sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Hemlmn / M / 72 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radicular pain to BLE with mild paresthesias since 5 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 slight retroplacement of the L3 over the L4 and L4 over the L5 vertebrae.

There is loss of water content of the D10-D11, D12-L1, L3-L4, L4-L5 and L5-S1 intervertebral discs. The L3-L4 and L4-L5 intervertebral discs show evidence of calcium/vacuum phenomena.

A postero-central protruded disc with peridiscal osteophyte is noted at the L5-S1 level. There is facetal and ligamentum flavum hypertrophy and resultant canal stenosis at this level.

There are posteriorly herniated discs with peridiscal osteophytes at the L4-L5 and L3-L4 levels with thecal sac compression and bilateral neural foraminal narrowing. Facetal and ligamentum flavum hypertrophy is also noted with canal stenosis. Bilateral far lateral and anterior disc herniations with peridiscal osteophytes are also noted at the L3-L4 and L4-L5 levels. There appears to be impingement of the left L5 nerve root within the neural foramen. This nerve root appears larger in calibre and is probably inflamed.
..2/.






Small posterior peridiscal osteophyte is noted at the D12-L1 level and facetal hypertrophy is noted at the D10-D11 level.

The lumbar vertebral bodies adjacent the L3-L4 and L4-L5 intervertebral discs show Type I/III degenerative changes.

The rest of 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 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 :

17.0 mm at L1-L2
16.0 mm at L2-L3
12.0 mm at L3-L4
6.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. A postero-central protruded disc with peridiscal osteophyte at the L5-S1 level with facetal and ligamentum flavum hypertrophy with resultant canal stenosis at this level.

2. Posteriorly herniated discs with peridiscal osteophytes at the L4-L5 and L3-L4 levels with facetal and ligamentum flavum hypertrophy with canal stenosis at this level.

sb/bv
Date : 00.00.00

Name of the Patient : Abc XyzN. lmn / M / 36 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O single episode of seizure on 00.00.00.
C/O right sided headaches with momentary blackouts since 2-3 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 is unremarkable on either side. The right temporal horn appears larger than the left and may be a normal variant.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the maxillary antra bilaterally.

IMPRESSION :

No significant abnormality is detected on this study.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzee Klmn / F / 9 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the S. I. Joints.

CLINICAL PROFILE :

H/O pyoderma. Received intramuscular injection. Developed pain in the left gluteal region with restriction of movement of the LLE.

EXAMINATION :

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

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

3 mm thick T1 Weighted and STIR coronal images.

5 mm thick T2 Weighted sagittal images through the L. S. Spine.

OBSERVATION :

There is an ill-defined hypointense signal on the T1 Weighted images involving the marrow of the left iliac bone adjacent to the left sacro-iliac joint. This lesion appears hyperintense on the T2 Weighted and STIR images. No obvious cortical erosion or bone destruction is noted. The sacral component of the left sacro-iliac joint and the left sacro-iliac joint per se are unremarkable.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images deep to the left gluteus maximus and medius muscles in close, relation to the left iliac bone. This lesion appears hyperintense on the T2 Weighted and STIR images. Similar lesion is seen deep to the left ilio-psoas muscle, along the left lateral pelvic wall and involving the left piriformis muscle.



The visualized right sacro-iliac joint and the hip joints on either side are unremarkable.

The screening images of the lumbo-sacral spine do not reveal any significant feature of note.

IMPRESSION :

Altered signal in the left iliac bone adjacent to the left sacro-iliac joint as described is not specific for a single etiology. This most likely represents osteitis, in the given clinical setting. Soft tissue lesion deep to the left gluteal muscles and left ilio-psoas muscle in close relation to the left iliac bone and in the region of the left piriformis muscle may either represent a small inflammatory collection/granulation tissue, or may suggest myositis involving the gluteus muscles, iliacus muscle and the piriformis muscle.

sb/bv
Date : 00.00.00

Name of the Patient : Abc XyzP. Plmn / M / 40 yrs.
Referred by : Dr. Abc Xyzdar / Dr. Abc Xyzhru.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias since 0000.
H/O fall prior to this.

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 Grade I spondylolisthesis of the L5 over the S1 vertebra with spondylolysis. A resultant small pseudoposterior disc bulge is noted at this level.

A minimal posterior disc bulge is noted at the L4-L5 level.

There is slight increase in the epidural fat in the sacral region and at the L5 vertebral level. This may suggest epidural lipomatosis.

The lumbar vertebral bodies and the 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 S1 level.

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

19.0 mm at L1-L2
18.0 mm at L2-L3
19.0 mm at L3-L4
16.0 mm at L4-L5
20.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L5 over the S1 vertebra with spondylolysis.

2. A small pseudoposterior disc bulge at the L5-S1 level.

As compared to the previous MRI (study no:0000) dated 00.00.00, there is no significant change noted.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzingh Mulmn / M / 21 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with episodic loss of memory (6-7 episodes) since 3 months.
To r/o complex partial seizures.

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.

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 noted in the left maxillary sinus.

IMPRESSION :

Normal study of the Brain.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzati Mlmn / F / 74 yrs.
Referred by : Dr. Abc Xyztrak / Dr. Abc Xyz. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (right more than left) with tingling in toes since several years which has increased since 5-6 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 loss of water content of the lumbar intervertebral discs.

The visualized dorso-lumbo-sacral vertebral bodies show spotty fatty marrow changes suggesting osteoporosis. The D10 vertebral body appears wedged.

There is slight retroplacement of the L1 vertebral body.

There is a right postero-lateral (foraminal) disc herniation at the L5-S1 level with right neural foraminal narrowing and mininal indentation on the traversing right S1 nerve root.






A postero-central disc herniation with peridiscal osteophytes is noted at the L3-L4 level with bilateral neural foraminal narrowing.

A small posterior disc bulge is noted at the L4-L5 level.

A small postero-central protruded disc is identified at the L2-L3 level.

Posterior peridiscal osteophytes are noted at the L1-L2 level with left neural foraminal narrowing.

The facet joints from the L2-L3 to the L5-S1 levels show hypertrophic degenerative changes. Slight ligamentum flavum hypertrophy is noted at the L3-L4 and L4-L5 levels.

Anterior disc herniations are noted in the upper lumbar region.

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 :

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













- 3 - Scan-00000

IMPRESSION :

1. Spotty fatty marrow changes in the visualized dorso-lumbo-sacral vertebrae suggests osteoporotic changes. Wedging of D10 vertebral body may be the sequelae of trauma superimposed on an osteoporotic spine.

2. A right postero-lateral (foraminal) disc herniation at the L5-S1 level with right neural foraminal narrowing and mininal indentation on the traversing right S1 nerve root.

3. A postero-central disc herniation with peridiscal osteophytes at the L3-L4 level.

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

5. Small postero-central protruded disc at the L2-L3 level.

6. Posterior peridiscal osteophytes at the L1-L2 level.

7. Hypertrophic facetal arthropathy from the L2-L3 to the L5-S1 levels with slight ligamentum flavum hypertrophy at the L3-L4 and L4-L5 levels.

8. Canal stenosis at L3-L4 and L4-L5 levels.

As compared to the previous MRI dated 00.00.00 (scan no.0000), canal stenosis is noted at the L3-L4 and L4-L5 levels, probably to a greater degree at the L3-L4 level. Anterior wedging of the D10 vertebral body is identified on the present study (this vertebral body was not identified on the previous scan).

sb/bv
Date : 00.00.00

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

CLINICAL PROFILE :

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

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

4 mm thick T1 Weighted and T2 Weighted axial images.

4 mm thick T1 Weighted coronal images.

OBSERVATION :

There is seen an approximately 1.0 x 0.9 x 1.5 cms sized well-defined, intramedullary mass within the upper dorsal spinal cord at the D1 and D2 vertebral levels. Resultant slight expansion of the spinal cord is noted at that level. This lesion is predominantly hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted images (of fluid signal intensity). Within this lesion, is seen a linear signal which is isointense to the spinal cord on all the pulse sequences. The dorsal spinal cord, superior and inferior to this lesion shows a hyperintense signal on the T2 Weighted images, centrally, at the C7 and D3 vertebral levels which may represent cord edema.





- 2 - Scan-00009


The D8 vertebral body shows a hypointense signal, centrally on the T1 Weighted images which appears isointense to the rest of the vertebrae on the T2 Weighted images.

The remaining visualized dorsal vertebral bodies and 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 D12-L1 level.

Incidentally noted is soft tissue lesions in the pretracheal, paratracheal and subcarinal region which may represent enlarged lymphnodes.

IMPRESSION :

An approximately 1.0 x 0.9 x 1.5 cms sized intramedullary mass lesion within the upper dorsal spinal cord at the D1 and D2 vertebral levels with signal characteristics as described is not specific for a single etiology. This lesion may represent a granuloma (? cysticercus) or a focal neoplasm like a glial cell tumor. The possibility of a focal syrinx may also be considered.

A follow-up scan with contrast would be worth while.

sb/bv
/00008 Date : 00.00.00

Name of the Patient : Abc Xyza lmn / M / 48 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Dorsal & Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O radicular pain in the RLE since March 0000.
H/O laminectomy with discectomy done at L3/L4/L5 levels in August 0000.

EXAMINATION :

M.R.I of the dorsal and 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 vertebra is as marked on the film.

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

There is evidence of laminectomy of the L3, L4 and L5 vertebrae with post-operative changes in the soft tissues in the posterior lumbar region over these levels.

There is a diffuse intermediate signal on the T1 Weighted images in the posterior soft tissues in the lumbar region at the operative site. This turns hyperintense on the T2 Weighted images. This most likely represent scar tissue/granulation tissue, the sequelae of previous surgery. The posterior margin of the thecal sac is ill-defined. This scar/granulation lesion is seen to extend into the spinal canal laterally, at the laminectomy site and is seen to encase the thecal sac at the L4 and L4-L5 levels. The intrathecal nerve roots over L1 to L3 vertebral levels are clumped, suggesting arachnoiditis. Scar ..2/.



- 2 - scan-00008


tissue is also noted along the S1 nerve roots bilaterally.

The L4-L5 disc is reduced in height and shows evidence of posterior peridiscal osteophytes which is most likely the sequelae of previous discectomy. Bilateral neural foraminal narrowing is noted.

A posteriorly bulging disc with peridiscal osteophyte is noted at the L3-L4 level with bilateral neural foraminal narrowing. A bony bar is noted at the L3-L4 disc level, posteriorly with canal stenosis.

A left and right postero-lateral disc herniation is noted at the L2-L3 level with bilateral neural foraminal narrowing.

A posterior peridiscal osteophyte is noted at the L1-L2 level.

The mid-dorsal intervertebral discs are slightly reduced in height. A small posterior disc bulge is noted at the D10-D11 level.

A hemangioma with fat content is noted in the D5 vertebral body.

Type II degenerative marrow changes are noted adjacent to the L4-L5 intervertebral disc.

The facet joints at the L2-L3, L4-L5 and L5-S1 levels appear slightly hypertrophied.

The rest of the dorsal and lumbar vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

The visualized dorsal spinal cord reveal normal signal intensity.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.
..3/.







- 3 - scan-00008


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

14.0 mm at L1-L2
14.0 mm at L2-L3.

IMPRESSION :

1. Post-operative status.

2. Altered signal in the posterior soft tissues in the lumbar region at the operative site most likely represent scar tissue/granulation tissue, the sequelae of previous surgery.
Extension of the scar tissue into the spinal canal laterally, at the laminectomy site is noted with encasement of the thecal sac at the L4 and L4-L5 levels and with encasement of the S1 nerve roots.

3. Arachoid over L1 to L3 vertebral levels.

4. Posterior peridiscal osteophytes at L4-L5 level with bilateral neural foraminal narrowing.

5. A posteriorly bulging disc with peridiscal osteophyte at the L3-L4 level.

6. A left and right postero-lateral disc herniation at the L2-L3 level with bilateral neural foraminal narrowing.

7. Slight hypertrophy of the facet joints at the L2-L3, L4-L5 and L5-S1 levels.

8. Canal stenosis at L2-L3 and L3-L4 levels.

As compared to the previous MRI (study no. 0000) dated 00.00.00, the patient is now status post-operative. The L4-L5 disc is reduced in height due to previous discectomy. Stenotic canal is still noted at the L2-L3 and L3-L4 levels.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Slmn / F / 6 months.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O deviation of mouth towards right with closure of left eye and decreased movements of LUE and LLE since 00.00.00.
H/O fever with vomiting 7 days back.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

4 mm thick FLAIR and 3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is an ill-defined, hyperintense signal on the proton and T2 Weighted images in the right lentiform nucleus, head of the right caudate nucleus extending into the right corona radiata. This lesion appears hypointense on the T1 Weighted images. There is no evidence of haemorrhage on this study. The myelination pattern appears normal for the patients age.

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 :

Altered signal in the right lentiform nucleus, head of right caudate nucleus extending into the right corona radiata most likely represents ischemic changes.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz K. Wallmn / F / 8 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

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 :

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 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.

Note is made of enlarged adenoids.

IMPRESSION :

Normal study of the Brain.