sb/hs/nl/rg
Date : 00.00.00

Name of the Patient : Abc Xylmn / F / 30 yrs.
Referred by : Dr. Abc Xyzndhi.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since childhood upto the age of 5 years.
Now C/O headaches with ? seizures since March 0000.

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, T2 Weighted and FLAIR coronal images.

OBSERVATION :

There is a CSF signal intensity lesion on all the pulse sequences in the right parieto-occipital lobe, which represents cystic changes. Minimal, perilesional hyperintense signal on the FLAIR images may represent gliotic changes.

The left hippocampus appears slightly smaller in size when compared to the right and shows a hyperintense signal on the T2 Weighted images.

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 :

1. Altered signal in the right parieto-occipital lobe represents an area of cystic encephalomalacia.

2. Slight decrease in the volume of the left hippocampal complex with altered signal suggests left hippocampal sclerosis.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzollmn / M / 15 yrs.
Referred by : Dr. Abc Xyzzzare.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O febrile illness 1 month back with quadriparesis since 15 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.
5 mm thick FLAIR coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are near symmetric, ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally, bilateral capsular regions, centrum semiovale and thalami, in the brainstem and in the white matter in the cerebellar hemispheres bilaterally. These lesions appear hypointense to normal white matter on the T1 Weighted images. Few cystic (hypointense on the T1 Weighted and FLAIR images) areas are seen in the parietal lobes bilaterally.

Both the lateral and third ventricles are normal. Mild effacement of the fourth ventricle is noted. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Near symmetric, altered signal intensity in the cerebral and cerebellar hemispheres bilaterally and in the brainstem as described is not specific for a single etiology. Post-infective demyelination seems a likely possibility in the given clinical setting (leukodystrophies may have a similar appearance)

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz. Sollmn / M / 15 yrs.
Referred by : Dr. Abc Xyzzzare.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

H/O febrile illness 1 month back with quadriparesis since 15 days.

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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

Small postero-central protruded discs are noted at the C4-C5 and C5-C6 levels.

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

There is no extrinsic cord compression. The cervical spinal cord shows normal signal intensity.

The atlanto-axial region is unremarkable.

Altered signal in the brainstem is as described on the brain study.

- 2 - scan-00006


IMPRESSION :

The MRI features are suggestive of a small postero-central protruded discs at the C4-C5 and C5-C6 levels.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzhlmn / F / 20 yrs.
Referred by : Dr. Abc Xyzinani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures 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.
4 mm thick FLAIR coronal images.
3 mm thick T1 Weighted coronal images.

PATIENT REFUSED CONTRAST EXAMINATION.

OBSERVATION :

There is an ill-defined hyperintense signal on the proton, T2 Weighted and FLAIR images in the subcortical white matter in the left posterior parietal region. This signal appears iso to hypointense to normal white matter on the T1 Weighted images.

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 :

Altered signal in the subcortical white matter in the left posterior parietal region as described, most likely represents perilesional edema, probably around a granuloma. It is however difficult to identify a focal lesion in that region.

A contrast enhanced scan is essential.

The previous CT Scan was not available for review/comparison.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Prathlmn / M / 28 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 3 1/2 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is no focal area of altered signal intensity within the brain parenchyma (A prominent perivascular space is noted in the left periatrial region).

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.

d Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 21 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O TB of left TM joint. Craniotomy with excision of tumor (tuberculoma) in left occipital lobe done on 00.00.00.
For follow up. On AKT since May 0000.

EXAMINATION :

M.R.I of the cervico-dorsal 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 anterior wedging of the D3 and D4 vertebral bodies. The D3-D4 intervertebral disc is reduced in height and shows loss of water content.

The D3 and D4 vertebral bodies on the right appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the right paravertebral region over the D3 to D5 vertebral levels. This lesion appears hyperintense on the T2 Weighted images and shows a well-marginated hypointense rim, peripherally. Erosion of the right lateral margin and right pedicle of D3 and D4 vertebrae is noted. Extension of soft tissue lesion into the right neural foramen at the D3-D4 and D4-D5 levels and in the anterior right lateral epidural space at D3 and D4 levels is noted. There is
Scan-00003


also involvement of the D3 and D4 ribs proximally and the respective costo-vertebral joints on the right side. There is however no significant cord compression. The dorsal spinal cord over the D2 to D4 vertebral levels shows an ill-defined hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia.

A similar smaller lesion is noted in the left paravertebral region at the D2 and D3 vertebral levels. The left half of the D3 and D4 vertebral bodies show spotty fatty marrow changes which may suggests partial healing. The posterior elements of the D4 and D5 vertebrae seems to be involved by the lesion with subtle hyperintense signal on the T2 Weighted images in the right half of the D5 vertebral body.

A congenital block C5/C6 vertebra is noted.

The rest of the visualized cervico-dorsal vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

IMPRESSION :

Altered signal of the D3 and D4 vertebral bodies as described most likely represents osteitis, probably tuberculous osteitis. Right paravertebral soft tissue lesion at the D3 and D4 vertebral levels may represent granulation tissue, which is seen to extend into the anterior and right lateral epidural space. Altered signal in the dorsal spinal cord over the D2 to D4 vertebral levels suggests cord edema/ischemia.

Altered signal in the D5 vertebra and the posterior elements of the D4 and D5 may also represent osteitis.

The possibility of the neoplasm is less likely.

Previous investigations were unavailable for comparison.

Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 21 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O TB of left TM joint. Craniotomy with excision of tuberculoma in left occipital lobe done on 00.00.00.
For follow up. On AKT since May 0000.

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 evidence of a left parieto-occipital craniotomy. Susceptibility artifacts are noted in that region.

There is volume loss in the left occipital lobe. There is an ill-defined, hypointense signal on the T1 Weighted images in the left parieto-occipital region which appears hyperintense on the proton, T2 Weighted and FLAIR images. These changes may represent gliotic/encephalomalacic changes, the sequelae of previous surgery. Minimal fullness of the occipital horn of the left lateral ventricle is noted.

Both the lateral, third and the fourth ventricles are otherwise unremarkable. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.









IMPRESSION :

1. Post-operative status.

2. Volume loss in the left occipital lobe with altered signal
suggests gliotic/encephalomalacic changes, the sequelae of previous surgery.

As compared to the previous MRI dated 00.00.00 (scan no. 733), the previously identified lesion in the occipital lobe is not identified on the present study. The lesion in the clivus and in the left frontal lobe are not well identified on this scan and show resolution.

If clinically indicated a contrast enhanced scan may be worthwhile.

ke/sb/rg.
/82 Date : 00.00.00

Name of the Patient : Abc Xyzhai Jlmn / M / 68 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches and difficulty in speaking since 2-3 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.

5 mm thick FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

IMAGES SHOW PATIENT MOTION. PATIENT WAS UN-COOPERATIVE INSPITE OF SEDATION.

OBSERVATION :

There is an ill-defined hyperintense area in the left frontal region on the proton, T2 Weighted and FLAIR images. This is isointense to hypointense to the normal white mater on the T1 Weighted images suggestive of an area of ischemia/infarction.

Ill-defined areas which are seen to follow CSF signal characteristics on all the pulse sequences in the cerebellar hemispheres bilaterally and represent old infarcts.

There is mild fullness of both the lateral ventricles.

There is slight prominence of the cerebral cortical sulci bilaterally.

The 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.
..2/.




- 2 - scan-00002


IMPRESSION :

The MRI features are suggestive of :

1. Areas of ischemia/infarction in the left frontal region.

2. Old infarcts in the cerebellar hemispheres bilaterally.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzJolmn / M / 54 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial M.R.A.

CLINICAL PROFILE :

C/O drooping of the right eyelid with diplopia and left sided headaches since 1 month.

EXAMINATION :

The brain was scanned with 5 mm thick T2 Weighted axial images, 4 mm thick T1 Weighted and STIR coronal images and 5 mm thick T1 Weighted sagittal images.

Intracranial MRA was performed with a 3D TOF sequence.

OBSERVATION :

There is seen a well-defined, expansile lesion in the sphenoid sinus measuring approximately 5.3 x 3.6 x 2.9 cms. This lesion is slightly hyperintense to CSF on all the pulse sequences. Extension of the lesion into the posterior ethmoidal air cells on the left is noted. There is elevation of the floor of the sella, which appears flattened. The pituitary gland is displaced superiorly with compression upon the optic chiasm more so on the right side. Slight compression upon the cavernous sinuses is noted.

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

Both the lateral, third and the fourth ventricles are normal.

The optic nerves show normal signal intensity.
Scan-00001



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.

IMPRESSION :

An expansile mass lesion in the sphenoid sinus as described, most likely represents a mucocele of the sphenoid sinus.

No significant abnormality is detected in the brain parenchyma per se or on the intracranial MRA on this study.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzi Jalmn / M / 46 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (right more than left) with paresthesias since 1 year.

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 L3-L4 and L4-L5 intervertebral discs.

A small posterior disc bulge is noted at the L5-S1 level.

A small posterior disc herniation is noted at the L4-L5 level with bilateral neural foraminal narrowing. There is also ligamentum flavum hypertrophy at the L5 and L4-L5 levels with resultant canal stenosis.

A small posterior bulge and left far lateral disc herniation is noted at the L3-L4 level with left neural foraminal narrowing.

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





Anterior disc herniations are seen at the L4-L5 and L3-L4 levels.

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 lower dorsal spinal cord shows normal signal.

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 :

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

IMPRESSION :

1. A small posterior disc herniation at the L4-L5 level with slight bilateral neural foraminal narrowing and ligamentum flavum hypertrophy.

2. A small posterior disc bulge and left far lateral disc herniation at the L3-L4 level with left neural foraminal narrowing.

3. Slight facet hypertrophy at the L4-L5 and L5-S1 levels.

4. A small posterior disc bulge at the L5-S1 level.

5. Congenitally short pedicles of the lower lumbar vertebrae in their antero-posterior dimensions with lower lumbar canal stenosis.