sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzC. Billimlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 00.00.00.

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, L4-L5 and L5-S1 intervertebral discs.

Small postero-central protruded disc with peridiscal osteophytes is noted at the L5-S1 level.

Small posterior disc bulges with peridiscal osteophytes are seen at the L3-L4 and L4-L5 levels.

Hypertrophic facetal arthropathy is noted at the L4-L5 and L5-S1 levels on the right side.

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 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
13.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

1. Small postero-central protruded disc with peridiscal osteophytes at the L5-S1 level.

2. Small posterior disc bulges with peridiscal osteophytes at the L3-L4 and L4-L5 levels.

3. Hypertrophic facetal arthropathy at the L4-L5 and L5-S1 levels on the right.

hs/bv/nl/nl
/56 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 Cervical and Upper
Dorsal Spine.

CLINICAL PROFILE :

C/O pain in the entire back (on an off) since February 0000 with radiation of pain to the RUE and RLE with paresthesias.

EXAMINATION :

M.R.I of the cervical and upper dorsal spine was performed using the following parameters :

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

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

OBSERVATION :

The C2-C3, C3-C4 and C5-C6 intervertebral discs show loss of water content.

There is mild anti-clockwise rotation of the upper cervical vertebrae.

There are mild posterior disc bulges at the C3-C4, C4-C5, C5-C6 and C6-C7 levels.

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 cervical spinal cord reveals normal signal intensity.







The atlanto-axial region and the cervico-medullary junction are unremarkable.

There is no obvious mass lesion in the region of the thoracic outlet.

The dorsal spine was screened with 5 mm thick T2 Weighted (with fat saturation) sagittal images. The D5-D6 intervertebral disc shows loss of water content. A postero-central disc protrusion is seen at this level.

IMPRESSION :

1. Mild posterior disc bulges at the C3-C4, C4-C5, C5-C6 and C6-C7 levels.

2. A postero-central disc protrusion at the D5-D6 level.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzn Chavalmn / M / 70 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O progressive paraparesis since 15 days.
Past H/O spinal surgery twice - 5 yrs ago and 10 yrs ago.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There appears to be laminectomy of the D8, D9 and D10 vertebrae with post-operative changes in the posterior soft tissues.

The dorso-lumbar vertebrae appear to be fused.

Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the D9 to L3 vertebral bodies and appendages. The D10 to L2 vertebral bodies also show spotty fatty changes, as do the other visualized dorso-lumbar vertebral bodies. There is mild extension of the pathologic process into the pre and paravertebral soft tissues over these levels. Also seen is extension into the epidural space over the D9 to D12 levels with encasement and compression of the cord. The cord signal cannot be ascertained with any degree of reliability. The D10-D11 to L2-L3 intervertebral discs are not well identified. There also appears to be subtle involvement of the L4 vertebral body.





There is laminectomy of the L3, L4 and L5 vertebrae. The CSF within thecal sac over these levels is hyperintense to normal CSF on the T1 Weighted images and would reflect arachnoiditis.

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

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. Altered signal of the D9 to L4 vertebrae with soft tissue extensions and encasement of the cord is most likely the result of an infective process. A neoplastic process like a small cell tumor cannot be entirely excluded.

3. Arachnoiditis in the lumbar region as described.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzbee Sayyed lmn / F / 55 yrs.
Referred by : Dr. Abc Xyzzare.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O weakness of BLE with incontinence of urine since 10-12 days.
C/O neckpain since 1 month.

EXAMINATION :

M.R.I of the cervico-dorsal 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 partial collapse of the D1 vertebral body which is slightly retropulsed. The C7 and D1 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. Break in the superior and inferior cortical endplates of D1 is noted with a hyperintense signal on the T2 Weighted images in the C7-D1 intervertebral disc.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the prevertebral and paravertebral region extending over the C6 to D2 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. There is extension of the soft tissue lesion into the anterior and right lateral epidural space over the C7 to D2 vertebral levels and into the neural foramina at the C6-C7, C7-D1 and D1-D2 levels. There is resultant cord compression and cord signal alteration over these levels (hyperintense on the T2 Weighted images) suggesting cord edema/ischemia/myelitis.



Erosion of the both the pedicles of C7 and D1 vertebrae and the right transverse process of D1 and both transverse processes of the C7 vertebra is noted.

The rest of the visualized cervico-dorsal vertebral bodies reveal normal signal intensity. The remaining cervico-dorsal intervertebral discs show loss of water content.

Screening, T1 Weighted sagittal images of the mid and lower dorsal spine do not reveal any significant feature of note.

IMPRESSION :

Partial collapse of the D1 vertebral body with altered signal of the C7 and D1 vertebrae and the C7-D1 intervertebral disc most likely represents osteitis with discitis, probably tuberculous in etiology. Prevertebral, paravertebral and epidural soft tissue lesion may represent granulation tissue/abscess. There is resultant cord compression and cord signal alteration suggesting cord edema/ischemia/myelitis.

The possibility of the above described lesion representing a neoplasm is less likely.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz S. Baindulmn / F / 56 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O discharge from left nostril since 2 months.
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.

3 mm thick T2 Weighted coronal and sagittal images through the region interest.

OBSERVATION :

There are small bright foci, best appreciated on the FLAIR images in the subcortical white matter in the frontal regions bilaterally (scans 105.15-105.17). These lesions appear isointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes.

There is a small, extra-axial CSF signal intensity lesion on all the pulse sequences in the left anterior temporal region which most likely represents an arachnoid cyst.

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci bilaterally. 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 deviation of the nasal septum to the right. Slight hypertrophy of the inferior nasal turbinates is noted bilaterally, more on the left side.

There is seen an intermediate signal intensity lesion on the T1 Weighted images in the sphenoid sinus, right maxillary antrum and in the right anterior ethmoidal air cells. These lesions appear hyperintense on the T2 Weighted images. Fluid signal is also noted in the above described paranasal sinuses.

There is no obvious break of the cortex along the floor of the anterior and middle cranial fossa on either side.

IMPRESSION :

1. Small bright foci better appreciated on the FLAIR images in the subcortical white matter in the frontal regions bilaterally most likely represent ischemic changes.

2. An arachnoid cyst in the left anterior temporal region.

3. Soft tissue in the paranasal sinuses as described may either represent inflammatory soft tissue or pooled CSF (in a c/o suspected CSF rhinorrhea).

4. Deviated nasal septum to the right with hypertrophied inferior nasal turbinates.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyztan Harlmn / M / 17 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O unresponsiveness, rigidity of all four limbs and inability to speak since 1 1/2 months.
H/O dog bite 1 year back. Received ARV 1 month back.

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/sb/nl/nl
/552 Date : 00.00.00

Name of the Patient : Abc XyzBartlmn / M / 28 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O gait imbalance with speech disturbances.

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 signal on the T2 Weighted images in the right thalamus, extending into the right internal capsular region superiorly and into the subthalamic region, right cerebral peduncle and in the pons on the right, inferiorly.

A similar signal intensity lesion is noted in the left cerebral peduncle and in the left corona radiata.

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

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 thalamus, extending into the right internal capsular region superiorly and into the subthalamic region, both cerebral peduncles, in the pons on the right, inferiorly and in the left corona radiata is not specific for a single etiology. These lesions most likely represent ischemic lesions.

The possibility of demyelinating lesions is less likely.

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

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 51 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

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

5 mm thick T1 Weighted sagittal images.

3 mm thick T2 Weighted sagittal images.

OBSERVATION :

Artifacts due to dentures are noted.

There is evidence of a plaque-like lesion along the meninges, posterior to the clivus and extending upto the C2 vertebral level. This lesion is of intermediate signal intensity on the T1 Weighted images and turns hypointense on the T2 Weighted images. There is mild indentation upon the cervico-medullary junction by this lesion.

Few foci of hyperintensity on the proton, T2 Weighted and FLAIR images are noted within the white matter in the frontal lobes bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.






An area of hypointensity on the T1 Weighted images which turns hyperintense on the T2 Weighted images within the medial right temporal lobe (se/im 104/8, 102/8) most likely represents partial voluming with the right temporal horn.

There is mild fullness of the third and both the lateral ventricles. Also seen is mild prominence of the basal cisternal spaces and cerebral cortical sulci bilaterally.

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

Inflammatory changes are noted in the sphenoid sinus on the left side.

IMPRESSION :

The MRI features are suggestive of a plaque-like lesion along the meninges just posterior to the clivus and extending upto the C2 vertebral level as described. The differential diagnosis would include :

1. Neoplastic processes like :

a. Small cell tumors.

b. Metastasis.

c. En plaque meningioma.

2. Infective processes like tuberculosis.

A contrast enhanced study may be worthwhile.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzesh Nlmn / M / 3 yrs 9 mnths.
Referred by : Dr. Abc Xyzsbekar.
Examination : M.R.I. of the Abdomen & Pelvis.

CLINICAL PROFILE :

C/O fever, vomiting and pain in the abdomen since 00.00.00.

EXAMINATION :

M.R.I of the abdomen and pelvis was performed using the following parameters:

6 mm thick T1 Weighted, T2 Weighted (with fat saturation) and STIR axial images.

5 mm thick T1 Weighted coronal images.

6 mm thick T1 Weighted sagittal images.

OBSERVATION :

The liver is normal in size, shape and position. There is no focal or diffuse area of altered signal intensity. There is no intrahepatic biliary radicle dilatation. The intrahepatic venous architexture is normal.

The gall bladder is normal and reveals no intrinsic abnormality.

The pancreas is normal in size and signal intensity.

The spleen is normal.

Both the kidneys are normal in size and shape.

No lymphadenopathy is detected. There is no evidence of free fluid within the abdomen and pelvis.
Scan-00004


Urinary bladder shows normal wall thickness. No pelvic abnormality is detected.

Hyperintense signal on the T2 Weighted images seen in the left gluteal region is most likely the result of an intramuscular injection.

IMPRESSION :

No abnormality is detected within the Abdomen and Pelvis on this study.