Date : 00.00.00

Name of the Patient : Abc Xyzh Plmn / M / 10 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O progressive myoclonic epilepsy with mental regression and diminished vision of the right eye 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.

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.

The body of the right lateral ventricle appears smaller as compared to the left and may be a normal variant.

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.

Note is made of subgaleal edema in the posterior parietal region (? due to fall) and enlarged adenoids.

IMPRESSION :

No significant abnormality is detected within the brain per se on this study.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzm Slmn / M / 22 yrs.
Referred by : Dr. Abc Xyz. Modi.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

C/O pain in the right knee joint since 7 months.

EXAMINATION :

M.R.I of the right knee joint was performed using the following parameters :

4 mm thick T1 Weighted, proton and GRASS sagittal images.

4 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick GRASS axial images.

OBSERVATION :

Menisci

There is a linear hyperintense signal on all the pulse sequences in the posterior horn of the medial meniscus reaching upto the inferior articular surface and represents Grade III meniscal signal (meniscal tear).

Linear hyperintense signal is seen in the anterior and posterior horns of the lateral meniscus not reaching upto the articular surface and represent Grade II meniscal signal (meniscal degeneration).

The anterior horn of the medial meniscus reveal normal configuration and signal characteristics.





Cruciate Ligaments :

A subtle hyperintense signal is seen in the mid portion of the anterior cruciate ligament on all the pulse sequences which may represent a strain.

The posterior cruciate ligament does not show its normal attachment to the femur and is not well-visualized and suggestive of a tear.

Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.

Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

The articular cartilage overlying the patella, tibia and femur appears normal.

Very minimal fluid is seen in the right knee joint.

IMPRESSION :

1. Grade III meniscal signal (meniscal tear) in the posterior horn of the medial meniscus reaching upto the inferior articular surface.
..3/.











- 3 - Scan-00008



2. Grade II meniscal signal (meniscal degeneration) in the anterior and posterior horns of the lateral meniscus not reaching upto the articular surface.

3. Strain of the anterior cruciate ligament.

4. Tear of the posterior cruciate ligament.

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzh Palmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O fall at the age of 14 years with seizures since then.

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 on either side is unremarkable.

There is moderate dilatation of both the lateral and third ventricles with fullness of the fourth ventricle. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally. The inferior cerebellar vermis is hypoplastic.

The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of cerebral and cerebellar atrophy.

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Kawlmn / F / 47 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 15 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 a posterior disc herniation at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. There is inferior migration of the disc and which is seen to lie posterior to the L4 vertebral body. A left far lateral (extraforaminal) disc herniation is seen to indent the extraforaminal portion of the exiting left L4 nerve root at this level.

Small posterior disc herniations are noted at the L2-L3, L3-L4 and L5-S1 levels. The lumbar intervertebral discs show loss of water content. Schmorls nodes are noted in the dorso-lumbar region.

Facetal hypertrophy is noted at the L4-L5 and L5-S1 levels.

Bilateral far lateral (extraforaminal) disc bulges are noted at the L3-L4 level.

The pedicles of the lumbar vertebrae appear to be congenitally short in their antero-posterior dimensions.
..2/.






Type II degenerative changes are noted in the antero-superior aspect of the L4 vertebral body and the S1 vertebra adjacent to the L5-S1 disc.

The rest of 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 S1 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
15.0 mm at L2-L3
12.0 mm at L3-L4
14.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. A posterior disc herniation at the L4-L5 level with inferior migration of the disc and which is seen to lie posterior to the L4 vertebral body.

2. Small posterior disc herniations at the L2-L3, L3-L4 and L5-S1 levels.

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

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

5. Facetal hypertrophy at the L4-L5 and L5-S1 levels.

6. Tight spinal canal at the L3-L4 and L4-L5 levels.

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzralmn / M / 27 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 1 year.

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 is unremarkable on either side.

There is slight prominence of the cerebellar folia bilaterally.

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.

A polyp is seen in the left maxillary sinus and enlarged adenoids.

IMPRESSION :

The MRI features are suggestive of mild prominence of the cerebellar folia bilaterally.

hs/ke/nl/rg.
/44/45 Date : 00.00.00

Name of the Patient : Abc Xyzsh Blmn / M / 31 yrs.
Referred by : Dr. Abc Xyzhru.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O heaviness of the head and headaches since 2-3 years.
H/O hypertension.

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.

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

INTRACRANIAL MRA :

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

The right vertebral artery is hypoplastic.

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



NECK MRA :

The right vertebral artery in the neck is also hypoplastic.

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

IMPRESSION :

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

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

Name of the Patient : Abc Xyzi Nalmn / F / 45 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 2-3 months.

EXAMINATION :

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

5 mm thick T1 Weighted sagittal images.

6 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There is replacement of the normal marrow of the sacral vertebrae by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted and STIR images. There is extension into the presacral soft tissues with obliteration of fat plane. There is indentation and displacement of the ilio-psoas muscle anteriorly. The piriformis muscle on the right side appears bulky and is also involved by the pathology. Slight involvement of the piriformis muscle on the left is also noted. The gluteus maximus muscle on the right side also shows altered signal suggestive of its involvement. The sacral nerve roots on either side are encased by this lesion, more on the right. There is extension into the spinal canal upto the L5 level with non-visualization of the thecal sac.

The visualized lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.


The uterus and the urinary bladder appear normal.

Enlarged para-aortic and right iliac enlarged lymph nodes are noted in the pelvis.

IMPRESSION :

The MRI features are suggestive of altered signal of the sacral vertebrae with soft tissue extensions and lymph nodal enlargement as described.

These changes are not specific for a single etiology. A round cell tumor like lymphoma or an infective lesion like tuberculosis may be considered as differential diagnosis.

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzR. Kalmn / F / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 10 years. On anti-epileptics.

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 superior surface of the pituitary gland has a convex upper margin ? significance.

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.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzm Chlmn / M / 65 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 1 year which has increased since 15 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 a left paracentral and left postero-lateral disc herniation at the L4-L5 level with antero-lateral compression of the thecal sac and left neural foraminal narrowing. There is indentation upon the extraforaminal portion of the left L4 nerve root. There is suggestion of inflammation of the left L5 nerve root. Facetal and ligamentum flavum hypertrophy is also noted at the L4-L5 and L5 levels with resultant left lateral stenosis.

Right far lateral disc herniations are noted at the L4-L5 and L3-L4 levels with slight indentation upon the extraforaminal portion on the right L4 and L3 nerve roots, respectively.

Small posterior disc herniations are noted at the L2-L3 and L5-S1 levels. The lumbar intervertebral discs show loss of water content.
Scan-00009

The L5-S1 facet joint on the left shows slight degenerative change and the facet joints at the L1-L2 and L3-L4 levels appear hypertrophied.

The lumbar vertebral bodies reveal normal signal intensity. The remaining facet joints and 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 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
15.0 mm at L2-L3
16.0 mm at L3-L4
9.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. A left paracentral and left postero-lateral disc herniation at the L4-L5 level with indentation upon the extraforaminal portion of the left L4 nerve root. There is ligamentum flavum and facetal hypertrophy at the L4-L5 and L5 levels with canal stenosis. There is suggestion of inflammation of the left L5 nerve root.

2. Right far lateral disc herniations at the L4-L5 and L3-L4 levels with slight indentation upon the extraforaminal portion on the right L4 and L3 nerve roots, respectively.

3. Small posterior disc herniations at the L2-L3 and L5-S1 levels.

4. Facetal hypertrophy at the L1-L2 and L3-L4 levels and slight facetal arthropathy at the L5-S1 level on the left.

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzKlmn / M / 42 yrs.
Referred by : Dr. Abc Xyzolanki / Dr. Abc Xyzhah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neck pain radiating to the LUE with tingling since 1 1/2 months. Also C/O giddiness.
H/O fall 2 months back.

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 :

The cervical intervertebral discs show loss of water content.

Postero-central disc herniations, more to the left of the midline are seen to indent the ventral aspect of the cord at the C4-C5 and C5-C6 levels.

A left postero-lateral disc herniation is seen to narrow the left neural foramen at the C6-C7 level with indentation upon the spinal cord and the left C7 nerve root. Part of the disc is seen at the C6 vertebral level.

Small posterior peridiscal osteophytes are noted over the C3-C4 to the C6-C7 level.






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

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

There is anterior wedging of the C6 vertebra without any change in signal intensity.

The facet joints on the right side at the C4-C5, C5-C6 and C6-C7 levels show hypertrophic changes.

The cervical spinal cord shows normal signal intensity.

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

IMPRESSION :

The MRI features are suggestive of :

1. Postero-central disc herniations, more to the left of the midline at the C4-C5 and C5-C6 levels.

2. A left postero-lateral disc herniation at the C6-C7 level with indentation upon the spinal cord and the left C7 nerve root.