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Sunday, 27 December 2015 16:48

12379

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzben lmn / F / 78 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with numbness since 1 month.
H/O fall 2 years back.

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 right which is as marked on the film.

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

There is Grade I spondylolisthesis of the L4 over the L5 vertebra without obvious spondylolysis.

There is central wedging of the D12 vertebral body which appears hypointense on the T1 Weighted images and heterogeneously hypointense on the T2 Weighted images. The superior and inferior cortical endplates of D12 appear intact. Mild bulge of the posterior margin of the D12 body is noted indenting the dural theca anteriorly.

Central and anterior wedging of the D10 and L1 vertebral bodies is also noted with fatty marrow changes. Fairly large posterior peridiscal osteophyte is noted at the L1-L2 and D10-D11 levels indenting the dural theca anteriorly.
..2/.




- 2 - scan-00009


Slight central wedging of the L3 vertebral body along its inferior margin is noted with a subtle hypointense signal on T1 Weighted images which turns hyperintense on the T2 Weighted images adjacent to the inferior cortical endplates of the L3 vertebral body which may represent a compression fracture.

Posteriorly bulging discs are noted at the L5-S1, L4-L5 and L2-L3 levels indenting the dural theca anteriorly.

A posteriorly herniated disc is noted at the L3-L4 level with bilateral neural foraminal narrowing and canal stenosis.

Facetal hypertrophy is noted at the D11-D12, L4-L5 and L3-L4 levels bilaterally.

The rest of the visualized dorsal and lumbar vertebral bodies show spotty fatty changes suggesting osteoporosis.

The visualized pre and paravertebral soft tissues are unremarkable.

The lower dorsal spinal cord shows normal signal.

The conus medullaris terminates at the D12-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 :

15.0 mm at L1-L2
15.0 mm at L2-L3
12.0 mm at L3-L4
10.0 mm at L4-L5
9.0 mm at L5-S1.

Screening T1 Weighted sagittal images of the dorsal spine reveal wedged D9 vertebra with fatty marrow changes in the rest of the dorsal vertebrae as described.
..3/.






- 3 - scan-00009

IMPRESSION :

1. Partial sacralization of the L5 vertebra on the right.

2. Grade I spondylolisthesis of the L4 over the L5 vertebra without obvious spondylolysis.

3. Wedging of the D10, D12, L1 and L3 vertebral bodies as described most likely is the sequelae of previous compression fractures superimposed on an osteoporotic spine. Altered signal in the D12 vertebral body suggests bone bruise/edema.

4. Fairly large posterior peridiscal osteophyte at the L1-L2 and D10-D11 levels.

5. Posteriorly bulging discs at the L5-S1, L4-L5 and L2-L3 levels.

6. A posteriorly herniated disc at the L3-L4 level with bilateral neural foraminal narrowing.

7. Facetal hypertrophy at the D11-D12, L4-L5 and L3-L4 levels bilaterally.

8. Lower lumbar canal stenosis.

9. Fatty marrow changes in the visualized dorsal and lumbar vertebral bodies (except for D12 and L3 vertebrae) suggests osteoporosis.






Sunday, 27 December 2015 16:48

12378

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzam Ylmn / M / 44 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

H/O fall 7-8 years back followed with pain in the RLE.
C/O radicular pain to the RLE with tingling in the sole.

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 a right postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level with indentation on the right S1 nerve root and right neural foraminal narrowing. There is a sequestered disc fragment in the right lateral recess at S1. There is also a suggestion of inflammation of the right S1 nerve root.

A diffuse posterior disc herniation with peridiscal osteophytes is seen at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. Mild facetal arthropathy and ligamentum flavum hypertrophy is noted at this level with resultant canal stenosis.

Small left far lateral disc bulge is noted at the L3-L4 level. The L4-L5 and L5-S1 intervertebral discs show loss of water content.



Subtle hypointense signal is seen in the S1 vertebral body on the T1 Weighted images adjacent to its superior cortical endplate and is heterogeneously hypointense on the T2 Weighted images and would represent Type I/III degenerative changes.

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 :

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

Screening, T2 Weighted sagittal images of the dorsal spine do not show any significant feature of note.

IMPRESSION :

1. A right postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level with indentation on the right S1 nerve root. There is a suggestion of inflammation of the right S1 nerve root. A sequestered disc fragment is noted in the right lateral recess of S1 vertebra.

2. A diffuse posterior disc herniation with peridiscal osteophytes at the L4-L5 level with mild facetal arthropathy and ligamentum flavum hypertrophy at this level with resultant canal stenosis.

3. Small left far lateral disc bulge at the L3-L4 level.






Sunday, 27 December 2015 16:48

12377

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzl P. Jlmn / M / 16 yrs.
Referred by : Dr. Abc Xyzla.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain and pain in the entire body.

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 :

Slight clockwise rotation of the cervical vertebrae (? due to spasm, inspite of sedation) is noted.

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.

The cervical spinal cord shows normal signal intensity.

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

IMPRESSION :

No significant abnormality is detected within the cervical spine on this study.







Sunday, 27 December 2015 16:48

12375

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Shilmn / M / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered behaviour with diminished vision since 2 months.
Known alcoholic.

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.

3 mm thick STIR coronal images through the optic nerves.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a large area in the left temporo-occipital region which is iso to hypointense to CSF on the T1 Weighted images and is seen to turn hyperintense on the proton and T2 Weighted images. Hyperintense areas are noted adjacent to this lesion on the proton and T2 Weighted images which would represent gliosis. There is dilatation of the occipital horn of the left lateral ventricle and this lesion would represent an area of cystic encephalomalacia.

Hyperintense areas are noted in the periventricular deep white matter, pons and the right corona radiata and centrum semiovale. These are hypointense to the normal white matter on the T1 Weighted images suggestive of areas of ischemia/infarction.





Lacunar infarcts which are nearly isointense to CSF on all the pulse sequences of varying sizes are seen in the fronto-parietal deep white matter, right corona radiata and centrum semiovale, right cerebellar hemisphere, right occipital white matter and bilateral thalami.

Dilated perivascular spaces are seen in the lentiform nuclei bilaterally.

The optic nerves show normal signal intensity on the STIR images.

There is mild to moderate dilatation of both the lateral ventricles with fullness of the third and the fourth ventricles. There is slight prominence of the cerebral cortical sulci and cerebellar folia. 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. An area of cystic encephalomalacia in the left temporo-occipital region, the sequelae of previous vascular insult.

2. Altered signal in the periventricular deep white matter, pons and the right corona radiata and centrum semiovale are suggestive of areas of ischemia/infarction.

3. Lacunar infarcts in the fronto-parietal deep white matter, right corona radiata and centrum semiovale, right cerebellar hemisphere, right occipital white matter and bilateral thalami.


Sunday, 27 December 2015 16:48

12374

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 65 yrs.
Referred by : Dr. Abc Xyzrkar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered behaviour since 1 month.
Chronic alcoholic.

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 an ill-defined, hypointense area in the right temporo-occipital lobes along the gyri and the adjacent white matter on the T1 Weighted images. This is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images.

There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular and fronto-parietal white matter bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are most likely ischemic in etilogy. Similar but smaller areas are seen in bilateral thalami and in the pons on the right side.

Lacunar infarcts (iso to hyperintense to CSF on all the pulse sequences) are seen in the left thalamus and right lentiform nucleus.

There is mild fullness of the third and both the lateral ventricles. The fourth ventricle is 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-00004


IMPRESSION :

The MRI features are suggestive of :

1. An old infarct in the right temporo-occipital lobes.

2. Altered signal in the periventricular and fronto-parietal white matter bilaterally, bilateral thalami and in the pons on the right side are most likely ischemic in etiology.

3. Lacunar infarcts in the left thalamus and right lenfiform nucleus.
Sunday, 27 December 2015 16:48

12373

Date : 00.00.00

Name of the Patient : Abc Xyznlmn / F / 23 yrs.
Referred by : Dr. Abc Xyzinde.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O sudden onset of paraparesis of BLE and weakness of BUE since 15 days.
C/O backache since 7-8 months.

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.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is collapse of the D3 vertebral body with retropulsion
with a small angular kyphus at that level. There is replacement of the normal marrow of the D2, D3 and D4 vertebral bodies by hypointense areas on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted images. The D2-D3 and D3-D4 invertebral discs are also involved. There is pre and paravertebral soft tissue extension over the D1-D2 to D4-D5 levels which shows slight hyperintense signal on the T1 Weighted images with few areas of hypointensity. This is seen to turn heterogeneously hyperintense on the T2 Weighted images
and would represent abscess/granulation tissue. Anterior epidural extension is seen over the D2 to D4 vertebral levels with severe compression of the spinal cord with subtle hyperintense signal on the T2 Weighted images over these levels. There is encroachment of the pathologic process into the D2-D3 and D3-D4 neural foramina bilaterally with encasement of the exiting nerve roots.


Subtle altered signal is also seen in the C5, D9 and D10 vertebral bodies.

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

Incidental note is made of gravid uterus.

IMPRESSION :

The MRI features are suggestive of altered signal of the D2, D3, D4, C5, D9 and D10 vertebrae with soft tissue extensions with cord compression and cord edema/ischemia/myelitis as described. This most likely represents a granulomatous infective process like tuberculosis.

The possibility of this being a neoplastic process like a small cell tumor is less likely.

Sunday, 27 December 2015 16:48

12372

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzhad Sollmn / M / 6 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall from staircase on 00.00.00.
C/O pain in the LLE with inability to stand and inability to swallow.

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 T2 Weighted coronal images.

5 mm thick Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal 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.

There is no evidence of any obvious haemorrhage on this study.

IMPRESSION :

Normal study of the Brain.

Sunday, 27 December 2015 16:48

12371

ke/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzaj lmn / M / 46 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE (left more than right) with paresthesias since 0000.

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.

FEW IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

There is slight forward subluxation of the L5 vertebra over the S1 vertebra. There is a suspicion of spondylolysis of the L5 vertebra. Please correlate with plain radiographs.

A pseudoposterior disc bulge with a peridiscal osteophyte is seen at the L5-S1 level with mild bilateral neural foraminal narrowing. Bilateral far lateral (extraforaminal) disc bulges are seen at this level.

A small postero-central disc herniation is seen to indent the thecal sac at the L4-L5 level. A left far lateral (extraforaminal) disc herniation is seen to indent the extraforaminal portion of the exiting left L4 nerve root at the L4-L5 level.
Scan-00001


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

The L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.

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

Mild ligamentum flavum hypertrophy is seen at the 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 D12 level and the thecal sac terminates at the S1-S2 level.

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

16.0 mm at L1-L2

16.0 mm at L2-L3

15.0 mm at L3-L4

13.0 mm at L4-L5

18.0 mm at L5-S1.
..3/.














- 3 - Scan-00001


IMPRESSION :

1. Slight forward subluxation of the L5 vertebra over the S1 vertebra with suspicious spondylolysis of the L5 vertebra. Please correlate with plain radiographs.

2. A small postero-central disc herniation at the L4-L5 level.

3. A left far lateral (extraforaminal) disc herniation indenting the extraforaminal portion of the exiting left L4 nerve root at the L4-L5 level.

4. A posterior disc bulge at the L3-L4 level.

5. Facetal arthropathy at the L3-L4 and L4-L5 levels.








Sunday, 27 December 2015 16:48

12370

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzdas Ralmn / M / 68 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in both hips since 2 years.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

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

5 mm thick Fast Scan (T2 *) sagittal images.

OBSERVATION :

The femoral head and the acetabulum reveal normal signal intensity bilaterally. There is no obvious bony destruction or erosions noted. The articular cartilages are unremarkable. There is no effusion within both the hip joints.

The musculature surrounding both the hip joints is normal.

Incidentally noted is slight enlargement of the prostate.

IMPRESSION :

No abnormality detected within the hip joints on this study.

Sunday, 27 December 2015 16:48

12367

ke/hs/rg/nl
/00007 Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 30 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness, vomiting and inability to walk since 5-6 days and tendency to fall to the right side.

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 are hyperintense areas in the right cerebellar hemisphere inferiorly and posterior to the fourth ventricle on the proton, T2 Weighted and Fast Scan (T2 *) images. These are hypointense to grey matter on the T1 Weighted images. Similar areas are noted in the medulla on the right side, posteriorly. There is mild compression upon the fourth ventricle. There is herniation of the cerebellar tonsils through the foramen magnum.

There is mild fullness of both the lateral ventricles. The third ventricle is re normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

The calibre of the right vertebral artery is smaller as compared to the opposite side.

Incidental note is made of left frontal sinusitis.

IMPRESSION :

Altered signal in the right cerebellar hemisphere and medulla as described on the right side, would represent a fresh infarct (right posterior inferior cerebellar artery territory and the watershed with the right superior cerebellar artery).