sb/hs/nl
Date : 00.00.00

Name of the Patient : Abc Xyzni lmn / F / 33 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with numbness.

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 water content of the L5-S1 intervertebral disc and slight loss of water content of the L2-L3 intervertebral disc.

There is a fairly large, postero-central and left paracentral extruded disc with peridiscal osteophytes at the L5-S1 level with thecal sac compression and indentation on the traversing left S1 nerve root. Slight superior migration of the disc fragment is also noted.

Type I and Type II degenerative marrow changes are noted in the L5 and S1 vertebral bodies adjacent to the L5-S1 disc. Anterior disc bulge with peridiscal osteophytes is noted at this level.








The rest of the lumbar vertebral bodies and the remaining 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 L1 level and the thecal sac terminates at the S3 level.

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

21.0 mm at L1-L2
21.0 mm at L2-L3
20.0 mm at L3-L4
18.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

Fairly large, postero-central and left paracentral extruded disc with peridiscal osteophytes at the L5-S1 level indenting the traversing left S1 nerve root with resultant canal stenosis at this level.

Date : 00.00.00

Name of the Patient : Abc Xyzlal B. lmn / M / 68 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

H/O fracture neck femur in November 0000.
C/O pain in the LLE with inability to walk since November 0000.
H/O left hip joint arthroplasty on 00.00.00 with subsequent traction. Infection at site of pin in the left knee joint.
Now C/O inability to walk.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is evidence of excision of the head and neck of left femur. There is loss of normal contour of the left acetabulum. Superior migration of the left femur is noted with the greater trochanter lying about 5.5 cms inferior to the left iliac crest. There is seen an intermediate signal intensity lesion on the T1 Weighted images in the region of the left acetabulum, which appears hyperintense on the T2 Weighted images. This may represent fibrous/scar tissue, in the given clinical setting. Probable synovial thickening around the left acetabulum is noted.

The left iliac and pubic bones constituting the left acetabulum appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted and STIR images.


There is seen an ill-defined, hyperintense signal on the T2 Weighted and STIR images in the fat planes along the muscles around the left hip joint and in the visualized proximal left thigh (namely, the left obturator internus, obturator externus, biceps, semitendinous and vastus lateralis). Some of the muscles themselves seem to show altered signal. The muscles around the visualized hip joints on either side and in the visualized proximal thighs appear atrophied, more on the left side.

No obvious signal change is identified in the visualized left femur.

The visualized right hip joint and right femur are unremarkable.

IMPRESSION :

1. Post-operative status.

2. Altered signal intensity lesion in the region of the left acetabulum may represent fibrous tissue in the given clinical setting. Altered signal in the left iliac and pubic bones constituting the left acetabulum may also represent post-operative changes.

3. Altered signal along the fat planes around the muscles around the left hip joint and proximal left thigh suggest inflammatory changes/myositis, in the given clinical setting.

4. Atrophy of the muscles around both the hip joints and proximal thighs, more on the left side.

sb/hs/nl
Date : 00.00.00

Name of the Patient : Abc Xyzslmn / M / 72 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O right sided weakness since 1 day.

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 an ill-defined, hyperintense signal on the T2 Weighted images in the pons, just to the left of the midline. This lesion most likely represents an ischemic lesion, probably recent, in the given clinical setting.

Ill-defined, hyperintense signal on the T2 Weighted images in the periventricular white matter bilaterally and in bilateral centrum semiovale also represents white matter ischemic changes.

Lacunar infarcts are noted in the right lentiform nucleus and right thalamus.

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

Incidentally noted is an empty sella.



INTRACRANIAL MRA :

There is hypoplasia of the right vertebral artery. There is slight irregularity and narrowing of both the vertebral arteries, distally, the proximal basilar artery and the cavernous segment of the right internal carotid artery. The posterior cerewbral arteries are slightly attenuated.

The vertebral arteries are ectatic.

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

NECK MRA :

The visualized common carotid arteries and their bifurcations are unremarkable. The visualized left vertebral artery appears normal.

The visualized right vertebral artery is hypoplastic. Slight narrowing of the right vertebral artery at the junction of its proximal and middle third segments in the neck is noted.

IMPRESSION :

1. Altered signal in the pons, just to the left of the midline most likely represents an ischemic lesion, probably recent, in the given clinical setting.

2. Altered signal in the periventricular white matter bilaterally and in bilateral centrum semiovale also represents white matter ischemic changes.
..3/.









- 3 - Scan-00003



3. Lacunar infarcts in the right lentiform nucleus and right thalamus.

4. Irregularity and narrowing of the distal vertebral arteries, the proximal basilar artery and the cavernous segment of the right internal carotid artery may represent atherosclerotic changes.

sb/hs/nl
Date : 00.00.00

Name of the Patient : Abc Xyzben Dhlmn / F / 63 yrs.
Referred by : Dr. Abc Xyz Kothari.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the right thigh since 15 days.

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 axial images.

5 mm thick T1 Weighted 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 and the visualized pelvis is normal.

The uterus appears slightly bulky.

IMPRESSION :

Normal study of Both Hip Joints.

sb/hs/nl
Date : 00.00.00

Name of the Patient : Abc XyzDlmn / M / 75 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O weakness of BLE since 4-6 months with bladder involvement since 8 days.

EXAMINATION :

M.R.I of the 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.

The cervical and lumbar spines were screened with 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

All the vertebrae in the entire spinal axis, the clivus and the visualized iliac bones show replacement of their normal fatty marrow by a hypointense signal on the T1 Weighted images which appears heterogeneously hyperintense on the T2 Weighted images. The dorsal intervertebral discs show slight loss of water content. The posterior segments of the visualized ribs on either side also show similar signal intensity changes.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the epidural space, circumferentially at the D6, D7, D9, D10 and D11 vertebral levels. This lesion also appears slightly hyperintense on the T2 Weighted images. Resultant effacement of the CSF space and mild












cord compression is noted at these levels. The dorsal spinal cord shows a hyperintense signal on the T2 Weighted images at the D6, D7 and D10 vertebral levels which may suggest cord edema/ischemia. There is compromise of the neural foramina bilaterally, in the dorsal region, at the levels of the epidural soft tissue lesion.

Bulging of the posterior margins of the lumbar vertebral bodies is noted.

The conus medullaris terminates at the L1 level.

Incidentally noted is a soft tissue lesion in the lower lobe of the right lung, posteriorly and probable pleural effusion bilaterally.

IMPRESSION :

Altered signal of all the vertebrae in the spinal axis, the clivus, iliac bones and the posterior segments of the visualized ribs as described, with epidural soft tissue lesion in the dorsal region, is not specific for a single etiology. The differential diagnosis would include :

1. Sclerotic metastasis, (? from a carcinoma of the prostate).

2. Round cell tumors (eg. lymphoma).

sb/hs/nl
Date : 00.00.00

Name of the Patient : Abc Xyzai Shlmn / F / 12 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O severe mental retardation.

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 T2 Weighted coronal images.

OBSERVATION :

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

The hippocampal complex is unremarkable on either side.

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/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Chlmn / F / 15 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 14 years with speech disturbances since 4 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.

The hippocampal complex on either side is unremarkable.

The cerebellar tonsils appear pointed but are seen to lie above the foramen magnum.

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.

Note is made of a giant cisterna magna and enlarged adenoids. Note is also made of a superior convex margin of the pituitary gland which may be normal for the patients age.

IMPRESSION :

Normal study of the Brain.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzBlmn / M / 35 yrs.
Referred by : Dr. Abc XyzDhiware.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 0000 which has increased since 8 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 is sacralization of the L5 vertebra.

There is loss of water content of the L2-L3, L3-L4 and L4-L5 intervertebral discs.

A small, postero-central protruded disc with peridiscal osteophytes is noted at the L5-S1 level.

A small, postero-central and left paracentral disc herniation with peridiscal osteophyte is noted at the L4-L5 level with left neural foraminal narrowing.

A left paracentral disc herniation is noted at the L3-L4 level indenting the traversing left L4 nerve root.

A postero-central and left paracentral disc herniation is noted at the L2-L3 level indenting the left L3 nerve root.
Scan-00008


A small postero-central protruded disc is noted at the L1-L2 level.

The facet joints in the lumbar region appear slightly hypertrophied.

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

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 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 :

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

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. A small, postero-central protruded disc with peridiscal osteophytes at the L5-S1 level.
..3/.












- 3 - Scan-00008



3. A small, postero-central and left paracentral disc herniation with peridiscal osteophyte at the L4-L5 level with left neural foraminal narrowing.

4. A left paracentral disc herniation at the L3-L4 level indenting the traversing left L4 nerve root.

5. A postero-central and left paracentral disc herniation at the L2-L3 level indenting the left L3 nerve root.

6. A small postero-central protruded disc at the L1-L2 level.

7. Slight facetal hypertrophy in the lumbar region.

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

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzSilmn / M / 59 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches and numbness over the left side of the face since 2 1/2 months.
H/O high blood pressure with profuse bleeding from nose prior to this.

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.

A limited MRA sequence (source images) was also obtained.

OBSERVATION :

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

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

No focal mass lesion is identified along the trigeminal nerve or the seventh and the eighth cranial nerve complex on either side. A vascular twig is noted at the root exit zone of the left seventh and eighth cranial nerve complex, without deforming the same. No vascular loop is seen to deform the root entry zone of the trigeminal nerves on either side.
scan-00007


Inflammatory changes are noted in the left maxillary antrum.

IMPRESSION :

No significant abnormality is detected within the brain parenchyma per se.

A vascular twig is noted at the root exit zone of the left seventh and eighth cranial nerve complex, without deforming the same.

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzna Fernalmn / F / 49 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O vomiting for 4 days with giddiness since 8 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.

OBSERVATION :

There is a small area of hyperintensity on the FLAIR images within the white matter in the right frontal lobe (se/im 105.14).

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.

Inflammatory changes are seen within the maxillary sinuses (right more than left)

IMPRESSION :

The MRI features are suggestive of a focus of altered signal within the right frontal lobe (? ischemic in etiology).