hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzhammed lmn / M / 33 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE 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 mild retroplacement of the L4 over the L5 and L5 over the S1 vertebrae.

There is a large postero-central disc extrusion with small peridiscal osteophytes, more to the left of the midline compressing upon the thecal sac at the L5-S1 level. A disc portion is seen to lie within the left lateral recess of the L5 and S1 vertebrae. Also seen is impingement of the traversing left S1 nerve root.

Left postero-lateral and left far lateral disc herniations are seen to narrow the left neural foramen and indent the extraforaminal portion of the exiting left L5 nerve root respectively at the L5-S1 level.

A posterior disc bulge is noted at the L4-L5 level.
..2/.











Facetal hypertrophy is seen at the L4-L5 and L5-S1 levels. The intervertebral discs at these levels show loss of water content.

Type II degenerative changes are noted in the S1 vertebral body adjacent to the L5-S1 intervertebral disc.

The rest of 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.

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 :

19.0 mm at L1-L2
19.0 mm at L2-L3
21.0 mm at L3-L4
18.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. A large postero-central disc extrusion with small peridiscal osteophytes, more to the left of the midline with canal stenosis at the L5-S1 level. A disc portion is seen to lie within the left lateral recess of the L5 and S1 vertebrae.

2. Left postero-lateral and left far lateral disc herniations indenting the extraforaminal portion of the exiting left L5 nerve root respectively at the L5-S1 level.

3. Facetal hypertrophy at the L4-L5 and L5-S1 levels.

hs/sb/nl/rg.
/5 Date : 00.00.00

Name of the Patient : Abc Xyz Payyaplmn / M / 32 yrs.
Referred by : Dr. Abc Xyzni Dr. Abc Xyzhijwala.
Examination : M.R.I. of the Left Shoulder.

EXAMINATION :

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

4 mm thick GRASS axial images.

4 mm thick T1 Weighted sagittal images.

4 mm thick T1 Weighted and T2 Weighted coronal images.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

The head of the left humerus shows normal contour and the head and upper shaft of the left humerus show normal signal intensity. The visualized scapula appears normal. The glenoid labrum is unremarkable. The biceps tendon in the biciptical groove shows normal signal intensity.

The articular cartilage of the head of the left humerus appears normal. There is no joint effusion.

The tendinous insertion of the supraspinatous muscle shows normal signal intensity. There is no evidence of fluid in the subdeltoid bursa. There is no evidence of a tear of the supraspinatous muscle. The soft tissues around the left shoulder joint are unremarkable.






There is no bone erosion or destruction seen.

The acromio-clavicular joint is normal.

The visualized axilla is unremarkable.

IMPRESSION :

No significant abnormality is detected within the left shoulder joint on this study.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzh Sanzlmn / M / 71 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O tingling with weakness and wasting of the RUE since 4 months.
EMG s/o right C5, C6 & C7 lesion at the proximal level, probably at the root on brachial plexus level.

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 :

The cervical intervertebral discs show loss of water content and the C3-C4, C4-C5 and C5-C6 are reduced in height. There is clockwise rotation of the mid cervical vertebrae.

There are posterior peridiscal osteophytes at the C3-C4, C4-C5, C5-C6, C6-C7 and C7-D1 levels with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. There is indentation on the cord over the C3-C4 to the C5-C6 levels with ligamentum flavum hypertrophy and a tight cervical canal. The cervical spinal cord over these levels appear triangular in shape.







The spinal cord at C3-C4, C4-C5 and C5-C6 levels shows subtle hyperintense signal on the Fast Scan (T2 *) images and is isointense to normal cord on the T1 Weighted images suggesting of cord edema/ischemia.

The C3-C4, C4-C5 and C5-C6 facet joints on the right side show degenerative changes.

Type I/II degenerative changes are seen in the C3, C4, C5 and C6 vertebrae adjacent to the intervertebral discs.

The cervical vertebrae show diffuse fatty change.

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. Posterior peridiscal osteophytes at the C3-C4, C4-C5, C5-C6, C6-C7 and C7-D1 levels with indentation on the cord over the C3-C4 to the C5-C6 levels and ligamentum flavum hypertrophy and a tight cervical canal over these levels.

2. Altered signal of the cervical spinal cord at the C3-C4, C4-C5 and C5-C6 levels suggesting cord edema/ischemia.

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 35 yrs.
Referred by : Dr. Abc Xyzandel.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O fall with injury to back of the head with vomiting and LOC for 12-13 hours.
Now C/O pain in the back of the head and in both shoulders.

EXAMINATION :

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

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

OBSERVATION :

There is an ill-defined, hyperintense area in the left high frontal region on the T1 Weighted images which is seen to remain hyperintense on the T2 Weighted images and would represent extracellular methaemoglobin. There is slight effacement of the adjacent sulci and mild perilesional edema.

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

Incidental note is made of left 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.
- 2 - Scan-00002

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 :

Altered signal in the left frontal region would represent extracelluar methemoglobin suggesting a residual, late subacute hematoma.

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

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzed Kamran Safailmn / M / 28 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Right Shoulder.

CLINICAL PROFILE :

C/O pain in the right shoulder joint since 3 months.

EXAMINATION :

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

4 mm thick T1 Weighted and GRASS axial images.

4 mm thick T1 Weighted sagittal images.

4 mm thick T1 Weighted, Proton and T2 Weighted coronal images.

OBSERVATION :

The head of the right humerus shows normal contour and the head and upper shaft of the right humerus show normal signal intensity. The visualized scapula appears normal. The glenoid labrum is unremarkable. The biceps tendon in the bicipital groove shows normal signal intensity.

The articular cartilage of the head of the right humerus appears normal. There is no joint effusion.

The tendinous insertion of the supraspinatous muscle shows normal signal intensity. There is no evidence of fluid in the subdeltoid bursa. There is no evidence of a tear of the supraspinatous muscle. The soft tissues around the right shoulder joint are unremarkable.

There is no bone erosion or destruction seen.



The acromio-clavicular joint is normal.

The visualized axilla is unremarkable.

IMPRESSION :

No abnormality is detected within the right shoulder joint on this study.

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 53 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O severe headaches with vomiting and altered sensorium since 1 day.

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 intermediate signal intensity within the prepontine, interpeduncular Sylvian and the suprasellar cisterns on the T1 Weighted images which is seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images but heterogeneously hypointense on the Fast Scan (T2 *) coronal images and would represent altered blood in the basal cisterns.

There is thickening of the gyri in the inferior frontal parafalcine regions bilaterally, which appear hypointense to the normal gray matter on the T1 Weighted images and turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images.

There is slight fullness of both the lateral ventricles with a fluid level in the occipital horns bilaterally.

The third and the fourth ventricles are normal. There is no shift of the midline structures.
scan-00000


IMPRESSION :

1. Altered signal within the prepontine, interpeduncular, Sylvian and the suprasellar cisterns would represent altered blood suggesting subarachnoid haemorrhage.

2. Altered signal in the inferior frontal-parafalcine regions bilaterally represent a recent ischemic lesion.

Distribution of the ischemic lesions and subarachnoid and intraventricular haemorrhage as described above may suggest a ruptured aneurysm in the anterior circulation.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Liladhlmn / M / 18 yrs.
Referred by : Dr. Abc Xyz D. Patel.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 2 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 :

Small postero-central disc protrusions are seen to indent the thecal sac at the L4-L5 and L5-S1 levels. Also seen are bilateral far lateral (extraforaminal) disc bulges at these levels.

Schmorls nodes are noted at the L4-L5 and L5-S1 levels and in the dorso-lumbar region.

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 :

19.0 mm at L1-L2
17.0 mm at L2-L3
16.0 mm at L3-L4
12.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of small postero-central disc protrusions at the L4-L5 and L5-S1 levels

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzth Hanlmn / M / 48 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the right hip and the RLE since 2 months with tingling.

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

OBSERVATION :

There is loss of normal contour of the right femoral head. Hypointense areas are seen within the right femoral head predominantly in the anterior and superior portion on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the T2 Weighted and STIR images. The double line sign is noted. There is slight thinning of the articular cartilage overlying the right femoral head. Effusion is seen within the right hip joint.

The acetabular margins are also deformed. Hypointense areas are seen in the right acetabular roof on the T1 Weighted images which are seen to turn hyperintense on the T2 Weighted and STIR images.

The left hip joint is unremarkable. The visualized pelvis is normal.

IMPRESSION :

The MRI features are suggestive of Class C avascular necrosis (Mitchells classification) with effusion in the hip joint and edema in the right acetabular roof as described.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzbi Shlmn / F / 54 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BUE and RLE 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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

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

There is a right paracentral protruded disc at the L5-S1 level, minimally indenting the traversing right S1 nerve root with slight right neural foraminal narrowing at this level.

A small, left postero-lateral disc herniation with a peridiscal osteophyte is noted at the L4-L5 level with slight left neural foraminal narrowing. The L4-L5 facet joints show mild hypertrophic degenerative changes.

Bilateral far lateral (extraforaminal) disc bulges are noted at the L4-L5 and L5-S1 levels.
Scan-00007


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

Screening, T2 Weighted sagittal images of the dorsal spine do not reveal any significant feature of note. There appear to be degenerative changes of visualized lower cervical spine.

IMPRESSION :

1. A right paracentral protruded disc at the L5-S1 level, minimally indenting the traversing right S1 nerve root.

2. A small, left postero-lateral disc herniation with a peridiscal osteophyte at the L4-L5 level.

3. Mild hypertrophic facetal arthropathy at the L4-L5 level.

ke/bv/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O pain in the entire spine with radiation of pain to the RUE and RLE and paresthesias (on and off) since February 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 :

Small posterior disc bulges with small peridiscal osteophytes are seen at the L4-L5 and L5-S1 levels with anterior indentation of the thecal sac.

The L5-S1 facet joints show mild degenerative changes.

The lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12 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
16.0 mm at L2-L3
17.0 mm at L3-L4
14.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

Small posterior disc bulges with small peridiscal osteophytes at the L4-L5 and L5-S1 levels.