ke/sb/rg/nl.
Date : 00.00.00

Name of the Patient : Abc Xyzillmn / M / 65 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O abnormal behaviour with involuntary movements of the RUE and RLE with slurred speech since 5 months.

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 are hypointense areas (isointense to CSF) on the T1 Weighted images, of varying size in the left cerebellar hemisphere, pons, right external capsule, bilateral lentiform nuclei, bilateral thalami and right periatrial region. These are seen to turn hyperintense on the proton and T2 Weighted images and represent lacunar infarcts. The lesion in the right external capsular region may be the sequelae of a previous bleed.

Hyperintense areas are seen on the proton, T2 Weighted and FLAIR images in the periventricular and frontal deep white matter. These are iso to hypointense to normal white matter on the T1 Weighted images and are suggestive of ischemia/infarction.

There is mild fullness of both the lateral ventricles.

The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. The vertebro-basilar system is ectatic.


IMPRESSION :

1. Lacunar infarcts in the left cerebellar hemisphere, pons, right external capsule, bilateral lentiform nuclei, bilateral thalami and in the right periatrial region. The lesion in the right external capsular region may be the sequelae of previous hematoma.

2. Altered signal in the periventricular and frontal deep white matter would represent areas of ischemia/infarction.

hs/ke/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache (on & off) radiating to BLE since 8 years which has increased since 4-5 months and paresthesias since 4-5 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 :

Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the L5 vertebral body, transverse processes, pedicles, articular pillars, laminae and spinous process. There appears to be a break of its superior cortical endplate.

There is extension of this pathologic process into the paravertebral soft tissues on the right side over the L4 to S1 vertebral levels. Also seen is extension into the anterior and
right lateral epidural space over the L3 to the S1 vertebral level with encroachement into the L4-L5 neural foramina bilaterally and on the right side at the L5-S1 level. There is resultant indentation of the thecal sac over these levels.

A hypointense focus on the T1 Weighted images is seen in the right iliac bone adjacent to the right sacro-iliac joint.

There appears to be an enlarged interaortico-caval lymphnode at the L3/L3-L4 levels.
..2/.




- 2 - scan-00009


The L4-L5 intervertebral disc shows loss of water content (?? minimal involvement).

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

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the L5 vertebra with soft tissue extension and a smaller lesion in the right iliac wing as described. The differential diagnosis would include,

1. Infective process like tuberculosis.

2. Neoplasia like a small cell tumor.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 49 yrs.
Referred by : Dr. Abc XyzB. Shah.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

Operated for hernia on 00.00.00 with discharging sinus since then.

EXAMINATION :

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

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

7 mm thick T1 Weighted and STIR coronal images.

8 mm thick T1 Weighted sagittal images.

OBSERVATION :

The subcutaneous fat in the inguinal regions on either side shows an ill-defined hypointense signal on the T1 Weighted images and which turns significantly hyperintense on the T2 Weighted and STIR images. There is a break in the continuity of the surface of the skin on either side in these regions at about the level of the roof of the acetabulum, suggesting a sinus. The sinus tract on the left side also shows evidence of air. The underlying abdominal wall muscles on the left at the operative site also show an ill-defined hyperintense signal on the T2 Weighted and STIR images. An approximately 2.0 cms diameter sized collection is noted deep to the sinus tract on the left in close relation to the left ilio-psoas muscle (se/im 103.21, 104.6). Another smaller collection is seen in the anterior abdominal wall to the right of the midline at the acetabular roof level (se/im 102/22, 102.23, 103/22 and 103.23).



The urinary bladder shows normal wall thickness. There is no prostatic enlargement noted. The seminal vesicles are unremarkable.

The visualized bony pelvis shows normal signal intensity. The visualized hip joints are unremarkable.

The ischio-rectal fossae on either side appear normal.

There are no abnormally enlarged pelvic lymph nodes identified. No obvious vascular anomaly is noted. There is no free fluid in the pelvis.

IMPRESSION :

Altered signal in the subcutaneous fat in the inguinal regions on either side may represent inflammatory changes, in the given clinical setting. Break in continuity of the skin surface in these regions suggest sinus tracts. Involvement of the anterior abdominal wall muscles on the left is noted with a small collection deep to the anterior abdominal wall muscles to the left and a smaller collection in the anterior abdominal wall, to the right of the midline as described.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzee Galmn / F / 53 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Left Tibia.

CLINICAL PROFILE :

C/O pain in the left leg (below knee) since 3-4 months.

EXAMINATION :

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

4 mm thick T1 Weighted sagittal images.

4 mm thick STIR coronal images.

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

OBSERVATION :

There is seen an ill-defined, hypointense signal on the T1 Weighted images in the diaphysis of the proximal third of the left tibia, extending over a 10 cms long segment, approximately 5.0 cms distal to the left knee joint. This lesion appears hyperintense on the T2 Weighted and STIR images. There is no obvious cortical or bone erosion or destruction seen though there is some element of periosteal reaction along the antero-medial margin of the left tibia. The soft tissues overlying the antero-medial margin of the left tibia appear hyperintense on the T2 Weighted and STIR images which may represent inflammatory changes/soft tissue edema.

The zone of transition between the affacted segment and the normal marrow is ill-defined.

The visualized fibula is unremarkable.

There is no extension of the lesion into the left knee joint. The visualized muscles in the proximal left leg are unremarkable.
..2/.



- 2 - scan-00007


IMPRESSION :

Altered signal in the diaphysis of the proximal third of the left tibia as described is not specific for a single etiology. A stressed fracture is a likely possibility.

The possibility of a infective or a neoplastic etiology cannot be excluded.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc XyzJ. Kalmn / F / 42 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 4-5 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 is loss of water content of the L4-L5 and L5-S1 intervertebral discs.

Slight retroplacement of the L5 over the S1 vertebra is noted.

There is a posterior and bilateral far lateral disc bulge with peridiscal osteophytes at the L5-S1 level with slight bilateral neural foraminal narrowing.

A postero-central disc herniation with peridiscal osteophytes is noted at the L4-L5 level with indentation on the dural theca anteriorly.

The facet joints at the L3-L4, L4-L5 and L5-S1 levels appear slightly hypertrophied.

Type III degenerative marrow changes are noted adjacent to the L5-S1 intervertebral disc.
- 2 - scan-00005


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 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
15.0 mm at L3-L4
12.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. Slight retroplacement of the L5 over the S1 vertebra.

2. A posterior and bilateral far lateral disc bulge with peridiscal osteophytes at the L5-S1 level with slight bilateral neural foraminal narrowing.

3. A postero-central disc herniation with peridiscal osteophytes at the L4-L5 level.

4. Slight facetal hypertrophy at the L3-L4, L4-L5 and L5-S1 levels.

sb/hs/rg.
/6 Date : 00.00.00

Name of the Patient : Abc Xyzrai Bhilmn / M / 61 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O left sided hemiparesis with dysarthria in January 0000 which recovered in 3-4 days.
C/O mild weakness of the LUE and LLE (still persists).
Known hypertensive. On Rx.

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 a focal hyperintense signal with a hypointense rim on the T2 Weighted images in the right thalamus. This lesion blooms on the Fast Scan (T2 *) images and represents residual haemosiderin, the sequelae of a previous right thalamic hematoma.

Prominent perivascular spaces are noted in the posterior parietal regions and lentiform nuclei bilaterally. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

There is mild fullness of both the lateral and the third ventricles. The fourth ventricle is normal. The left cerebellar hemisphere appear slightly hypoplastic with a prominent left cerebellar cistern. The rest of the basal cisternal spaces are unremarkable. There is no shift of the midline structures.

A polyp is noted in the right maxillary antrum.
- 2 - scan-00004/6


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 :

There is slight ectasia of the visualized vessels of the neck.

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 represents residual haemosiderin, the sequalae of a previous right thalamic hematoma.

2. Ectasia of the neck vessels.

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

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Rulmn / M / 43 yrs.
Referred by : Dr. Abc Xyzshi / Dr. Abc Xyz. Modi.
Examination : M.R.I. of the Right Ankle.

CLINICAL PROFILE :

C/O tear with repair of the right Achilles tendon 5 months ago.

EXAMINATION :

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

4 mm thick T1 Weighted and STIR coronal images.

4 mm thick T1 Weighted and GRASS sagittal images.

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

OBSERVATION :

The right Achilles tendon is bulky and shows a few areas of intermediate signal intensity within it. This would be the result of the previous tear/repair (? use of PLA). The visualized tendon is seen to be continuous.

The visualized bone show normal configuration and signal intensity. No obvious bone destruction or erosion is evident.

No joint effusion is evident. The visualized soft tissues are unremarkable.

The left tendo-achilles is unremarkable.

IMPRESSION :

The MRI features are suggestive of a thickened but continuous right Achilles tendon and this may be the result of previous tear/repair.

sb/ke/rg.
Date : 00.00.00
Name of the Patient : Abc XyzAgalmn / M / 52 yrs.
Referred by : Dr. Abc Xyzndesha. Examination : M.R.Cholangiogram.EXAMINATION :

MR Cholangiogram was performed. 7 mm thick T1 Weighted and T2 Weighted axial images. 6 mm thick T2 Weighted coronal images.OBSERVATION

There is seen a well-defined, approximately 3.0 x 2.5 cms sized, hypointense mass lesion on the T1 Weighted images in the right lobe of the liver, posteriorly. This lesion appears hyperinetense on the T2 Weighted images but is relatively suppressed on the long TE sequence. No perilesional satellite lesions are noted. No distortion of the intrahepatic vascular anatomy is noted.

The gall bladder is well-distended with evidence of gall stones. The gall bladder wall is not thickened. No pericolicystic fluid collection is noted.

A small cortical renal cyst is noted in the upper pole of the right kidney.

Both the visualized kidneys, pancreas, adrenals and spleen are otherwise normal.

There are no abnormally enlarged abdominal lymphnodes noted. There is no free fluid in the abdomen.

On the MRCP, the visualized hepatic ducts and cystic duct is normal in it's course and calibre. The common bile duct is well-visualized in it's entire course upto it's insertion into the duodenum and is of normal calibre (an apparent narrowing of the CBD is noted in its midsegment. This is due to a kink of the CBD at that level). There are no intrinsic lesions in the cystic and common bile ducts. The pancreatic duct
is visualized on the source images and is unremarkable. ..2/.





- 2 - scan-00002
IMPRESSION :

1. An approximately 3.0 x 2.5 cms sized mass lesion in the right lobe of the liver, posteriorly is not specific for a single etiology. This most likely represents a hemangioma.

2. Multiple gall bladder calculi.

3. The biliary tree shows no obvious intrinsic lesion on this study.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzrali Chlmn / M / 5 yrs.
Referred by : Dr. Abc Xyzsbekar / Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O fall at 4.30 pm on 00.00.00 with vomiting and drowsiness.

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 a hypointense focus on the T1 Weighted images in the right high parietal, parafalcine region (scan 104.16). This lesion appears hyperintense on the T2 Weighted images and may represent a cortical contusion in the given clinical setting.

A suspicious fracture of the left frontal bone is noted (scan 103.14).

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.

There is no obvious evidence of haemorrhage on this study.

IMPRESSION :

1. Altered signal in the right high parietal parafalcine region most likely represents a cortical contusion in the given clinical setting.

2. A suspicious fracture of the left frontal bone.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzThalmn / F / 42 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O pain in the nape of the neck since 20 days.
Past H/O C1-C2 tuberculous involvement. On AKT since 1 1/2 years. C1 laminectomy with posterior fixation done on 00.00.0000.

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 axial images.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

Image quality is degraded due to susceptibility artifacts due to previous posterior fixation. It is hence difficult to evaluate the cord signal and cord status over the C2 to C5 vertebral levels.

The visualized cervical vertebral bodies show no obvious signal change. The cervical intervertebral discs show mild loss of water content.

Postero-central protruded discs are noted at the C4-C5, C5-C6 and C6-C7 levels.







The visualized pre and paravertebral soft tissues are unremarkable.

IMPRESSION :

1. Post-operative status.

2. Postero-central protruded discs at the C4-C5, C5-C6 and C6-C7 levels.

3. Susceptibility artifacts due to previous posterior fixation.