sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyznt Blmn / M / 48 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 2 months.

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 L3-L4 and L4-L5 intervertebral discs.

There is a fairly large, posteriorly herniated disc with a peridiscal osteophyte at the L4-L5 level with thecal sac compression and canal stenosis.

A small, postero-central and right paracentral disc herniation with peridiscal osteophytes is noted at the L3-L4 level indenting the dural theca anteriorly.

Minimal postero-central protruded discs are noted at the L5-S1 and L2-L3 levels. The right S1 nerve root appears to be of larger calibre ? baggy nerve root sleeve.

The facet joints at the L4-L5 and L3-L4 levels appear slightly hypertrophied.

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/.






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 :

18.0 mm at L1-L2
17.0 mm at L2-L3
13.0 mm at L3-L4
9.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

1. A fairly large, posteriorly herniated disc with a peridiscal osteophyte at the L4-L5 level with canal stenosis.

2. A small, postero-central and right paracentral disc herniation with peridiscal osteophytes at the L3-L4 level.

3. Slight facetal hypertrophy at the L3-L4 and L4-L5 levels.

As compared to the previous MRI dated 00.00.00, there is no significant change noted.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Llmn / M / 19 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

Alleged H/O fall 9 months back.
Now C/O left knee (giving way) since then.
Past H/O aspiration of fluid from the left knee joint.

EXAMINATION :

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

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

4 mm thick T1 Weighted coronal images.

4 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

Menisci :

The anterior and posterior horns of the lateral and medial menisci reveal normal configuration and signal characteristics.

Cruciate Ligaments :

The anterior and posterior cruciate ligaments show normal contour and signal characteristics.

Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.


Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

There is evidence of lateral subluxation of the patella beyond the lateral margin of the lateral femoral condyle. Slight lateral tilt of the patella is also noted. Buckling of the lateral patellar retinaculum is noted while the medial patellar retinaculum appears slightly stretched. Marginal osteophytosis is noted around the patella. The articular cartilage overlying the patella is however unremarkable. Minimal fluid is noted in the patello-femoral joint.

The articular cartilage overlying the tibia and femur is also unremarkable.

IMPRESSION :

Laterally subluxed patella with the knee joint in extension may suggest a maltracking patella.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzR. Ghalmn / F / 40 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O giddiness with fall at 9.30 pm on 00.00.00 and speech difficulty 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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

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

Prominent perivascular spaces are noted in the right lentiform nucleus.

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 right mastoid air cells. The diploic space of the skull vault is slightly prominent (? anemic).

IMPRESSION :

No significant abnormality detected within the brain per se on this study.

sb/ke/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 8-10 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.

IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There are ill-defined, hyperintense areas on the T2 Weighted 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 are noted in the lentiform nuclei bilaterally, right thalamus and in the left 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.





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 left corona radiata, posteriorly

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

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 35 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 13 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 appears to be sacralization of the L5 vertebra and the L2 vertebra is as marked on the film. Please correlate with plain radiographs.

A small posterior disc bulge with peridiscal osteophytes is seen to indent the thecal sac at the L4-L5 level. Facetal hypertrophy is noted at this level.

The L4-L5 intervertebral disc shows loss of water content.

A mild posterior disc bulge is seen at the D12-L1 level.

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 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
18.0 mm at L3-L4
12.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

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

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

Date : 00.00.00

Name of the Patient : Abc Xyzra lmn / M / 45 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in both the hips since 3 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 (with fat saturation) axial images.

5 mm thick Proton density sagittal images.

OBSERVATION :

There is seen a well marginated, slightly hypointense lesion (when compared to normal marrow) on the T1 Weighted images in the superior quadrant of the left femoral head. This lesion remains hypointense on all the pulse sequences and is demarcated from the rest of the femoral head by a peripheral hypointense rim on all the pulse sequences. The left femoral head shows normal contour. The articular cartilage overlying the left femoral head and the left acetabulum are unremarkable. There is no left hip joint effusion.

The visualized right femoral head, right acetabulum and the right hip joint per se are unremarkable.








Fluid collection is seen in the pelvis and this would require further evaluation.

There is an ill-marginated hypointense lesion on all the pulse sequences at the junction of the femoral head and neck on either side. No obvious cortical erosion or perilesional bone edema is noted.

IMPRESSION :

1. Altered signal in the left femoral head suggest Class D avascular necrosis of the left femoral head.

2. Altered signal at the junction of the head and neck of the femora on either side suggest sclerosis. The etiology of these sclerotic lesions is not specific for a single diagnosis. Compressed trabeculae due to stress fractures may be considered as a differential diagnosis.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzBlmn / F / 75 yrs.
Referred by : Dr. Abc Xyziwala / Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O seizures 25 years ago.
C/O sudden onset of loss of consciousness for 7-8 minutes on 00.00.00.

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 are ill-defined, hyperintense areas on the proton and T2 Weighted images in the pons, anteriorly and in the posterior parietal periventricular white matter bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images.

The hippocampal complex on either side is unremarkable.

There is mild fullness of the third and both the lateral ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and 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.

IMPRESSION :

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

2. Mild cerebral cortical and cerebellar atrophy.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzJalmn / F / 21 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O pontine tuberculoma. On AKT.
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.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is evidence of a small, approximately 6.0 mms diameter sized hyperintense area on the proton and T2 Weighted images in the upper aspect of the pons, posteriorly and to the right. This is mildly hypointense on the T1 Weighted images.

There is mild prominence of the cerebellar folia bilaterally.

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 :

Altered signal in the upper pons, posteriorly and to the right as described most likely represents a resolving granuloma/gliotic changes.

As compared to the previous MRI (study no:0000) dated 00.00.00, there is no significant change in the size of the lesion.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz. Slmn / M / 44 yrs.
Referred by : Dr. Abc Xyzhijwala / Dr. Abc Xyzarucha.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O pain in the left eye region.
H/O left 3rd nerve palsy.

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 FLAIR coronal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

3 mm thick T1 Weighted coronal images with magnetization transfer.

OBSERVATION :

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

After administration of contrast, there is no area of abnormal enhancement within the brain parenchyma or the meninges.

A vascular loop is seen to indent the cisternal component of the left oculomotor nerve.
Scan-00008


Note is made of a giant cisterna magna.

Both the lateral, third and the fourth ventricles are normal. The rest of the basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Inflammatory changes are noted in the left maxillary sinus.

IMPRESSION :

The MRI features are suggestive of a vascular loop indenting the cisternal component of the left oculomotor nerve.

No other significant abnormality is detected on this study.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Khlmn / F / 10 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

H/O fall 4-5 years back.
C/O swelling over the back with weakness of BLE with bladder/bowel involvement since 6 months.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is evidence of an acute kypho-scoliotic deformity in the dorso-lumbar region with the apex of the kyphus at the D12-L1 level. Slight wedging of the D12 and L1 vertebral bodies is noted.

There is seen an intraspinal (most likely epidural), intermediate signal intensity mass lesion on the T1 Weighted images extending over the D9-D10 disc level upto the L2 vertebral level. This lesion appears relatively hypointense on the T2 Weighted images and is located in the posterior epidural space. There is resultant compression and anterior displacement of the lower dorsal spinal cord over these levels. The dorsal spinal cord over the affected levels appears to be slightly hyperintense to the normal cord on the T2 Weighted images. Slight widening of the spinal canal is noted at the D9, D10 and D11 vertebral levels, with scalloping of the right postero-lateral margin of these vertebrae. There is extension of the lesion through the left neural foramen at D11-D12, D12-L1 and L1-L2 levels into the left paravertebral soft tissues at these levels.
..2/.






The rest of the visualized 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-L2 level.

IMPRESSION :

1. An acute kypho-scoliotic deformity in the dorso-lumbar region with the apex of the kyphus at the D12-L1 level.

2. An intraspinal (most likely epidural) mass lesion extending over the D9-D10 disc level upto L2 vertebral level and through the neural foramen as described is not specific for a single etiology. The differential diagnosis would include :

a. A nerve sheath tumor.

b. Meningioma less likely.

c. An organized inflammatory lesion ? of tuberculous etiology less likely.

3. Cord compression with cord signal alteration over the D9-D10 disc level to the L1 vertebral level.