ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Walmn / M / 49 yrs.
Referred by : Dr. Abc Xyzi.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to the RUE since 1 month.

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 right postero-lateral disc herniation with peridiscal osteophytes at the C6-C7 level with right neural foraminal narrowing and indentation upon the right C7 nerve root.

Mild facetal hypertrophy is seen at the C4-C5 and C5-C6 levels.

The cervical intervertebral discs show loss of water content.

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.

IMPRESSION :

A right postero-lateral disc herniation with peridiscal osteophytes at the C6-C7 level with indentation upon the right C7 nerve root.

ke/hs/nl/nl
/08 Date : 00.00.00

Name of the Patient : Abc Xyzu Jlmn / M / 67 yrs.
Referred by : Dr. Abc Xyzogle.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

Alleged H/O fall on 00.00.00 with heaviness of head since then.
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.

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

OBSERVATION :

BRAIN :

There are hypointense areas in the right cerebellar hemisphere, centre of the pons, bilateral thalami, corona radiata and centrum semiovale, right middle cerebellar peduncle and the periatrial white matter on the T1 Weighted images. These are hypointense to white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.

Lacunar infarcts (iso to hyperintense to CSF) are noted in the lentiform nuclei bilaterally.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal.
Scan-00006/08

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

The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidental note is made of bilateral maxillary sinusitis.

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 :

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Altered signal in the right cerebellar hemisphere, centre of the pons, bilateral thalami, corona radiata and centrum semiovale, right middle cerebellar peduncle and the periatrial white matter are suggestive of areas of ischemia/infarction.

2. Lacunar infarcts in the lentiform nuclei bilaterally.

3. No significant abnormality is detected on the intracranial and neck MRA on this study.

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzAgalmn / M / 14 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the left hip with difficulty in squatting since 5-7 months.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick Gradient sagittal images.

OBSERVATION :

There is minimal effusion within the right hip joint.

The femoral epiphysis shows normal signal intensity and normal contour and height.

The femoral head and the acetabulum reveal normal signal intensity bilaterally. There is no obvious bony destruction or erosions noted. The articular cartilages are unremarkable.
The musculature surrounding both the hip joints and the visualized pelvis is normal.

IMPRESSION :

No significant abnormality is detected on this study.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Almn / F / 28 yrs.
Referred by : Dr. Abc Xyz Sampat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O miliary kochs in February 0000. On AKT since then.
For follow-up.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

4 mm thick FLAIR coronal images.

After administration of contrast, the following parameters were used :5 mm thick T1 Weighted axial and coronal images with magnetization transfer. 5 mm thick T1 Weighted sagittal images. OBSERVATION :
There is a focal hyperintense area on the proton, T2 Weighted and FLAIR images within the left occipital, left high parietal and left frontal lobes. After contrast administration, this area shows disc/ring enhancement.

Focal hypointensities on the FLAIR images are noted within the left frontal, left parietal and left temporal lobes (would represent granulomas ? calcified).




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 :

In a known C/O miliary tuberculosis the MRI features are suggestive of multiple tuberculomas in the left cerebral hemisphere as described.
As compared to the previous MRI (study no:0000) dated 00.00.00, there is a definite decrease in the size of lesions with no perilesional edema.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzDhlmn / F / 22 yrs.
Referred by : Dr. Abc Xyzzzare.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O loss of vision with forgetfullness since 1 month.
Similar episode 8 years ago.

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.
3 mm thick STIR coronal images through the optic nerves.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined hypointense areas in the left occipito-parietal region and in the right temporo-parieto-occipital region on the T1 Weighted images with involvement of the optic radiation bilaterally. These are seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. There is loss of underlying white matter with focal prominence of the atrium of the left lateral ventricle. An area following CSF characteristics is observed in the right temporal lobe.

There are hyperintense areas in the periventricular deep white matter in the fronto-parietal regions bilaterally on the proton, T2 Weighted and FLAIR images. These are iso to hypointense to normal white matter on the T1 Weighted images.

There is thinning of the corpus callosum with involvement of the genu and splenium.





There is fullness of the ventricular system. There is prominence
of the cerebral cortical sulci and the cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

The optic nerves show normal signal intensity on the STIR images.

Incidental note is made of bilateral maxillary sinusitis.

IMPRESSION :

Nearly symmetric white matter changes in the left occipito-parietal and right temporo-parieto-occipital regions and periventricular deep white matter in the fronto-parietal regions bilaterally also to some extent involving the grey matter with thinning of the corpus callosum, tissue loss and cerebral and cerebellar atrophy is not specific for a single etiology.

This probably represents a long standing demyelinating disorder or neurodegenerative disorder. Subacute sclerosing panencephalitis should be ruled out. Possibility of ischemic lesions seems less likely.

sb/bv/nl/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O neckpain radiating to the LUE since 3 months.

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.

5 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

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

There is a left postero-lateral (foraminal) disc herniation with peridiscal osteophyte at the C6-C7 level with left neural foraminal narrowing and indentation on the traversing left C7 nerve root (scans 105.16, 104.16, 102.3, 103.4).

Small postero-central protruded discs with peridiscal osteophytes is noted at the C4-C5 and C5-C6 levels.

The cervical vertebral bodies show spotty fatty marrow changes suggesting osteoporosis. 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.

Centimetre and subcentimetre lymph nodes are identified deep to the sternocleidomastoid muscles bilaterally.

The coronal images through the brachial plexus do not reveal any significant feature of note.

IMPRESSION :

A left postero-lateral (foraminal) disc herniation with peridiscal osteophyte at the C6-C7 level with indentation on the traversing left C7 nerve root.

ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzAlmn / M / 23 yrs.
Referred by : Dr. Abc Xyz Hashim.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with numbness since 2-3 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 :

Posterior disc bulges are seen to indent the thecal sac at the L4-L5 and L5-S1 levels.

The lumbar 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 the 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 :

19.0 mm at L1-L2
17.0 mm at L2-L3
17.0 mm at L3-L4
15.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of posterior disc bulges at the L4-L5 and L5-S1 levels.

ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzdas Slmn / M / 48 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias since 3 months.
H/O laminectomy in the lumbar region 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 :

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

There is a right postero-lateral and right paracentral disc herniation at the L5-S1 level with posterior peridiscal osteophytes. This disc shows loss of water content. The traversing right S1 nerve root appears a little enlarged and may be inflamed.

A posterior disc bulge is seen at the L4-L5 level.

The L4-L5 and L5-S1 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.
- 2 - Scan-00000


The conus medullaris terminates at the 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 :

13.0 mm at L1-L2
13.0 mm at L2-L3
17.0 mm at L3-L4
18.0 mm at L4-L5.

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. A right postero-lateral and right paracentral disc herniation at the L5-S1 level with posterior peridiscal osteophytes. There is probable inflammation of the traversing right S1 nerve root.

3. A posterior disc bulge at the L4-L5 level.

4. Facetal arthropathy at the L4-L5 and L5-S1 levels.

ke/sb/rg/nl
Date : 00.00.00Name of the Patient : Abc Xyzben lmn / F / 63 yrs.Referred by : Dr. Abc Xyzshar.Examination : M.R.I. of the Brain.
CLINICAL PROFILE : Known C/O adenocarcinoma of lung with metastasis to the brain. Gamma knife radiosurgery for the brain metastasis was performed in August 0000. For follow-up.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.
After administration of contrast, the following parameters were used :5 mm thick T1 Weighted axial and coronal images with magnetization transfer.5 mm thick T1 Weighted sagittal images.OBSERVATION :There is seen an approximately 4.2 x 3.5 x 3.2 cms sized well marginated, predominantly hyperintense lesion on the proton, T2 Weighted and FLAIR images in the left parieto-occipital-parafalcine region. This lesion appears hypointense on the T1 Weighted images. Faint hyperintense signal is noted within this lesion on the T1 Weighted images (? paramagnetic substances, ?? haemorrhage). This lesion enhances
Scan-00009



patchily after contrast administration. There is perilesional edema with effacement of the sulcal spaces in the left parieto-occipital region and mild compression and anterior displacement of the occipital horn and atrium of the left lateral ventricle. Edema is also seen to encroach into the splenium of the corpus callosum on the left side and the posterior limb of the internal capsule.
A smaller, ring enhancing lesion is noted in the right parieto-occipital region, measuring approximately 1.2 cms in maximum transverse dimension. Mild perilesional edema is also noted around this lesion. Another very small, enhancing focus is noted in the right posterior temporo-occipital region. Small bright foci on FLAIR images are noted in the frontal white matter bilaterally. The right 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.There is no other focal area of abnormal enhancement in the brain parenchyma or the meninges.IMPRESSION :The MRI features suggest multiple metastasis in the brain parenchyma as described above. As compared to the previous MRI (study no:00002) dated 00.00.00, there is increase in the size of the lesions, especially in the left parieto-occipital parafalcine region and the surrounding edema.

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz V. Varlmn / M / 85 yrs.
Referred by : Dr. Abc Xyzonawalla.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

H/O fall 1 year ago.
C/O backache radiating to BLE with paresthesias since 8 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 :

There is scoliosis of the lumbar spine with slight convexity to the right.

There is wedging of the L3 vertebral body which shows hypointense signal replacing the normal marrow on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the T2 Weighted images. There is slight bulging of the vertebral body in the pre and paravertebral soft tissues which is hyperintense on the T2 Weighted images. Indentation on the anterior dural theca by the postero-superior margin of L3 is noted.

There is mild forward subluxation of the L4 over the L5 vertebra. A pseudo-posterior disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. The L4-L5 facet joints show degenerative changes, right more than left with resultant lateral canal stenosis.

- 2 - scan-00008

A posterior and left far lateral disc herniation is noted at the L3-L4 level with anterior indentation of the thecal sac and left neural foraminal narrowing.

There is a posterior and bilateral far lateral disc herniations with peridiscal osteophytes at the L2-L3 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing.

The lumbar facet joints show degenerative changes.

The lumbar intervertebral discs expect for the L2-L3 disc show loss of water content.

The visualized dorsal, rest of the lumbar and sacral vertebral bodies and the iliac bones show fatty marrow changes suggestive of osteoporosis.

The visualized prevertebral 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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. Wedging of the L3 vertebral body with altered signal is most likely due to osteoporotic collapse with bone edema as described.
..3/.





- 3 - Scan-00008


The possibility of this being a pathological fracture cannot be ruled out though less likely.

2. Mild forward subluxation of the L4 over the L5 vertebra with a pseudo-posterior disc herniation at the L4-L5 level
and facetal arthropathy, right more than left with resultant lateral canal stenosis at this level.

3. A posterior and left far lateral disc herniation at the L3-L4 level.

4. A posterior and bilateral far lateral disc herniations with peridiscal osteophytes at the L2-L3 level.

5. Mild facetal arthropathy in the lumbar region.

6. Osteoporotic changes in the rest of the visualized vertebrae and bony pelvis.