hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzShlmn / F / 34 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches since 5-6 years.
C/O occasional giddiness and vomiting.

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 no focal area of altered signal intensity within the brain parenchyma.

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

The 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 :

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

hs/sb/nl/rg.
/77 Date : 00.00.00

Name of the Patient : Abc Xyz Sanlmn / M / 46 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches and long standing giddiness.

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

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

The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Note is made of a right maxillary polyp. Inflammatory changes are noted in the frontal sinuses and ethmoidal air cells.
Scan-00005


INTRACRANIAL MRA :

The left vertebral artery and the A1 segement of the right anterior cerebral artery are hypoplastic.

There is ectasia of the vertebral arteries.

The right posterior cerebral artery appears to be a continuation of the right posterior communicating artery.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized left anterior cerebral, middle cerebral, basilar, right vertebral and left posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The left vertebral artery in the neck is also hypoplastic.

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

The MRI/MRA features are suggestive of a hypoplastic left vertebral artery and the A1 segment of the right anterior cerebral artery.

No other significant abnormality is detected on this study.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Chilmn / F / 30 yrs.
Referred by : Dr. Abc Xyzrkar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered behaviour since 1 week (? indifferentiated schizophrenia).
C/O twitching on the right side of mouth and right hemifacial spasm since 4 days.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
3 mm thick T1 Weighted coronal images.
Limited MRA through the region of interest.
5 mm thick T1 Weighted sagittal images.
MR cisternogram was obtained in the coronal plane.

OBSERVATION :

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

The seventh and eighth cranial nerve complex on either side are unremarkable.

There is mild fullness of the ventricular system. Also seen is mild 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.

IMPRESSION :

No significant abnormality detected on this study.

hs/nv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Palmn / M / 13 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O fall with loss of consciousness for 15 minutes on 00.00.00.

EXAMINATION :

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

5 mm thick Proton and T2 Weighted axial images.

3 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick FLAIR coronal images.

OBSERVATION :

There is severe distortion and degrading of the anatomy as well as the signal characteristics, more so anteriorly on the axial images due to the presence of dental prosthesis.

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

The hippocampus is unremarkable on either side. Mild fullness of right temporal horn is noted.

Both the lateral, third and the fourth ventricles are otherwise 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 :

No significant abnormality is detected within brain on this study.

hs/sb/nl/rg/nl
/00002 Date : 00.00.00

Name of the Patient : Abc Xylmn / F / 74 yrs.
Referred by : Dr. Abc Xyzlal.
Examination : M.R.I. of the Pelvis & Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O menorrhagia.
C/O urinary incontinence and renal insufficiency.
Known diabetic/hypertensive.

EXAMINATION :

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

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

6 mm thick T1 Weighted coronal images.

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 T2 Weighted axial images.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

PELVIS:

The uterus is seen to be bulky. The endometrial cavity is widened and shows a hyperintense signal on the T2 Weighted images. There is a break of the junctional zone at the posterior aspect of the uterus (se/im 103.10). The myometrium shows a few areas of hyperintensity on the T2 Weighted images.
..2/.







A Foleys catheter is noted in the urinary bladder. There is slight thickening of the wall of the urinary bladder. The utero-vesical pouch appears to be well maintained.

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.

LUMBO-SACRAL SPINE:

There is Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra. Also seen is retroplacement of the L5 vertebra over the S1 vertebra.

Posterior and far lateral (extraforaminal) disc bulges are seen at the L2-L3, L3-L4, L4-L5 and L5-S1 levels. There is mild bilateral neural foraminal narrowing at these levels.

The L4-L5 facet joints show hypertrophic degenerative changes. The L3-L4 and L5-S1 facet joints show mild degenerative changes.

A large Schmorls node is seen at the superior aspect of the L5 vertebral body.

The lumbar intervertebral discs show loss of water content. The lumbar vertebral bodies show areas of fatty replacement of normal marrow.

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 S1 level.
..3/.









- 3 - Scan-00002


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

14.0 mm at L1-L2
15.0 mm at L2-L3
15.0 mm at L3-L4
10.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. A bulky uterus with a widened endometrial cavity and a break in the junctional zone as decribed may be the result of an endometrial carcinoma.

2. Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra.

3. Posterior and far lateral (extraforaminal) disc bulges at the L2-L3, L3-L4, L4-L5 and L5-S1 levels.

4. Hypertrophic facetal arthropathy at the L4-L5 level.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Panlmn / F / 14 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 1 year.
H/O fall 3 months back.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

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

The visualized dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

The lumbo-sacral spine was screened with 5 mm thick T1 Weighted sagittal images and the cervico-dorsal spine was screened with 4 mm thick T1 Weighted sagittal images and this do not reveal any significant feature of note.

IMPRESSION :

No abnormality is detected within the dorsal spine on this study.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 46 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O surgery for a tumor (glial cell tumor) on 00.00.00. Lesion was a Grade III astrocytoma. Patient has received radiotherapy.
For follow-up.

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 evidence of a right frontal craniotomy.

There are fairly well-defined areas which are iso to hyperintense to CSF on all the pulse sequences within the right frontal lobe and would most likely represent cystic changes. Areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images are seen adjacent to these areas. Also seen is indentation upon and inferior displacement of the frontal horn and posterior body of the right lateral ventricle. There is a slight shift of the anterior falx to the left side.

The left lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.





IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. A mass lesion in the right frontal lobe as described. This most likely represents residual/recurrent lesion (? a few areas of cystic encephalomalacia may be the result of previous surgery.

A contrast enhanced scan would be worthwhile.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzPlmn / M / 32 yrs.
Referred by : Dr. Abc Xyzlal.
Examination : M.R.I. of the Neck.

CLINICAL PROFILE :

C/O intraoral swelling, gradually progressive since 2 years with change in voice since 10-15 days.

EXAMINATION :

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

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

5 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is seen a fairly large, approximately 6.5 x 4.1 x 5.8 cms sized mass lesion in the left parapharyngeal space. This lesion is of intermediate signal on the T1 Weighted images and turns heterogeneously hyperintense on the T2 Weighted images. Cystic/necrotic areas (hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images) are noted within this lesion. A focal, hyperintense signal on all the pulse sequences is noted within this lesion, inferiorly, which may represent haemorrhage. There is resultant compression of the nasopharynx
and oropharynx, which is displaced to the right. The pterygoid muscles on the left are displaced laterally. The base of the tongue is pushed anteriorly and the left carotid sheath is displaced posteriorly. Effacement of the left Fossa of Rosenmuller and eustachion tube is noted.

The parotid and submandibular glands are seen separate from the lesion.
..2/.






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

Inflammatory mucosal thickening is noted in the maxillary sinuses and mastoid air cells bilaterally.

IMPRESSION :

An approximately 6.5 x 4.1 x 5.8 cms sized mass lesion in the left parapharyngeal space with signal characteristics and relations as described is not specific for a single etiology. This most likely represents a salivary gland tumor arising from salivary cell rests.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Banlmn / F / 80 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O weakness and paresthesias in BLE since 10 days.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is seen a hyperintense signal on the T2 Weighted images in the dorsal spinal cord, centrally, at the D8 and D9 vertebral levels. This lesion appears isointense to normal cord on the T1 Weighted images (scan 104.4, 107.9, 107.10).

Slight facetal hypertrophy is noted at the D9-D10 and D10-D11 levels on the right.

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

The dorsal vertebral bodies show spotty fatty marrow changes suggesting osteoporosis. The D6 vertebral body appears wedged. Slight wedging of the D11 body is also noted.

The visualized pre and paravertebral soft tissues are unremarkable.




The conus medullaris terminates at the L1-L2 level.

Screening T1 Weighted sagittal images of the lumbo-sacral spine reveal fatty marrow changes of the lumbar vertebrae. Small, postero-central protruded discs are also noted at the L4-L5 and L5-S1 levels.

IMPRESSION :

1. Altered signal in the dorsal spinal cord, centrally, at the D8 and D9 vertebral levels, may represent myelitis/demyelinating lesion.

2. Fatty marrow changes in the dorsal and lumbar vertebrae may suggest osteoporotic changes.

3. Wedged D6 and D11 vertebrae may suggest osteoporotic fractures.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzal Panlmn / M / 72 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O stiffness all over the body with memory loss, gait imbalance and dysarthria since 3 days.
H/O excessive sleep and slowing of activities since 5 years.

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 an ill-defined, iso to hypointense lesion on the T1 Weighted images in the subcortical white matter in the right frontal region. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images, but blooms on the Fast Scan (T2 *) images. Perilesional hyperintense signal on the FLAIR and Fast Scan (T2 *) images may represent edema/gliotic changes.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci and basal cisternal spaces bilaterally. There is no shift of the midline structures.

IMPRESSION :

A small, ill-marginated lesion in the subcortical white matter in the right frontal region, which blooms on the Fast Scan (T2 *) images, follows the signal characteristics of hemosiderin. This may represent residual hemosiderin from a previous bleed or may represent an occult vascular malformation (possibility of calcification is less likely).