ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzj Jlmn / M / 58 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the RUE and RLE with paresthesias.

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 continuous ossification of the posterior longitudinal ligament over the C3 to C5 vertebral levels.

A large posterior disc herniation with peridiscal osteophytes is seen at the C4-C5 level with compression of the spinal cord. The spinal cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images. This is isointense to normal cord on the T1 Weighted images and represents cord edema/ischemia.

A postero-central disc herniation is noted at the C3-C4 level with superior migration of the disc posterior to the C3 vertebral body.

Small posterior disc herniations are also noted at the C5-C6 and C6-C7 levels.

The C4-C5 and C5-C6 facet joints show degenerative changes. Ligamentum flavum hypertrophy is seen over the C3 to C5 vertebral levels.


The cervical intervertebral discs show loss of water content.

The cervical vertebral bodies show normal signal intensity. 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. Continuous ossification of posterior longitudinal ligament over the C3 to C5 vertebral levels.

2. A large posterior disc herniation with peridiscal osteophytes at the C4-C5 level with cord compression and altered cord signal at this level which represents cord edema/ischemia.

3. A postero-central disc herniation at the C3-C4 level with superior migration of the disc posterior to the C3 vertebral body.

4. Posterior disc herniations at the C5-C6 and C6-C7 levels.

5. Facetal arthropathy at the C4-C5 and C5-C6 levels.

6. Ligamentum flavum hypertrophy over the C3 to C5 vertebral levels.

ke/hs/rg/nl.
Date : 00.00.00

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

CLINICAL PROFILE :

C/O headaches (26 years) with giddiness and tinnitus since 6 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.
MR Cisternogram was obtained in the coronal plane.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are hyperintense foci on the proton, T2 Weighted and FLAIR images in the left periatrial white matter. These are isointense to normal white matter on the T1 Weighted images and are probably ischemic in etiology.

The seventh and eighth cranial nerve complex is unremarkable on either side. Note is made of an empty sella.

Both the lateral, third and the fourth ventricles are normal. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of :

1. Foci of altered signal in the left periatrial white matter and these are probably ischemic in etiology.

2. An empty sella.

ke/hs/rg/nl.
Date : 00.00.00

Name of the Patient : Abc Xyzi Pednlmn / F / 33 yrs.
Referred by : Dr. Abc Xyzhalani.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O amenorrhea since October 0000.
Prolactin level is 260.2 ng/ml.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.
3 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

There is an intermediate signal intensity lesion on the T1 Weighted images involving the anterior pituitary gland. This is near isointense to grey matter on the T2 Weighted images. The lesion appears to involve the stalk and which cannot be identified separately. There is encroachment into the cavernous sinus on the right side with encasement of the cavernous portion of the internal carotid artery which shows normal flow void signal albeit a smaller calibre on all the pulse sequences. Superiorly there is mild indentation upon the optic chiasm and the third ventricle.

The sella is slightly enlarged with remodeling of the sellar floor, especially on the right side.

The left cavernous sinus appears normal. The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images.
R>
Septae are seen in the sphenoid sinus.

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

There is mild fullness of the third and both the lateral ventricles. The fourth ventricle is normal.

IMPRESSION :

The MRI features are suggestive of a pituitary macroadenoma as described.

ke/sb/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to BLE (right more than left) with paresthesias.

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 partial sacralization of the L5 vertebra on the left side and the L1 vertebral body is as marked on the film.

A large postero-central disc extrusion is seen at the L4-L5 level with compression of the thecal sac and canal stenosis.
There is inferior migration of the disc fragment which is seen to lie posterior to the L5 vertebral body. The L4-L5 facet joints show degenerative changes.

A small posterior disc herniation is seen at the L3-L4 level with anterior indentation of the thecal sac. The L3-L4 and L4-L5 intervertebral discs show 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 D12 level and the thecal sac terminates at the S1 level.
..2/.




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

17.0 mm at L1-L2
17.0 mm at L2-L3
13.0 mm at L3-L4
8.0 mm at L4-L5
7.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Partial sacralization of the L5 vertebra on the left side and the L1 vertebral body is as marked on the film.

2. A large postero-central disc extrusion at the L4-L5 level with canal stenosis and inferior migration of the disc fragment lying posterior to the L5 vertebral body.

3. Facetal arthropathy at the L4-L5 level.

5. A small posterior disc herniation at the L3-L4 level.

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzli Slmn / M / 30 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in the RLE since 2-3 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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is probable sacralization of the L5 vertebra and the L3 vertebral body is as marked on the film.

There is slight loss of water content of the L4-L5 intervertebral disc.

There is postero-central and right paracentral disc herniation with peridiscal osteophytes at the L4-L5 level indenting the traversing right L5 nerve root. Slight facetal hypertrophy is noted at the L4-L5 level.

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 :

17.0 mm at L1-L2
17.0 mm at L2-L3
16.0 mm at L3-L4
10.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. Probable sacralization of the L5 vertebra and the L3 vertebral body is as marked on the film.

2. Postero-central and right paracentral disc herniation with peridiscal osteophytes at the L4-L5 level indenting the traversing right L5 nerve root with slight facetal hypertrophy at that level.

bv/ke/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to the RLE.
Received 6 cycles of Chemotherapy for Non-Hodgkins lymphoma, completed on 00.00.00.
For follow up.

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 evidence of hemi-laminectomy of the L5 and S1 vertebral bodies on the right side.

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, the transverse processes, pedicles and articular pillars. There appears to be a suspicious 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 encroachment into the L4-L5 neural foramina bilaterally and on the right side at the L5-S1 level. In some parts, the soft tissue is seen to encircle the thecal sac. 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.
..2/.

- 2 - scan-00002


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

The rest of the lumbar vertebral bodies reveal spotty fatty changes. Fatty changes are also visualized in the L5 vertebral body on the left side. This suggests healing of the disease process. 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 :

In a known C/O Non-Hodgkins lymphoma, the MRI features are suggestive of the pathologic process involving the L5 vertebra with soft tissue and epidural extension and a smaller lesion in the right iliac wing as described.

As compared to the previous MRI dated 00.00.00 (Study No.00009) the patient is now status post-operative. The left half of the L5 vertebra now shows fatty changes suggesting healing. There is reduction in the paravertebral and the epidural soft tissue component. The previously identified interaortico-caval lymphnodes are no longer visualized.

hs/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Mlmn / F / 10 yrs.
Referred by : Dr. Abc Xyzla.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches, vomiting and convulsions 10 days back.
H/O similar episode 1 year ago.

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 and coronal images.

OBSERVATION :

There is evidence of a fairly well-defined, extra-axial mass lesion in the right fronto-temporo-parietal regions and measuring approximately 8.0 x 7.0 x 4.8 cms.

This lesion is iso to hypointense to gray matter on all the pulse sequences. A few hypointense areas on the T1 Weighted images which turn hyperintense on the proton and T2 Weighted images are seen within the lesion and may represent cystic/necrotic changes. Few hypointense areas on all the pulse sequences are seen within this lesion and may represent calcium. A CSF cleft is seen around this lesion with a presence of curvilinear and punctate signal voids suggestive of pial vessels. There appears to be hyperostosis of the bone adjacent to the lesion.

This lesion is seen to compress upon the adjacent brain parenchyma and the third and both the lateral ventricles. Also seen is right uncal herniation and effacement of the right perimesencephalic cistern with compression upon the midbrain and aqueduct. Also seen is compression and displacement of the right middle cerebral artery.
..2/.







There is dilatation of the left lateral ventricle with periventricular hyperintensities on the proton, T2 Weighted and FLAIR images suggestive of CSF ooze.

Note is made of an empty sella.

The fourth ventricle is normal.

IMPRESSION :

The MRI features are suggestive of an extra-axial mass lesion in the right fronto-temporo-parietal regions and measuring approximately 8.0 x 7.0 x 4.8 cms with mass effect as described and most likely represents a meningioma.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz B. Mhlmn / F / 6 mnths.
Referred by : Dr. Abc Xyzhiri.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O ? convulsions since 2 months.
H/O vacuum delivery.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

4 mm thick T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

The myelination pattern is normal for the patients age.

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.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzd Hussain / 45 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to BUE (right more than left) with paresthesias.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

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

OBSERVATION :

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

There is evidence of a transverse fracture of the odontoid process with anterior subluxation of the fractured fragment and the C1 vertebra over the rest of the C2 vertebra. There is resultant impingement of the cervical spinal cord by the residual odontoid process at the C2 vertebral level. The cervical spinal cord at this level appears smaller in diameter and shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images which suggest cord edema/ischemia/myelomalacic changes. The rest of the cervical spinal cord also appears slightly smaller in calibre as compared to normal.

Small postero-central disc herniation with peridiscal osteophyte is noted at the C2-C3 and C3-C4 levels. Slight ligamentum flavum hypertrophy is noted at the C4 vertebral level.



The C2 vertebral body shows 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.

IMPRESSION :

1. Fracture of the odontoid process with anterior subluxation of the fractured fragment and the C1 vertebra over the rest of the C2 vertebra and resultant impingement of the cervical spinal cord by the residual odontoid process at the C2 vertebral level.

2. Altered signal of the cervical spinal cord at the C2 level with change in calibre suggest cord edema/ischemia/myelomalacic changes.

3. Small postero-central disc herniation with peridiscal osteophyte at the C2-C3 and C3-C4 levels.

4. Slight ligamentum flavum hypertrophy at the C4 vertebral level.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzti Sanlmn / F / 43 yrs.
Referred by : Dr. Abc Xyzlkarni.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE.

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 slight loss of water content of the lumbar intervertebral discs.

Postero-central protruded discs are noted at the L4-L5 and L5-S1 levels.

Slight facetal hypertrophy is noted at the L5-S1 level.

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

The conus medullaris terminates at the L1-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 :

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

IMPRESSION :

1. Postero-central protruded discs at the L4-L5 and L5-S1 levels.

2. Slight facetal hypertrophy at the L5-S1 level.