ke/sb/nl/rg.
/00000 Date : 00.00.00

Name of the Patient : Abc Xyzdevi lmn / F / 45 yrs.
Referred by : Dr. Abc XyzShah.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O severe headaches since 2-3 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 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.

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

Incidentally noted is an empty sella.

INTRACRANIAL MRA :

The left posterior cerebral artery arises from the left internal carotid artery and may be a normal variant.

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 right 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 within the brain parenchyma or on the intracranial and neck MRA on this study.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzKaplmn / M / 67 yrs.
Referred by : Dr. Abc Xyz Sampat.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O diminished vision in the right eye with pain and heaviness of the head since 3-4 months.
Known hypertensive/diabetic.
Known C/O epilepsy.

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 ill-defined, hyperintense areas in the periatrial deep white matter on the T2 Weighted and FLAIR images. These are isointense to normal white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.

Small bright foci on the proton, T2 Weighted and FLAIR images are seen in the left corona radiata and centrum semiovale.

There is mild dilatation of both the lateral ventricles. The frontal horn of the right lateral ventricle appears small ? a normal variant. The third and the fourth ventricles are normal. There is slight prominence of the cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
..2/.






INTRACRANIAL MRA :

The right anterior communicating artery is hypoplastic. The right posterior cerebral artery arises from the right internal carotid artery.

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

NECK MRA :

There is concentric narrowing of the right carotid bulb and the proximal right and internal and external carotid arteries for approximately 1.2 cms. This could be due to atherosclerosis. A post-stenotic jet is noted in the proximal right internal cerebral artery.

The left common cartoid artery and its bifurcation and the vertebral arteries are unremarkable.

IMPRESSION :

1. Areas of altered signal in the periatrial deep white matter are suggestive of areas of ischemia/infarction.

2. Small bright foci in the left corona radiata and centrum semiovale may also represent ischemic lesions.

3. Hypoplastic right anterior communicating artery.

4. Concentric narrowing of the right carotid bulb and the proximal internal and external carotid arteries could be due to atherosclerosis.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzPalmn / M / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O backache and numbness in BLE and tingling in both hands.

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 :

Postero-central protruded discs are noted at the C3-C4, C4-C5 and C5-C6 levels.

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

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

The facet joints at the C3-C4, C4-C5 and C5-C6 levels show mild degenerative changes bilaterally.

The cervical spinal cord shows normal signal intensity.








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

IMPRESSION :

1. Postero-central protruded discs at the C3-C4, C4-C5 and C5-C6 levels.

2. Slight degenerative changes of the cervical facet joints bilaterally at the C3-C4, C4-C5 and C5-C6 levels.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Dlmn / M / 28 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

Alleged H/O fall 2 years back.
C/O pain in the left gluteal region with radiation to the LLE since 20 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.

OBSERVATION :

There is sacralization of the L5 vertebra and which is as marked on the film. There appears to be a spina bifida of the L5 vertebra.

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

There is a fairly large, postero-central and left paracentral extruded disc with peridiscal osteophytes at the L4-L5 level with thecal sac compression and indentation on the traversing left L5 nerve root. Slight inferior migration of the disc fragment is noted.

A minimal posterior disc bulge is noted at the L3-L4 level.

The articular facets at the L2-L3, L3-L4 and L4-L5 levels appear slightly hypertrophied.



The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. 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.

Fat is noted in the filum terminale.

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

19.0 mm at L1-L2
16.0 mm at L2-L3
15.0 mm at L3-L4
8.0 mm at L4-L5
15.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. A fairly large, postero-central and left paracentral extruded disc with peridiscal osteophytes at the L4-L5 level indenting the traversing left L5 nerve root. Slight inferior migration of the disc fragment is noted.

3. Canal stenosis at the L4-L5 level.

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzB. Jlmn / M / 45 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias (right more than left) since 4 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.

OBSERVATION :

The L5 vertebral body is as marked on the film.

There is loss of normal lumbar lordosis and loss of water content of the L3-L4, L4-L5 and L5-S1 intervertebral discs.

There is a fairly large, postero-central and right paracentral extruded disc with peridiscal osteophytes at the L5-S1 level with thecal sac compression and indentation on the traversing right S1 nerve root. Inferior migration of the disc fragment is noted. Bilateral postero-lateral and far lateral disc bulges are also noted at the L5-S1 level narrowing the neural foramina bilaterally at this level.

A posteriorly bulging disc is noted at the L4-L5 level with bilateral neural foraminal narrowing.






A left postero-lateral disc bulge is noted at the L3-L4 level.

The pedicles of the lower lumbar vertebrae are congenitally short in their antero-posterior dimensions.

The facet joints at the L5-S1 level show slight degenerative changes bilaterally.

Type II degenerative marrow changes are noted adjacent to the L5-S1 disc.

A hemangioma with fat content is noted in the L1 vertebral body.

The rest of the lumbar and sacral vertebral bodies show focal fatty change. 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-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 :

20.0 mm at L1-L2
17.0 mm at L2-L3
19.0 mm at L3-L4
19.0 mm at L4-L5
10.0 mm at L5-S1.
..3/.














- 3 - Scan-00004


IMPRESSION :

1. A fairly large, postero-central and right paracentral extruded disc with peridiscal osteophytes at the L5-S1 level indenting the traversing right S1 nerve root. Inferior migration of the disc fragment is noted. Bilateral postero-lateral and far lateral disc bulges are also noted at the L5-S1 level narrowing the neural foramina bilaterally at this level.

2. A posteriorly bulging disc at the L4-L5 level with bilateral neural foraminal narrowing.

3. A left postero-lateral disc bulge at the L3-L4 level.

4. Congenitally short pedicles of the lower lumbar vertebrae in their antero-posterior dimensions.

5. Slight degenerative changes of the facet joints at the L5-S1 level.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzxmi D. Dlmn / F / 48 yrs.
Referred by : Dr. Abc Xyzikwad.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in BLE.
H/O Right sided Ca Breast for which patient was operated in 0000. Received 6 cycles of chemotherapy and 10 sittings of radiotherapy.
Histopathology s/o infiltrative duct carcinoma.

EXAMINATION :

M.R.I of the dorso-lumbar 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 replacement of the normal marrow of nearly all the vertebrae of the spinal axis by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The C2, C4, D1, D2, D4 and D10 vertebral bodies appear expansile.

There is pre and paravertebral soft tissue extension over the D8 and D9 vertebral levels. The pedicles and the transverse processes of D9 vertebra is involved with anterior epidural extension and compression of the spinal cord. The spinal cord at this level shows a subtle hyperintense signal on the T2 Weighted images suggestive of cord edema/ischemia.
Scan-00003


The right pedicle and transverse process as well as the spinous process of the D3 vertebra is also involved with right lateral epidural extension. Posterior elements of the D2 are also involved.

The lumbar intervertebral discs show loss of water content.

The facet joints are unremarkable.

The conus medullaris terminates at the L1 level.

Susceptibility artifacts are noted in the pelvis.

IMPRESSION :

In a known C/O Ca breast the MRI features are suggestive of multiple metastases involving the spinal axis with epidural extension as described at the D3 and D9 levels with cord compression and cord signal alteration suggestive of cord edema/ischemia at the D9 level.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 15 yrs.
Referred by : Dr. Abc Xyzi.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O ALL diagnosed in 0000. Radiotherapy (10 sittings) and chemotherapy (4 cycles) received.

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.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzer lmn / F / 32 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE since 6 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 :

Minimal posterior disc bulges are noted at the L4-L5 and L5-S1 levels.

The lumbar vertebral bodies and the 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 D12 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
18.0 mm at L2-L3
17.0 mm at L3-L4
13.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of minimal posterior disc bulges at the L4-L5 and L5-S1 levels.

hs/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzalmn / F / 39 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (left more than right) since 0000 (on & off) with numbness which has increased since 3-4 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 are small posterior disc bulges at the L4-L5 and L5-S1 levels with indentation upon the thecal sac at the L4-L5 level.

The lumbar intervertebral discs show slight loss of water content.

The right kidney is not visualized in it normal position.

The lumbar vertebral bodies reveal normal signal intensity. 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.



- 2 - scan-00000


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

19.0 mm at L1-L2
21.0 mm at L2-L3
21.0 mm at L3-L4
19.0 mm at L4-L5
14.0 mm at L5-S1.

The cervical and dorsal spines were screened with 5 mm thick T2 Weighted sagittal images which do not reveal any significant feature of note.

IMPRESSION :

The MRI features are suggestive of small posterior disc bulges at the L4-L5 and L5-S1 levels.

hs/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzSollmn / F / 7 yrs.
Referred by : Dr. Abc Xyzroff.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 00.00.00.

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 and T2 Weighted coronal images.

OBSERVATION :

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

The hippocampal complex on either side is unremarkable.

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.