sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzhalmn / M / 50 yrs.
Referred by : Dr. Abc Xyzraf.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

H/O fall of heavy weight over the head 7 years back.
C/O progressive weakness of all four extremities, giddiness and loss of speech (since 4 years) since 6 years.
Known hypertensive.

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.

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

OBSERVATION :

There is slight anterior wedging of the C6 vertebral body without change in signal intensity. There is loss of normal cervical lordosis and loss of water content of the cervical intervertebral discs.

Small posterior peridiscal osteophytes are noted at the C3-C4 and C5-C6 levels.

A small posterior disc bulge with peridiscal osteophytes is noted at the C6-C7 level, indenting the dural theca anteriorly.





The left sided joint of Luschka at the C5-C6 level shows slight degenerative changes with left neural foraminal narrowing.

Slight hypertrophy of the facet joints is noted at the C4-C5 and C5-C6 levels.

The cervical vertebral bodies show spotty fatty marrow changes. The rest of 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 T2 Weighted axial images of the brain reveal a lacune in the left lentiform nucleus with mild cerebral cortical atrophy. Note is made of left maxillary sinusitis.

IMPRESSION :

1. Slight anterior wedging of the C6 vertebral body without change in signal intensity.

2. Small posterior peridiscal osteophytes at the C3-C4 and C5-C6 levels.

3. A small posterior disc bulge with peridiscal osteophytes at the C6-C7 level.

4. Degenerative changes of the left sided joint of Luschka at the C5-C6 level.

5. Slight hypertrophy of the facet joints at the C4-C5 and C5-C6 levels.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzMalmn / M / 32 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O generalized tonic/clonic convulsion on 00.00.00 at 4.00 pm with loss of consciousness since then.

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 an ill-defined, hyperintense signal on the proton, T2 Weighted, FLAIR and Fast Scan (T2 *) images along the cortex in the left temporo-parieto-occipital region. This lesion appears hypointense to normal grey matter on the T1 Weighted images and represents a recent ischemic insult. On the Fast Scan (T2 *) images there are some areas which appear significantly hypointense, suggesting acute haemorrhage within the lesion. There is sulcal space effacement, compression of the left lateral and third ventricles and shift of the midline structures to the right. There is also transtentorial herniation of the left medial temporal pole, distortion of the upper brainstem axis and effacement of the suprasellar and ambient cisterns. A small, left fronto-parietal subdural effusion is also noted. The sulcal/gyral differentiation in the right cerebral hemisphere is also not well appreciated.

The fourth ventricle is normal.


The left internal carotid artery appears smaller in calibre as compared to the opposite side.

Inflammatory changes are noted in the right maxillary antrum.

IMPRESSION :

The MRI features suggest a fairly large, left temporo-parieto- occipital haemorrhagic infarct with mass effect as described.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 51 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. - Brain (Post-contrast Study).

CLINICAL PROFILE :

C/O speech disturbance since 3-4 months.
Known hypertensive.

EXAMINATION :

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial, coronal and sagittal images with magnetization transfer.

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

The cervical spine was screened with 5 mm thick T1 Weighted sagittal and axial images (with fat saturation).

OBSERVATION :

After administration of contrast, there is enhancement of the previously described plaque like lesion. This lesion is seen to extend along the posterior margin of the clivus upto the C3 vertebral level. The lesion is most likely an epidural lesion. Minimal indentation on the cervico-medullary junction and on the anterior dural theca at the C2 and C3 vertebral levels is noted.

Artifacts due to dentures are noted.

There is no other focal area of abnormal enhancement within the brain parenchyma or along the meninges.

The previous differential diagnosis are still valid.

Please let us have the follow-up.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Palmn / M / 25 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O weakness of the RUE since 3 years.
C/O weakness of the LUE since 1 year.

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 loss of normal cervical lordosis and loss of water content of the C3-C4 and C5-C6 intervertebral discs.

There is a right paracentral disc herniation at the C5-C6 level.

The cervical spinal cord at the C5 and C6 vertebral levels appears atrophied. There is an ill-defined hypointense signal on the T1 Weighted images in the cervical spinal cord at the C5-C6 level. This lesion appears hyperintense on the T2 Weighted and Fast Scan (T2 *) images.

Small postero-central protruded disc with peridiscal osteophytes is noted at the C3-C4 level and a small left paracentral protruded disc is noted at the C4-C5 level.

A hyperintense signal seen in the posterior column of the spinal cord at the C3-C4 level on the T2 Weighted sagittal images is not seen on the axial scans and is most likely artifactual.
..2/.







The cervical vertebral bodies and the remaining intervertebral discs 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 :

1. Atrophy of the cervical spinal cord at the C5 and C6 vertebral levels with cord signal alteration at the C5-C6 level may suggest myelomalacia.

2. A right paracentral disc herniation at the C5-C6 level.

3. Small postero-central protruded disc with peridiscal osteophytes at the C3-C4 level and a small left paracentral protruded disc at the C4-C5 level.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzedali Shlmn / M / 35 yrs.
Referred by : Dr. Abc Xyzchani / Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

C/O pain in the right knee joint since 1 year.
H/O Click +.

EXAMINATION :

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

4 mm thick T1 Weighted, proton and GRASS sagittal images.

4 mm thick T1 Weighted and STIR coronal images.

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

OBSERVATION :

There is seen a well-marginated, approximately 6.2 x 4.1 x 6.5 cms sized intermediate signal intensity mass lesion on the T1 Weighted images in the distal end of the right femur. This lesion appears heterogeneously hyperintense on the T2 Weighted and STIR images. Resultant thinning of the cortex along the medial and posterior margin of the right femur is noted. Suspicious break of the cortex is noted along the posterior and medial margin of the distal left femur (se/im. 108.15, 16). The zone of transition between the normal and abnormal marrow is well-defined. The lesion is seen to extend well upto the distal margin of the right femur. There is however, no definite extension of the lesion into the right knee joint.





The menisci and the cruciate ligaments of the right knee joint are unremarkable. The collateral ligaments, patellar tendon and the visualized patella are unremarkable. There is no right knee joint effusion.

IMPRESSION :

An approximately 6.2 x 4.1 x 6.5 cms sized mass lesion in the distal end of the right femur as described, is not specific for a single etiology. A giant cell tumor is a likely possibility.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyze Jalmn / M / 19 yrs.
Referred by : Dr. Abc Xyzmat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches, giddiness, gait ataxia and speech disturbances since 7 years.

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

There is flattening of the skull vault in the right fronto-parietal region with resultant bulge of the midline to the left. There is however, no mass lesion identified in the brain parenchyma.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

Incidentally noted in pansinusitis.

IMPRESSION :

1. Flattening of the skull vault in the right fronto-parietal region.

2. Pansinusitis.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzai Vedalmn / F / 60 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O giddiness with fall on 00.00.00 with loss of consciousness and left sided hemiplegia since then.

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 diffuse, hyperintense signal on the proton and T2 Weighted images involving the cortex and subcortical white matter in the right fronto-temporo-parietal region and in the right lentiform nucleus and head of right caudate nucleus. This lesion appears hypointense to normal white matter on the T1 Weighted images. There is resultant effacement of the sulcal spaces in the right fronto-temporo-parietal region with compression of the right lateral ventricle and mild bulge of the midline structures
to the left. There is no obvious haemorrhage in the right fronto-temporo-parietal region on this study.

There is a very small, approximately 0.5 cm diameter sized hyperintense focus on all the pulse sequences in the precentral gyrus. No perilesional edema or mass effect is noted (scans 104.16, 103.16, 105.7).

There is mild dilatation of the left lateral ventricle. The third and the fourth ventricles are normal. There is prominence of the cerebral cortical sulci on the left and the basal cisternal spaces. The petrous and cavernous segments of the right internal carotid artery do not show the normal flow void signal.
..2/.






IMPRESSION :

1. Altered signal involving the cortex and subcortical white matter in the right fronto-temporo-parietal region and in the right lentiform nucleus and head of right caudate nucleus represents a recent infarct in the distribution of the right ACA and MCA territories.

2. Loss of normal flow in the petrous and cavernous segments of the right internal carotid artery may suggest slow flow/thrombus.

3. Altered signal intensity lesion in the left precentral sulcus as described is not specific for a single etiology. This lesion may represent a calcific focus or deposition of paramagnetic substances.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza B. Dlmn / F / 45 yrs.
Referred by : Dr. Abc Xyzoregaonkar.
Examination : M.R.I. of the Right Femur.

CLINICAL PROFILE :

C/O pain in the RLE with paresthesias since 1 month.
H/O Pulmonary kochs since 6 months. On AKT since then.

EXAMINATION :

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

3 mm thick STIR and GRASS coronal images.

4 mm thick T1 Weighted and Proton density sagittal images.

5 mm thick T1 Weighted axial images.

OBSERVATION :

There is a well-defined hypointense signal in the subcapital region of the right femur involving both cortices on the T1 Weighted images. This lesion remains hypointense to normal marrow signal on the T2 Weighted and Fast Scan (T2 *) images. There is surrounding edema.

There is seen a linear hypointense signal on all the pulse sequences in the proximal shaft of the right femur approximately 3.5 cms inferior to the lesser trochanter involving both cortices and the medulla. Mild periosteal thickening is noted in that region along the medial margin of the right femur. There is also surrounding edema.





Minimal fluid is noted in the right hip joint.

The right acetabulum is unremarkable. The right femoral head shows normal contour.

IMPRESSION :

1. Areas of altered signal in the subcaptial region of the right femur is most likely the result of a fracture (? stress induced) with surrounding edema.

2. Altered signal in the proximal shaft of the right femur approximately 3.5 cms inferior to the lesser trochanter may also represent a fracture.

The possibility of these representing Loosers zone may also be considered in the differential diagnosis.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzue Kalmn / M / 55 yrs.
Referred by : Dr. Abc Xyz Chauhan.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness, nausea, uneasiness and gait imbalance since 8-10 years.

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.

4 mm thick T1 Weighted coronal images through the posterior fossa.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebellar folia bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the paranasal sinuses.

The cranio-vertebral junction is unremarkable.

IMPRESSION :

Slight prominence of the cerebellar folia bilaterally.

No other significant abnormality is detected on this study.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Almn / M / 42 yrs.
Referred by : Dr. Abc Xyzsari.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 3-4 years.

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 scoliosis of the lumbar spine with convexity to the left. Lateral wedging of L2 vertebral body on right with lateral subluxation of the L2 vertebral body to the left is noted. Slight clockwise rotational anomaly of the L1, L2 and L3 vertebrae is noted. The thecal sac is hence identified more to the right of the midline over these levels.

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

Generalized, small, posterior and bilateral far lateral disc bulges are noted at the L3-L4 and L4-L5 levels.

Right postero-lateral and right far lateral disc bulges with peridiscal osteophytes are noted at the L1-L2 and L2-L3 levels.






The facet joints at the L1-L2, L2-L3 and L5-S1 levels show slight degenerative changes bilaterally.

Type II degenerative marrow changes are noted adjacent to the L1-L2 disc and Type I degenerative marrow changes are noted adjacent to the L2-L3 disc. A hemangioma with fat content is noted in the L3 vertebral body.

The rest of the lumbar vertebral bodies reveal normal signal intensity. 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 S1-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
16.0 mm at L2-L3
20.0 mm at L3-L4
18.0 mm at L4-L5
17.0 mm at L5-S1.

IMPRESSION :

1. Scoliosis of the lumbar spine with convexity to the left with lateral wedging of the L2 body on the right and lateral subluxation of the L2 vertebral body to the left is noted.

2. Right postero-lateral and right far lateral disc bulges with peridiscal osteophytes at the L1-L2 and L2-L3 levels.

3. Slight degenerative changes of the facet joints at the L1-L2, L2-L3 and L5-S1 levels, bilaterally.