinus is seen with encasement of the cavernous segment of the right internal carotid artery.

The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. The hypothalamus is unremarkable.



Inflammatory changes are noted in the sphenoid sinus on the left.

Screening images of the brain reveal hyperintense signal on the T2 Weighted images in the frontal deep white matter bilaterally and in the body of the corpus callosum anteriorly.
There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is no midline shift.

The optic nerves bilaterally show normal signal intensity.

IMPRESSION :

1. An approximately 2.0 x 1.7 x 2.3 cms sized lobulated, mass lesion in the sella and suprasellar region most likely represents a pituitary macroadenoma.

A contrast enhanced scan may be worthwhile.

2. Altered signal in the frontal deep white matter bilaterally and in the body of corpus callosum anteriorly as described is not specific for a single etiology. These may represent ischemic lesions or demyelinating plaques.


Sunday, 27 December 2015 16:48

12644

Date : 00.00.00

Name of the Patient : Abc Xyzen lmn / F / 78 yrs.
Referred by : Dr. Abc Xyz Shah / Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall in the morning of 00.00.00 with loss of consciousness.
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 Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a diffuse, intermediate signal on the T1 Weighted images in the paramedullary cisterns, prepontine, interpeduncular, suprasellar and the middle cerebral artery cisterns. This lesion is masked on the T2 Weighted images but appears hyperintense on the FLAIR images. Similar signal is noted in the posterior fossa around the cerebellar hemispheres and in the posterior parietal sulcal spaces bilaterally. This lesion represents subarachnoid haemorrhage. Extension of the haemorrhage into the ventricular system, bilaterally is also noted with fluid level in the occipital horns bilaterally.

There are 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. These lesions appear hypointense to normal white matter on the T1 Weighted images.
Scan-00004


There is mild to moderate dilatation of both the lateral, third and fourth ventricles.

There is no shift of the midline structures.

IMPRESSION :

1. Altered signal in the basal cisternal spaces as described represents subarachnoid haemorrhage. Intraventricular extension of the haemorrhage is also noted. An aneurysm should be ruled out.

2. Altered signal in the periventricular white matter and in the corona radiata and centrum semiovale most likely represents ischemic changes.

3. Mild to moderate dilatation of the ventricular system.

Sunday, 27 December 2015 16:48

12643

sb/bv/nl/rg.
can No : 00003 Date : 00.00.00

Name of the Patient : Abc Xyz Ghlmn / F / 24 yrs.
Referred by : Dr. Abc Xyzhatt.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O backache and weakness of the RUE since 10-12 days.
Known C/O rheumatoid arthritis, M.S and lymph node tuberculous. Completed AKT 2 months back.

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 an ill-defined, hypointense signal on the T1 Weighted images involving the marrow of the tip of the odontoid process and probably the right lateral mass of C2, superiorly. This lesion appears heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. The periodental fat is effaced with the atlanto-axial joint showing increased signal on the T2 Weighted images. The transverse ligament is well identified. There is no atlanto-dens subluxation. Minimal soft tissue extension of the lesion is noted in the right paravertebral and right anterior epidural region at C1-C2 level.

The rest of the cervical vertebral bodies and the intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.

The cervical spinal cord reveals normal signal intensity.


The cervico-medullary junction is unremarkable.

Incidentally noted are lymph nodes deep to the sternocleidomastoid muscles bilaterally measuring upto 1.5 cms in maximum dimension.

Probable scarring is noted at the apex of the lungs on either side.

Screening, T2 Weighted axial images of the brain reveal inflammatory changes in the ethmoidal air cells bilaterally. No other significant abnormality is detected.

IMPRESSION :

Altered signal in the tip of the odontoid process and probably the right lateral mass of C2, superiorly, as described is not specific for a single etiology. In a known C/O tuberculous lymphadenitis, these changes most likely represent tuberculous osteitis with granulation tissue in the right paravertebral region at that level. The possibility of these changes being due to rheumatoid arthritis seems less likely.
Sunday, 27 December 2015 16:48

12642

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzKhlmn / M / 47 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness on 00.00.00 and numbness in the LUE since 2 days.
H/O Pulmonary kochs in 0000. Received AKT.

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 seen a well marginated, approximately 8.0 mms diameter sized hyperintense lesion with a hypointense rim on the proton and T2 Weighted images in the subcortical white matter in the right posterior parietal region. This lesion is of intermediate signal on the T1 Weighted images. There is mild perilesional edema. No definite scolex can be identified on this study.

The calcified lesion seen in the left high parietal region on CT Scan is not well-identified on this MRI study.

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 :

An approximately 8.0 mms diameter sized lesion in the subcortical white matter in the right posterior parietal region as described follows the signal characteristics of a cysticercus in the colloid-vesicular stage.
Sunday, 27 December 2015 16:48

12641

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Batilmn / F / 29 yrs.
Referred by : Dr. Abc Xyznshah.
Examination : M.R.I. of the Right Wrist.

CLINICAL PROFILE :

H/O pain in the right hand.

EXAMINATION :

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

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

3 mm thick T1 Weighted and STIR coronal images.

3 mm thick T1 Weighted and GRASS sagittal images.

OBSERVATION :

The carpal bones of the right wrist show normal alignment and signal intensity. There is no obvious bone erosion or destruction seen. The intercarpal, radiocarpal and carpo- metacarpophalangeal joints are unremarkable. No joint effusion is noted. The soft tissues around the right wrist appear normal.

IMPRESSION :

Normal study of the Right Wrist.

Sunday, 27 December 2015 16:48

12640

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzal Plmn / M / 5 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain and swelling over the left hip joint with inability to walk since 2 months.
H/O fall prior to this.

EXAMINATION :

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

4 mm thick T1 Weighted and STIR coronal images.

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

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a fairly large, approximately 6.0 x 6.0 x 7.0 cms sized, well marginated, expansile, heterogeneous signal intensity mass lesion in the proximal metaphysis of the left femur. This lesion is iso to hyperintense to the normal muscle on the T1 Weighted images and appears heterogeneously hyperintense on the T2 Weighted and STIR images. Multiple, fluid-fluid levels are noted within this lesion. Hyperintense signal on the T1 Weighted images, within this lesion, in some places, may represent haemorrhage/high protein content fluid. Periosteal reaction is noted around the left femur just distal to this lesion for a distance of about 4.5 cms. The zone of transition between the mass lesion and the normal marrow appears sharp. The muscles and the subcutaneous fat around the mass lesion in the proximal left thigh show a hyperintense signal on the T2 Weighted and STIR images may represent soft tissue edema. There is a small left hip joint effusion noted. There is no vascular encasement identified.



There is no definite involvement of the left hip joint per se. The left acetabulum and the epiphysis of the left femoral head are unremarkable.

The visualized right hip joint appears normal.

IMPRESSION :

A fairly large, approximately 6.0 x 6.0 x 7.0 cms sized, well marginated, expansile, mass lesion in the proximal metaphysis of the left femur as described is not specific for a single etiology. Multiple fluid-fluid levels within the lesion favours the diagnosis of an aneurysmal bone cyst. Giant cell tumor may be considered as a differential diagnosis.

The possibility of this being a neoplastic process like an osteogenic sarcoma cannot be entirely ruled out, though less likely.


Sunday, 27 December 2015 16:48

12639

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzdin Glmn / M / 42 yrs.
Referred by : Dr. Abc Xyzhtekar.
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.

OBSERVATION :

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

The hippocampal complex on either side is unremarkable. The right temporal horn appears a little larger and may be a normal variant.

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 sphenoid sinus, ethmoidal air cells and frontal sinus. Note is also made of a deviated nasal setum to the left side.

IMPRESSION :

No abnormality detected within the brain on this study.