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Sunday, 27 December 2015 16:48

12237

hs/ke/nl
Date : 00.00.00

Name of the Patient : Abc XyzP. Kakolmn / F / 29 yrs.
Referred by : Dr. Abc Xyzl.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided headaches 1 week back with weakness of the right half of the body 3 days later.
C/O decreased hearing on 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 fairly well-defined areas which are near isointense to CSF on all the pulse sequences within the left temporal and left frontal lobes. These are surrounded by areas of hypointensity on the T1 Weighted images and which turn hyperintense on the proton, T2 Weighted and FLAIR images and would most likely represent perilesional edema (? a portion of the lesion per se). There is effacement of the adjacent cerebral cortical sulci and indentation upon the left lateral ventricle with slight inferior displacement. Also seen is mild bulging of the falx to the right side.

A sliver of fluid is seen to overlie the left cerebral hemisphere and this may be the result of previous biopsy.








The right lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of lesions within the left temporal and left frontal lobes as described. These most likely represent a neoplastic process like a glial cell tumor.

A contrast enhanced scan may be worthwhile.

Sunday, 27 December 2015 16:48

12236

ke/bv/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to BLE with tingling since 1 1/2 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 :

The L2 vertebra is as marked on the film. (Kindly correlate with plain radiographs-? sacralization of L5).

The L2-L3, L3-L4 and L4-L5 intervertebral discs show loss of water content.

There is a postero-central disc herniation at the L4-L5 level with mild indentation upon the L5 nerve roots bilaterally. There appears to be posterior displacement of the left L5 nerve root and which appears to be of slightly larger calibre ? inflammation. The L4-L5 facet joints show mild degenerative changes.

Ligamentum flavum hypertrophy is seen at the L5 level.

A small posterior disc bulge is seen at the L3-L4 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 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 :

16.0 mm at L1-L2
14.0 mm at L2-L3
13.0 mm at L3-L4
10.0 mm at L4-L5
7.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of a postero-central disc herniation at the L4-L5 level with mild indentation upon the L5 nerve roots bilaterally with ? inflammation of the left L5 nerve root.









Sunday, 27 December 2015 16:48

12235

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzee Jlmn / F / 58 yrs.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 2 1/2 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 :

There is scoliosis of the lumbar spine with convexity to the left side.

There is slight retrolisthesis of the L2 over the L3 and the L4 over the L5 vertebral body.

The lumbar intervertebral discs show loss of water content.

A large postero-central disc extrusion is seen at the L4-L5 level with anterior compression of the thecal sac and canal stenosis. There is inferior migration of the disc fragment which is seen to lie posterior to the L5 vertebral body with compression upon the thecal sac and indentation upon the left L5 nerve root. A left far lateral disc herniation is also noted at this level.






Posterior disc herniation and a left far lateral disc bulge is seen at the L3-L4 level with peridiscal osteophytes.

A posterior and left far lateral disc bulge is seen at the L5-S1 level.

Postero-central disc herniations are noted at the L1-L2 and L2-L3 levels with posterior peridiscal osteophytes.

Lateral peridiscal osteophytes are seen at the L2-L3 level on the right side.

Type II degenerative changes are seen in the L5 vertebral body adjacent to the L4-L5 intervertebral disc.

The lower lumbar facet joints show mild degenerative changes.

The rest of 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 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 :

14.0 mm at L1-L2
12.0 mm at L2-L3
11.0 mm at L3-L4
9.0 mm at L4-L5
10.0 mm at L5-S1.
..3/.












- 3 - Scan-00005



IMPRESSION :

1. Scoliosis of the spine with convexity to the left side.

2. Slight retrolisthesis of the L2 over the L3 and the L4 over the L5 vertebral body.

3. A large postero-central disc extrusion at the L4-L5 level
with inferior migration of the disc fragment which is seen to lie posterior to the L5 vertebral body and indentation upon the left L5 nerve root with canal stenosis.

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



Sunday, 27 December 2015 16:48

12234

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzPalmn / M / 53 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O paresthesias in BUE and both soles since 1 month.
H/O fall 2 years 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 :

There is a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images in the posterior column and in the centre of the spinal cord over the C2 to the C4-C5 levels. This is isointense to cord on the T1 Weighted images.

Small, posterior disc herniations with peridiscal osteophytes are noted at the C3-C4, C4-C5 and C5-C6 levels with anterior indentation of the thecal sac.

Ligamentum flavum hypertrophy is noted at the C5-C6 level.

The cervical intervertebral discs show loss of water content.

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

The atlanto-axial region is unremarkable.
..2/.





- 2 - Scan-00004


IMPRESSION :

1. Altered cord signal in the posterior column and in the centre of the spinal cord over the C2 to the C4-C5 levels would represent cord demyelination.

The possibility of subacute combined degeneration should be ruled out. The possibility of myelitis seems unlikely.

2. Small, posterior disc herniations with peridiscal osteophytes at the C3-C4, C4-C5 and C5-C6 levels.









Sunday, 27 December 2015 16:48

12233

ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzen Kadlmn / F / 75 yrs.
Referred by : Dr. Abc Xyzra.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 4 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 :

There is a posterior and left far lateral disc herniation at the L3-L4 level with anterior indentation of the thecal sac and upon the extraforaminal portion of the exiting left L3 nerve root. The L3-L4 facet joints show mild degenerative changes (left more than right).

A small posterior disc herniation is noted at the L2-L3 level.

Anterior disc herniations are seen over the L1-L2 to L3-L4 levels.

A posterior disc bulge is seen at the L4-L5 level. Far lateral (extraforaminal) disc bulges are seen bilaterally at the L2-L3 and L4-L5 levels and on the right side at the L3-L4 level.

Mild facetal hypertrophy is seen bilaterally at the L4-L5 level and on the left side at the L5-S1 level.
Scan-00003

Schmorls nodes are seen at the L3-L4 level.

The lumbar intervertebral discs show loss of water content.

Hemangioma with fatty content is seen in the L3 vertebral body. Focal fatty changes are noted in the lumbar vertebrae.

The rest of the 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 S1 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
17.0 mm at L3-L4
15.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

1. A posterior and left far lateral disc herniation at the L3-L4 level indenting the extraforaminal portion of the exiting left L3 nerve root and mild facetal arthropathy at this level.

2. A small posterior disc herniation at the L2-L3 level.







Sunday, 27 December 2015 16:48

12232

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzulmn / F / 40 days.
Referred by : Dr. Abc Xyzrmar / Dr. Abc Xyzari /
Dr. Abc Xyzankhla.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall from 2nd berth of train at 5.00 am on 00.00.00 followed with one episode of vomiting.

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 T2 Weighted coronal images.

OBSERVATION :

There is fracture of the left parietal bone posteriorly.

Small slivers of subdural collection are seen in both temporo-parietal regions which appear hyperintense on all the pulse sequences and would represent hematoma.

Subgaleal collection are seen in the left fronto-temporo-parietal and bilateral posterior parietal region suggestive of edema/contusion.

Suspicious hyperintense signal is seen in the sulci over both fronto-parietal regions with ? obliteration. Subarachnoid
blood should be excluded.

Cavum septum pellucidum is noted.





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. Fracture of the left parietal bone.

2. Small slivers of subdural collection in both temporo-parietal regions.

3. Subgaleal collection in the left fronto-temporo-parietal and bilateral posterior parietal regions.

Sunday, 27 December 2015 16:48

12231

ke/bv/nl/rg.
Date : 00.00.00
Name of the Patient : Abc Xyz M. Chlmn / F / 40 yrs.
Referred by : Dr. Abc Xyzndhi.
Examination : M.R.I. of the Chest.
CLINICAL PROFILE :
C/O hemoptysis since 00.00.00.
C/O generalized weakness with ? decreased appetite.
Family h/o kochs.
EXAMINATION :
M.R.I. of the chest was performed using the following parameters:

8 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.5 mm thick T1 Weighted and T2 Weighted coronal images.OBSERVATION :

There is a small lesion which is well-defined in the right paravertebral region extending over the D1-D2 to D2-D3 levels. This lesion measures approximately 0.8 x 1.6 x 0.9 cms. This lesion is isointense to muscle on the T1 Weighted images and turns hyperintense on the T2 Weighted images (scan 103.4 & 104.4).

There is a fairly well-defined lesion seen in the posterior basal segment of the left lower lobe which is isointense to normal muscle on the T1 Weighted images and turns mildly hyperintense on the T2 Weighted images and would represent small area of consolidation/pulmonary nodule (scan 105.3 & 103.17)

The vascular structures in the mediastinum are normal. The hila bilaterally appear to be normal.



The visualized cervico-dorsal spine was screened with 5 mm thick T1 Weighted sagittal images and 5 mm thick T1 Weighted and T2 Weighted axial images and does not reveal any pathology within the spinal canal.

IMPRESSION :
The MRI features are suggestive of :

1. A well-defined lesion in the right paravertebral region extending over the D1-D2 to D2-D3 levels and measuring approximately 0.8 x 1.6 x 0.9 cms. is not specific for a single etiology. A nerve sheath tumor should be included in the differential diagnosis.

2. A lesion in the posterior basal segment of the left lower lobe of the left lung which may represent consolidation/pulmonary nodule (? infective ?? neoplastic).
Sunday, 27 December 2015 16:48

12230

Date : 00.00.00

Name of the Patient : Abc Xyzn Bhanuslmn / F / 50 yrs.
Referred by : Dr. Abc Xyzndhi.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

C/O pain in the right knee joint with difficulty in bending the RLE since 1 1/2 months.
H/O fall 2 months back.

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 curvilinear hyperintense signal in the posterior horn of the medial meniscus reaching upto the inferior articular surface of the right knee joint and represents a Grade III meniscal signal (meniscal tear).

Linear hyperintense signal are noted in the anterior horn of the medial meniscus and anterior and posterior horns of the lateral meniscus not reaching upto the articular surface and represents Grade II meniscal signal (meniscal degeneration).






Cruciate Ligaments :

Slight buckling of the anterior cruciate ligament is noted.

The posterior cruciate ligament shows normal contour and signal characteristics.

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 :

Degenerative changes are noted in the form of osteophytic lippings around the right knee joint.

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

IMPRESSION :

1. Grade III meniscal signal (meniscal tear) in the posterior horn of the medial meniscus.

2. Grade II meniscal signal (meniscal degeneration) in the anterior horn of the medial meniscus and anterior and posterior horns of the lateral meniscus.

3. Slight buckling of the anterior cruciate ligament suggestive of a strain/partial tear.

4. Osteophytic lippings around the right knee joint.

Sunday, 27 December 2015 16:48

12229

ke/bv/nl/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

C/O headaches, vomiting since 10 days.
C/O visual loss on the right side and decreased vision on the left side since 5 days.
C/O bladder retention since 3 days.
H/O delivery 2 months back.

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 Fast Scan (T2 *) axial images.

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and 10 mm thick T2 Weighted axial images.

OBSERVATION :

There is a hyperintense area within the centre of the spinal cord extending over the D3 to D9 vertebral levels on the T2 Weighted and Fast Scan (T2 *) images. Subtle hyperintense signal is also noted in the anterior and posterior columns at the D2 and C7-D1 levels. This is isointense to cord on the T1 Weighted images. The CSF space is unremarkable.








Subtle hypointense signal is seen within the D1 vertebral body on the T1 Weighted images which is isointense to marrow on the T1 Weighted images.

Small posterior disc bulge is noted at the C4-C5 level. The upper cervical intervertebral discs show slight loss of water content.

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

IMPRESSION :

Altered signal within the centre of the spinal cord extending over the D3 to D9 vertebral levels and in the anterior and posterior columns at the D2 and C7-D1 levels could be due to demyelination/myelitis.

The MRI findings are consistent with the clinical diagnosis of Devics disease.
Sunday, 27 December 2015 16:48

12228

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz K. Wallmn / F / 8 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. - Dorsal Spine (Post-contrast
Study).

CLINICAL PROFILE :

C/O headaches since December 0000. Also C/O backache with weakness of BLE (right more than left) since 8-10 days.

EXAMINATION :

After administration of contrast, the following parameters were used.

4 mm thick T1 Weighted sagittal and axial images (with fat saturation).

3 mm thick T1 Weighted coronal images.

OBSERVATION :

There is very faint enhancement of the lesion peripherally,
which is intramedullary in location at the D1 and D2 levels.

No enhancement is seen in the adjacent meninges and in the cervical and visualized dorsal regions.

This most probably represents a neoplastic process like a glial cell tumor.

Note is also made of enhancement of enlarged lymphnodes in the right hilar and paratracheal regions.