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Sunday, 27 December 2015 16:48

12208

ke/sb/nl
Date : 00.00.00

Name of the Patient : Abc Xyzs Chavlmn / M / 3 1/4 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since birth.
H/O delayed speech.

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 T1 Weighted and T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined hypointense areas (nearly isointense to CSF) in the periventricular deep white matter on the T1 Weighted images. These are seen to turn hyperintense on the proton and T2 Weighted images. Hyperintense areas are also noted in bilateral centrum semiovale, left more than right. Resultant periventricular white matter loss is noted.

There is slight thinning of the corpus callosum.

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.








Incidental note is made of enlarged adenoids.

IMPRESSION :

Altered signal in the periventricular deep white matter and in bilateral centrum semiovale, left more than right and slight thinning of the corpus callosum may be due to hypoxic-ischemic insult-periventricular leucomalacia.
Sunday, 27 December 2015 16:48

12207

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzi Salmn / F / 14 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O quadriparesis since 1 month with respiratory failure.
H/O viral infection 15 days prior to this.

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 *) Weighted axial images.

OBSERVATION :

There is seen a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images in the spinal cord on either side of the midline over the C3-C4 disc level upto the C7-D1 disc level. This signal appears hypointense to normal cord on the T1 Weighted images. No significant cord atrophy or cord swelling is noted.

Small postero-central protruded discs are noted at the C5-C6 and C6-C7 levels.

There is loss of water content of the C6-C7 intervertebral disc.

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

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


Evidence of previous tracheotomy is noted.

Screening T2 Weighted sagittal images of the dorsal spine and T1 Weighted sagittal images of the lumbar spine do not reveal any significant feature of note.

Incidentally noted is right sided parahilar consolidation with probable enlarged subcarinal and right paratracheal lymphnodes.

IMPRESSION :

Altered signal in the spinal cord on either side of the midline over the C3-C4 disc level upto the C7-D1 disc level as described most likely represents gliotic/myelomalacic changes, probably the sequelae of previous myelitis/demyelination.








Sunday, 27 December 2015 16:48

12206

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Dlmn / M / 19 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 3 months.

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 loss of water content of the L3-L4 and L4-L5 intervertebral discs.

There is a postero-central disc herniation with peridiscal osteophytes at the L5-S1 level.

A posteriorly herniated disc with peridiscal osteophytes is noted at the L4-L5 level with thecal sac compression and bilateral neural foraminal narrowing. Hypertrophic facetal arthropathy is also seen at this level with canal stenosis.

A postero-central and right paracentral disc herniation is noted at the L3-L4 level with slight bilateral neural foraminal narrowing.

Facetal hypertrophy is also noted at the L2-L3 and L5-S1 levels.

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


Schmorls node is seen in the superior aspect of the L4 vertebral body.

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 :

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

IMPRESSION :

1. A postero-central disc herniation with peridiscal osteophytes at the L5-S1 level.

2. A posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level.

3. A postero-central and right paracentral disc herniation at the L3-L4 level with slight bilateral neural foraminal narrowing.

4. Facetal hypertrophy at the L2-L3, L4-L5 and L5-S1 levels.

5. Congenitally short pedicles of the lower lumbar vertebrae in their antero-posterior dimensions with lumbar canal stenosis over the L3-L4 to L5-S1 levels.









Sunday, 27 December 2015 16:48

12205

ke/sb/nl/rg
Date : 00.00.00

Name of the Patient : Abc XyzGlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzolakia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias.

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 forward translation of the L5 over the S1 vertebra (kindly correlate with plain radiographs to R/O spondylolysis).

A small pseudo-posterior disc herniation is seen at the L5-S1 level.

Small posterior disc bulge is noted at the L4-L5 level. The lower dorsal, L4-L5 and L5-S1 intervertebral discs show loss of water content.

The L4-L5 facet joints show 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 D12 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
17.0 mm at L2-L3
14.0 mm at L3-L4
13.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. Slight forward translation of the L5 over the S1 vertebra (kindly correlate with plain radiographs to R/O spondylolysis).

2. A small pseudo-posterior disc herniation at the L5-S1 level.

3. Small posterior disc bulge at the L4-L5 level.

4. Degenerative changes of the L4-L5 facet joints.








Sunday, 27 December 2015 16:48

12204

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz R. Nlmn / M / 20 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O railway accident on 00.00.00 with loss of consciousness for 1/2 an hour.
Now C/O memory loss and disorientation.

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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a well-marginated approximately 3.2 x 2.4 x 4.0 cms sized hyperintense lesion on T1 Weighted images in the left fronto-temporal cortex. This lesion shows a mixed signal on the T2 Weighted images with part of the lesion remaining hyperintense and part of the lesion turning hypointense. Perilesional white matter hyperintense signal on the proton, T2 Weighted and FLAIR images may represent perilesional edema/contusion.

A thin sliver of extracerebral haemorrhage is noted in the left occipital region and in the interhemispheric fissure in the high posterior parietal region. There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the subcortical white matter in the left high posterior parietal region and in the right frontal region. This lesion appears hypointense on the T1 Weighted images.
Scan-00004


An undisplaced fracture of the left temporal bone is noted. The overlying subgaleal soft tissues in that region shows altered signal and appears slightly swollen due to subgaleal hematoma.
Air is also noted in the subgaleal soft tissues.

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.

Mucosal thickening is noted in the left frontal sinus.

IMPRESSION :

1. Altered signal in the left fronto-temporal cortex represents a haemorrhagic contusion.

2. Altered signal in the subcortical white matter in the right frontal region and right high posterior parietal region may represent Shearing injuries in the given clinical setting.

3. A thin sliver of extracerebral haemorrhage in the left occipital region and in the interhemispheric fissure.

4. Undisplaced fracture of the left temporal bone.

5. Subgaleal hematoma and air in the left temporal region.


Sunday, 27 December 2015 16:48

12203

ke/sb/rg
Date : 00.00.00

Name of the Patient : Abc XyzSulmn / F / 34 yrs.
Referred by : Dr. Abc Xyz Modi / Dr. Abc Xyzejpal.
Examination : M.R.I. of the Abdomen.

CLINICAL PROFILE :

Appendectomy done on 00.00.00 with discharge from the operative site with pain and loss of weight (around 8 Kg.) since then.

EXAMINATION :

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

7 mm thick T1 Weighted and T2 Weighted axial images.

7 mm thick T1 Weighted and STIR coronal images (with fat saturation).

5 mm thick T2 Weighted (with fat saturation) sagittal images.

OBSERVATION :

There are post-operative changes in the subcutaneous fat of the anterior abdominal wall on the right side, inferiorly.

A sinus tract which is hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted and STIR images is seen to extend from the surface of the skin at a level just below the umbilicus to the right of the midline and extends through the subcutaneous fat involving the internal and the external oblique muscles of the abdominal wall. The internal and external oblique muscles on the right side at the site of surgery appear bulky as compared to the left and show a hyperintense signal on the T2 Weighted and STIR images suggesting of edema/inflammatory tissue/post-operative changes.

Signal change in the subcutaneous fat is noted for about 5 cms supero-inferiorly from the site of the sinus.

No obvious collection is seen on this study.
..2/.



- 2 - scan-00003


The rectus abdominus muscle on the right side appears slightly atrophic as compared to the left.

The visualized kidneys are normal in size and shape (mild fullness of the right pelvicalyceal system is noted).

No lymphadenopathy is detected. There is no evidence of free fluid within the abdomen.

A bowel loop is noted in the close relation to the anterior abdominal wall, on the right.

IMPRESSION :

1. Post-operative status.

2. A sinus tract extending from the surface of the skin at the operative site, just below the umbilicus to the right of the midline and involving the external and internal oblique muscles as described. No collection is noted.


Sunday, 27 December 2015 16:48

12202

ke/bv/nl
Date : 00.00.00

Name of the Patient : Abc Xyzakant Sarvlmn / M / 55 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

C/O pain in the right knee joint with difficulty in climbing stairs since 6 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 curvilinear hyperintense signal in the posterior horn of the medial meniscus not reaching upto the inferior articular surface and represents a Grade II meniscal signal (Meniscal degeneration).

The anterior and posterior horns of the lateral meniscus show linear hyperintense signal on all the pulse sequences not reaching upto the articular surface and would represent Grade I meniscal signal (Meniscal degeneration).

The anterior horn of the medial meniscus reveal normal configuration and signal characteristics.
Scan-00002


Cruciate Ligaments :

Intermediate signal is seen along the course of the anterior cruciate ligament of the right knee joint on the T1 Weighted images and is seen to be hyperintense on the T2 Weighted and GRASS images, suggestive of fluid. The anterior cruciate ligament is however well identified.

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 :

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

Effusion is seen within the right knee joint.

IMPRESSION :

1. Grade II meniscal signal (meniscal degeneration) in the posterior horn of the medial meniscus not reaching upto the inferior articular surface of the right knee joint.

2. Grade I meniscal signal (meniscal degeneration) in the anterior and posterior horns of the lateral meniscus of the right knee joint.

3. Effusion within the right knee joint.











Sunday, 27 December 2015 16:48

12201

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Ralmn / M / 40 yrs.
Referred by : Dr. Abc Xyzolakia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 3 months.

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 are small posterior disc herniations at the L4-L5 and L5-S1 levels. There is anterior indentation of the thecal sac and right neural foraminal narrowing at the L4-L5 level. These intervertebral discs show loss of water content.

Schmorls node is seen in the superior aspect of the D11 vertebra. The L5-S1 facet joints show mild 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-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 :

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

IMPRESSION :

1. Small posterior disc herniations at the L4-L5 and L5-S1 levels.

2. Mild degenerative changes of the L5-S1 facet joints.

Sunday, 27 December 2015 16:48

12200

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzal Blmn / M / 79 yrs.
Referred by : Dr. Abc Xyzshar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O radicular pain in the RLE since 2-3 months.

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 loss of water content of all the lumbar intervertebral discs except the L5-S1 disc.

There is Grade I spondylolisthesis of the L4 over the L5 vertebra without obvious spondylolysis. A pseudo-posterior disc herniation is noted at this level with thecal sac compression. Slight compromise of the neural foramen is noted bilaterally. There is also hypertrophic facetal arthropathy bilaterally at this level.

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

Anterior disc herniations with anterior peridiscal osteophytes are noted in the dorso-lumbar region.

The lumbar vertebral bodies 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.
..2/.







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
14.0 mm at L3-L4
6.0 mm at L4-L5
11.0 mm at L5-S1.

Incidentally noted is a cortical renal cyst on the left.

IMPRESSION :

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

2. A pseudo-posterior disc herniation at the L4-L5 level with
hypertrophic facetal arthropathy bilaterally and canal stenosis at this level.







Sunday, 27 December 2015 16:48

12199

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzen lmn / F / 52 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (left more than right) since 9 months.

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 which is as marked on the film.

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

Minimal posterior disc bulges are noted at the L4-L5 and L5-S1 levels. Small anterior disc herniations are noted at the L3-L4 and L4-L5 levels.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints and the visualized right 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 :

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

Incidentally noted are multiple lobulated soft tissue lesions in the prevertebral and left paravertebral regions over the L2 to L4 vertebral levels. These are of intermediate signal intensity on the T1 Weighted images and turn heterogeneously hyperintense on the T2 Weighted images and most likely represent enlarged lymphnodes. Also noted is a soft tissue mass lesion in the region of the left kidney which needs to be investigated further.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. Minimal posterior disc bulges at the L4-L5 and L5-S1 levels.

3. Multiple lobulated soft tissue lesions in the prevertebral and left paravertebral regions over the L2 to L4 vertebral levels most likely represent enlarged lymphnodes. Also noted is a soft tissue mass lesion in the region of the left kidney which needs to be investigated further.