sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzi Thanalmn / F / 33 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

C/O backache radiating to the LLE since February 0000.
H/O abscess drainage from lumbar region on 00.00.00.

EXAMINATION :

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

5 mm thick T1 Weighted sagittal images.

10 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

7 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There is an ill-defined hypointense signal on the T1 Weighted images involving the S1, S2 and S3 sacral segments. This lesion appears hyperintense on the T2 Weighted and STIR images. There is however, no obvious involvement of the sacro-iliac joints per se.

There is seen a fairly large, well-marginated, hypointense lesion (when compared to normal muscle) on the T1 Weighted images in the left gluteal region, extending from the level of the sacro-sciatic notch, upto the level of the ischial tuberosity. This lesion appears significantly hyperintense on the T2 Weighted and STIR images and is located between the gluteus medius and maximus muscles proximally and between gluteus medius and minimus muscles distally. Probable involvement of the left pyriformis is noted. There is extension of this lesion into the pelvis, upto the presacral region through the left sacro-sciatic notch. Extension of the soft tissue lesion into the presacral space and into the spinal canal in the sacral region is also noted.
..2/.







Similar signal intensity lesions, but of significantly smaller size are noted in the left paravertebral regions (lateral to the psoas muscle) and along the left ilio-psoas muscle in the pelvis.

Evidence of previous surgery is noted in the soft tissues in the left iliac region.

The uterus and its adnexae show no obvious intrinsic lesion. There is no free fluid in the pelvis. No obviously enlarged pelvic lymph nodes are identified.

IMPRESSION :

1. Altered signal in the sacral segments as described, most likely represents osteitis probably tuberculous osteitis.

2. Mass lesion in the left gluteal region, extending into the pelvis as described represents an abscess.

3. Smaller lesions along the left psoas muscle and left ilio-psoas muscle represents residual abscesses.

The patient is status post-operative for drainage of an intrapelvic abscess.

As compared to the previous MRI dated 00.00.00, there is significant reduction in size of the left psoas and ilio-psoas abscess. The left gluteal and presacral abscesses are still identified. The left gluteal abscess is largely unchanged.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc XyzA. Bhanpuralmn / M / 30 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O low back pain radiating to the LLE since 2 months which has increased since 3 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 loss of normal lumbar lordosis and loss of water content of the L5-S1 intervertebral disc.

There is a fairly large left paracentral extruded disc with peridiscal osteophyte at the L5-S1 level with slight inferior migration of the disc fragment indenting the traversing left S1 nerve root. The left S1 nerve root is probably inflammed.

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

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 L2 level and the thecal sac terminates at the S1 level.

- 2 - scan-00002


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

20.0 mm at L1-L2
20.0 mm at L2-L3
17.0 mm at L3-L4
15.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION

A fairly large left paracentral extruded disc with peridiscal osteophyte at the L5-S1 level with slight inferior migration of the disc fragment and indentation on the traversing left S1 nerve root.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz S. Tlmn / F / 35 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches and diplopia (on & off), giddiness and gait imbalance 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.
5 mm thick T1 Weighted sagittal images.
An MR Cisternogram was obtained in the sagittal plane.

OBSERVATION :

There is no focal area of altered signal intensity or any mass lesion within the brain parenchyma.

There is mild dilatation of both the lateral ventricles. The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. The distal aqueduct is not well-visualized. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the paranasal sinuses bilaterally.

Screening T2 Weighted sagittal images of the cervical spine do not reveal any significant feature of note.


IMPRESSION :

1. Mild fullness of both the lateral ventricles.

2. Distal aqueduct is not well-visualized ? cause ? partial stenosis ? congenital.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Tunglmn / M / 60 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O speech disturbances since 3-4 days.
Known diabetic. On Rx.

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.

OBSERVATION :

There is a focal hyperintense signal on the proton, T2 Weighted and FLAIR images in the left corona radiata, posteriorly. This lesion appears hypointense to normal white matter on the T1 Weighted images.

The brainstem is unremarkable.

Both the lateral, third and the fourth ventricles are normal.
There is slight prominence of the cerebellar cortical sulci and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the paranasal sinus bilaterally.

IMPRESSION :

Altered signal in the left corona radiata, posteriorly most likely represents an ischemic lesion, probably recent in the given clinical setting.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzahmed Uslmn / M / 72 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O road accident at 5.30 am on 00.00.00, with loss of consciousness and bleeding from the left ear.

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 evidence of a biconvex, extracerebral lesion in the right fronto-temporo-parietal region. This lesion is hyperintense on all the pulse sequences and would represent an extradural hematoma. There is resultant indentation upon the underlying brain parenchyma. Also seen is mild compression upon the right lateral and third ventricles with mild shift to the left side. Smaller extracerebral collections with similar signal characteristics are seen to overlie both cerebral hemispheres and may represent subdural fluid/blood.

A fluid-fluid level is noted within the left occipital horn and this would suggest presence of subarachnoid blood with extension into the ventricular system.

Hyperintense areas on the proton, T2 Weighted and FLAIR images are seen to involve the cortical grey matter in the right temporal lobe. A smaller similar area is also noted in the left temporal lobe. These would represent cortical contusions in the given clinical setting of trauma.




Areas of hyperintensity on the proton, T2 Weighted and FLAIR images are seen within the periventricular white matter bilaterally and these are most likely ischemic in etiology. Foci with similar signal characteristics are noted in the white matter in the frontal lobes bilaterally.

There is mild fullness of both the lateral ventricles. Also seen is prominence of the cerebral cortical sulci, more so in the frontal regions. The fourth ventricle is normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

Subgaleal edema is noted in the left fronto-temporo-parietal region.

Hyperintense signal on the T2 Weighted images is noted within the sphenoid sinus and mastoid air cells/middle ear cavity, bilaterally and this may represent blood, in the given clinical setting of trauma.

Suspicious skull vault fracture is noted in the left fronto-parietal region.

IMPRESSION :

The MRI features are suggestive of :

1. An extracerebral extradural hematoma in the right fronto-temporo-parietal region.

2. Subdural collection of fluid/blood overlying the cerebellar hemispheres, bilaterally.

3. Cortical contusions involving the cortical grey matter in the temporal lobes, right more than left.

4. Presence of blood in the ventricular system as described.

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to the RUE with paresthesias.
Alleged H/O fall.

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 (PATIENT WAS IN SEVERE PAIN).

OBSERVATION :

There is loss of normal lumbar lordosis. There is mild retroplacement of the L5 vertebra over the S1 vertebra.

A large postero-central disc extrusion, more to the right of the midline is seen to indent the thecal sac at the L5-S1 level. A disc portion is seen to lie within the right lateral recess of the S1 vertebra with impingement of the traversing right S1 nerve root.

A small right postero-lateral (foraminal) disc herniation is seen to narrow the right neural foramen at the L5-S1 level.

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






The L4-L5 and L5-S1 facet joints show mild degenerative changes.

The L5-S1 intervertebral disc shows loss of water content.

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 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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. A large postero-central disc extrusion, more to the right of the midline at the L5-S1 level with a disc portion lying within the right lateral recess of the S1 vertebra with impingement of the traversing right S1 nerve root.

2. A small right postero-lateral (foraminal) disc herniation at the L5-S1 level.

3. Mild facetal arthropathy at the L4-L5 and L5-S1 levels.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzVithalmn / F / 47 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O recent onset of seizures.
C/O paresthesias in the right hand.

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 multiple well-defined areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images within the white matter in the fronto-parietal lobes bilaterally, left temporal lobe, periatrial white matter bilaterally, within the left lateral aspect of the pons and the lateral aspect of the right cerebral peduncle. A few of these lesions are elongated and have a perivenular distribution.

An area of marked hypointensity on the T1 Weighted images which turns hyperintense on the proton and T2 Weighted images is noted within the white matter in the left frontal lobe (antero-superior to the left frontal horn). Note is also made of perilesional edema.




There is mild fullness of both the lateral and third ventricles. Also seen is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

There is a punctate signal void lesion on all the pulse sequences within the right cerebellar hemisphere which may represent a venous angioma.

The fourth ventricle is 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. The left common carotid artery arises from the right brachiocephalic artery.
..3/.
















- 3 - Scan-00007


IMPRESSION :

The MRI features are suggestive of multiple areas of altered signal within the white matter in the fronto-parietal lobes bilaterally, left temporal lobe, periatrial white matter bilaterally, within the left lateral aspect of the pons and the lateral aspect of the right cerebral peduncle as described. These most likely represent plaques of demyelination (less likely to be ischemic in etiology). The lesion within the white matter in the left frontal lobe (antero-superior to the left frontal horn) may represent an acute plaque of demyelination.

The left common carotid artery arises from the right brachiocephalic artery. No other significant abnormality is detected in the intracranial and neck MRA on this study.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzal K. Golmn / M / 43 yrs.
Referred by : Dr. Abc Xyzhatt.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tremors of BUE and BLE and irrelevant talk since 00.00.00.
Known alcoholic and Known C/O cirrhosis of liver.

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 are hyperintense areas on the T1 Weighted images within the lentiform nuclei bilaterally and cerebral peduncles/subthalamic regions.

There is mild prominence of the cerebral cortical sulci and 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 :

The MRI features are suggestive of areas of altered signal within the lentiform nuclei bilaterally and cerebral peduncles/ subthalamic regions and this may be seen with hepato-cerebral syndromes.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzini S. Dlmn / F / 60 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O giddiness with paresthesias in BUE and BLE since 1 year.

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 slight loss of water content of the cervical intervertebral discs.

Small posterior disc bulges are noted at the C3-C4 and C4-C5 levels.

A small posterior disc bulge with peridiscal osteophytes is noted at the C5-C6 level.

Slight facetal hypertrophy is seen at the C5-C6 level.

The upper cervical vertebral bodies show spotty fatty marrow changes.

The rest of the cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
Scan-00005




The cervical spinal cord shows normal signal intensity.

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

Incidentally noted are small, subcentimeter lymph nodes deep to the sternocleidomastoid muscles bilaterally.

IMPRESSION :

Small posterior disc bulge with peridiscal osteophytes at the C5-C6 level with slight facetal hypertrophy at this level.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz G. Plmn / M / 57 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O Parkinsonism.

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 mild fullness of the ventricular system and mild prominence of the cerebral cortical sulci. Also seen is prominence of 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.

Inflammatory changes are seen in the maxillary sinuses bilaterally, sphenoid sinus and ethmoidal air cells.

IMPRESSION :

The MRI features are suggestive of :

1. Cerebellar atrophy.

2. Mild cerebral atrophy.