hs/bv/nl/rg.
A Date : 00.00.00

Name of the Patient : Abc Xyzi Merclmn / F / 59 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 8-10 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.
5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

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. The cord over these levels shows a subtle hyperintense signal on the T2 Weighted images and which may represent cord edema/ischemia/myelitis. Also seen is extension into the pre and paravertebral soft tissues over these levels. There is also extension into the D10-D11 neural foramina bilaterally with encasement of the foraminal D10 nerve roots.

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.
..2/.





- 2 - Scan-00007A


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

The cervical spine was screened with 5 mm thick T1 Weighted sagittal images and does not show any diagnostic feature of note.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the D10 and D11 vertebrae and the D10-D11 intervertebral disc with cord compression and cord edema/ischemia/myelitis as described. This most likely represents an infective process like tuberculosis.

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

hys/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Merclmn / F / 59 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 8-10 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 a postero-central and right postero-lateral disc herniation indenting the thecal sac and the traversing right S1 nerve root at the L5-S1 level. There is right neural foraminal narrowing at this level.

There is a posterior disc herniation with peridiscal osteophytes indenting the thecal sac and narrowing both neural foramina (right more than left) at the L4-L5 level. Also seen is impingement of the exiting right L4 nerve root at this level. Bilateral far lateral (extraforaminal) disc herniations are noted at this level.

The L4-L5 and L5-S1 facet joints show hypertrophic degenerative changes. Ligamentum flavum hypertrophy is noted over the L3-L4 to the L5-S1 levels.

Posterior disc bulges are noted at the L2-L3 and L3-L4 levels. The facet joints at these levels show degenerative changes.

There are bilateral far lateral (extraforaminal) disc bulges at the L2-L3, L3-L4 and L5-S1 levels.
..2/.




- 2 - scan-00007



Well-defined areas of hyperintensity on the all the pulse sequences are noted in the L4 vertebral body and would represent hemangiomas.

The lumbar intervertebral discs except at the L4-L5 level show loss of water content. The L4-L5 intervertebral disc is decreased in height.

The visualized lumbo-sacral vertebrae show areas of fatty replacement of normal marrow suggestive of osteoporotic changes. Hypointense areas are seen to involve the D11 vertebral body on the T1 Weighted images, the details of which are mentioned in the dorsal spine report.

Increased fat is noted in the renal medulla and sinus on the left side.

The conus medullaris terminates at the L1-L2 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 :

14.0 mm at L1-L2
13.0 mm at L2-L3
12.0 mm at L3-L4
8.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. A postero-central and right postero-lateral disc herniation at the L5-S1 level.

2. A posterior disc herniation with peridiscal osteophytes at the L4-L5 level.
..3/.






- 3 - scan-00007



3. Bilateral far lateral (extraforaminal) disc bulges at the L2-L3, L3-L4 and L5-S1 levels.

4. Hypertrophic facetal arthropathy with canal stenosis at the L4-L5 and L5-S1 levels.

5. Posterior disc bulges with facetal arthropathy at the L2-L3 and L3-L4 levels.

6. Ligamentum flavum hypertrophy over the L3-L4 to the L5-S1 levels.

7. Osteoporotic changes in the visualized lumbo-sacral vertebrae.

hs/ke/nl/rg
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 75 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 2 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 a postero-central disc protrusion with peridiscal osteophytes at the L5-S1 level.

Posterior disc bulges are noted at the L2-L3, L3-L4 and L4-L5 levels.

There are bilateral far lateral (extraforaminal) disc bulges at the L3-L4, L4-L5 and L5-S1 levels.

The lumbar intervertebral discs show loss of water content. Type II degenerative changes are noted adjacent to the L5-S1 intervertebral disc. The lumbar vertebrae show areas of fatty replacement of normal marrow suggestive of osteoporotic changes.

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
15.0 mm at L2-L3
19.0 mm at L3-L4
18.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. A postero-central disc protrusion with peridiscal osteophytes at the L5-S1 level.

2. Posterior disc bulges at the L2-L3, L3-L4 and L4-L5 levels.

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzr Klmn / M / 53 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O altered sensorium since 9-11 days.
C/O left sided hemiplegia since 2 years.
Known hypertensive/diabetic.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and in the pons. These areas appear hypointense to normal white matter on the T1 Weighted images.

Lacunar infarcts (isointense to hyperintense to CSF on all the pulse sequences) are noted in the lentiform nuclei bilaterally, right thalamus and in the bilateral corona radiata, posteriorly.

There is mild to moderate dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is blunting of the cerebral peduncles bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
..2/.







Incidentally noted is a mega cisterna magna.

Inflammatory changes are noted in the right frontal sinus, left maxillary antrum, sphenoid sinus and the ethmoidal air cells bilaterally.

IMPRESSION :

1. Altered signal in the periventricular white matter bilaterally and in the pons most likely represent ischemic changes.

2. Lacunar infarcts in the lentiform nuclei bilaterally, right thalamus and in the bilateral corona radiata, posteriorly

3. Mild cerebral and cerebellar atrophy with mild to moderate ventricular dilatation.

As compared to the previous MRI (study no:00003) dated 00.00.00, there is no significant change.

sb/bv/nl/.nl
Date : 00.00.00

Name of the Patient : Abc Xyzn A. Banlmn / F / 34 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with tingling in BLE and bladder/bowel involvement.

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 the L4-L5 intervertebral disc and loss of normal lumbar lordosis.

There is sacralization of the L5 vertebra.

There is a fairly large, posteriorly extruded disc with peridiscal osteophyte at the L4-L5 level with thecal sac compression and canal stenosis. Slight inferior migration of the disc fragment is noted.

There is a small posterior disc bulge at the L3-L4 level.

Note is made of a distended bladder.

The 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.







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

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. A fairly large, posteriorly extruded disc with peridiscal osteophyte at the L4-L5 level with canal stenosis.

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza lmn / F / 56 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided hemiplegia since 0000.
C/O twitching in the left hand.
Known diabetic/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.

IMAGES SHOW PATIENT MOTION. PATIENT REFUSED SEDATION.

OBSERVATION :

There is a hypointense signal on the T2 Weighted images in the left external capsular region and which most likely represents residual hemosiderin the sequelae of previous hematoma and subsequent resolution.

There are areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton and T2 Weighted images in the region of the left lentiform nucleus and left fronto-temporo-parietal lobes. These most likely represent areas of encephalomalacia.








Ill-defined hyperintense signal on the T2 Weighted images in the left posterior parietal periventricular white matter, left thalamus and subthalamic regions extending into the left cerebral peduncle and pons on the left may represent gliotic changes (Wallerian degeneration or ischemic changes). There is blunting of the left cerebral peduncle.

There is mild to moderate dilatation of both the lateral (left more than right) and third ventricles. There is mild prominence of the cerebral cortical sulci bilaterally.

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

IMPRESSION :

1. Residual hemosiderin in the left external capsular region, the sequelae of previous hematoma.

2. Areas of encephalomalacia in the region of the left lentiform nucleus and left fronto-temporo-parietal lobes.

3. Altered signal in the left posterior parietal periventricular white matter, left thalamus and subthalamic regions extending into the left cerebral peduncle and pons on the left may represent gliotic changes or Wallerian degeneration.

4. Mild to moderate dilatation of both the lateral and third ventricles.

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Hasan Tlmn / F / 46 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

Alleged H/O fall 2 months ago with backache.
C/O weakness of BLE with bladder/bowel involvement since 10 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 appears to be sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.

There is loss of normal lumbar lordosis. Also seen is mild retrolisthesis of the L4 vertebra over the L5 vertebra. The lumbar intervertebral discs show mild loss of water content.

A large postero-central disc extrusion is seen to compress the thecal sac at the L3-L4 level.

A posterior disc herniation with peridiscal osteophyte is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level. Areas of hypointensity on the T1 Weighted images which remain predominantly hypointense on the T2 Weighted images are seen within the antero-superior aspect of the L5 vertebral body and may represent Type III degenerative changes.



Bilateral far lateral (extraforaminal) disc bulges are seen at the L1-L2, L2-L3 and L4-L5 levels. An anterior disc herniation with peridiscal osteophytes is noted at the L4-L5 level.

The rest of the lumbar vertebral bodies 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 :

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

IMPRESSION :

1. Sacralization of the L5 vertebra. Please correlate with plain radiographs.

2. A large postero-central disc extrusion with severe canal stenosis at the L3-L4 level.

3. A posterior disc herniation with peridiscal osteophyte with a tight canal at the L4-L5 level.

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyztala Sanlmn / F / 52 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches which has increased since 1 week.
C/O giddiness and numbness over the left side of the face since 3 days.

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.

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 :

Normal study of the Brain.

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzee Blmn / F / 29 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE 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 :

A postero-central disc protrusion is seen to indent the thecal sac at the D10-D11 level. This intervertebral disc shows loss of water content.

Posterior disc bulges are noted at the L4-L5 and L5-S1 levels.

The paraspinal muscles on the right side in the lower dorsal and lumbo-sacral regions are seen to be atrophic and show spotty fatty changes.

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.
scan-00009


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

15.0 mm at L1-L2
17.0 mm at L2-L3
14.0 mm at L3-L4
12.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

1. A postero-central disc protrusion at the D10-D11 level

2. Atrophy of the paraspinal muscles in the lower dorsal and lumbo-sacral regions.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Salgaolmn / F / 62 yrs.
Referred by : Dr. Abc Xyzralay.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O Gait ataxia since 2 1/2 months and speech disturbances since 1 year.

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 slight thinning of the superior collicular plate of the tectum. Also seen is fullness of the ventricular system.

There is prominence of the basal cisternal spaces and cerebral cortical sulci bilaterally predominantly in both temporal regions. Also seen is mild prominence of the cerebellar folia bilaterally.

There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. Thinning of the superior collicular plate of the tectum. Such changes may be seen with progressive supranuclear palsy. Please correlate clinically.

2. Cerebral and mild cerebellar atrophy.