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Sunday, 27 December 2015 16:48

14776

ke/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzhatarlmn / M / 50 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of right sided weakness with blurred vision of left eye since 3-4 days with drowsiness and irrelevant talk since 1-2 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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is a large ill-defined, hypointense lesion on the T1 Weighted images in the left cerebral peduncle extending into the left thalamus and inferiorly into the left side of the pons and left middle cerebellar peduncle. This lesion is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. There is surrounding edema with mass effect and mild indentation upon the superior portion of the fourth ventricle, aqueduct and the third ventricle with mild shift of the midline structures to the right side. Minimal edema is also noted in the right cerebral peduncle and the left lentiform nucleus. This lesion does not bloom on the Fast Scan (T2 *) images.

There is mild fullness of both the lateral ventricles with slight prominence of the cerebral cortical sulci.

No obvious vascular anomaly is identified on this study.

Incidental note is made of inflammatory changes in the
ethmoidal and mastoid air cells on the right side.


IMPRESSION :

The MRI features are suggestive of a mass lesion in the left cerebral peduncle with extensions as described. The possibilities to be considered are,

1. Ischemia/infarction.

2. Demyelinating lesion.

3. Neoplastic lesion (less likely).

A contrast enhanced scan would be worthwhile.











Sunday, 27 December 2015 16:48

14775

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Banlmn / F / 8 yrs.
Referred by : Dr. Abc Xyzvadekar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O weakness of BLE with bladder involvement.
? ATM.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.
8 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The visualized cervical and nearly entire dorsal spinal cord appears swollen and shows a hyperintense signal on the T2 Weighted images which appears hypointense on the T1 Weighted images. The CSF space is unremarkable.

The visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

There is no cord compression.

The conus medullaris terminates at the L1 level.

IMPRESSION :

Altered signal of the cervical and nearly entire dorsal spinal cord is not specific for a single diagnosis. The differential diagnosis would include :

1. Myelitis.

2. Demyelination.

The possibility of an ischemic lesion seems unlikely.
Sunday, 27 December 2015 16:48

14774

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzam Thalmn / M / 13 yrs.
Referred by : Dr. Abc XyzSingh.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache since 2 days.
Alleged H/O fall 1 month back.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed using the following parameters :

4 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 bulge at the D12-L1 level with a small peridiscal osteophyte.

A small hypointense area on the T1 Weighted images is seen in the postero-inferior aspect of the D12 vertebral body which is seen to turn heterogeneously hyperintense on the T2 Weighted images. No obvious break in the cortex is seen.

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

The visualized dorso-lumbar spinal cord reveals normal signal intensity.







The conus medullaris terminates at the L1 level and the thecal sac terminates at the S2 level.

IMPRESSION :

1. Posterior disc bulge at the D12-L1 level with a small peridiscal osteophyte.

2. Altered signal in the postero-inferior aspect of the D12 vertebral body is not specific for a single etiology. However this may represent edema/bone bruise in the given
H/O trauma.



Sunday, 27 December 2015 16:48

14773

ke/sb/nl/rg.

Date : 00.00.00

Name of the Patient : Abc Xyzed N. Talmn / F / 58 yrs.
Referred by : Dr. Abc Xyznshah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE.

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 vertebral body with spondylolysis at L5.

A pseudoposterior disc herniation is seen at the L5-S1 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing and mild indentation on L5 nerve roots bilaterally.

A small disc protrusion is noted at L1-L2 level and L4-L5 level. The lumbar intervertebral discs show loss of water content.

Schmorls node is seen in the superior aspect of the D12 and L2 vertebral bodies.

The facet joints at the L4-L5 and L5-S1 levels appear hypertrophied.

Type II degenerative changes are noted in the L5 and S1 vertebral bodies adjacent to the L5-S1 intervertebral disc.

..2/.







The rest of 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 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 :

17.0 mm at L1-L2
20.0 mm at L2-L3
19.0 mm at L3-L4
13.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L5 over the S1 vertebral body with spondylolysis at L5.

2. A pseudoposterior disc herniation at the L5-S1 level with bilateral neural foraminal narrowing and indentation of the L5 nerve roots bilaterally.

3. A small disc protrusion at L1-L2 level and L4-L5 level.

4. Slight facetal hypertrophy at the L5-S1 and L4-L5 levels.
Sunday, 27 December 2015 16:48

14772

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / F / 26 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE with tingling since February 0000.
Patient is on AKT since 00.00.00 for bone TB.

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 normal lumbar lordosis and loss of water content of the L5-S1 intervertebral disc.

There is right paracentral disc extrusion at the L5-S1 level with antero-lateral indentation of the thecal sac. There is inferior migration of the disc in the right lateral recess of the S1 vertebra and impingement of the right S1 nerve root.

The L3-L4, L4-L5 and L5-S1 facet joints show degenerative changes.

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 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 :

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

Incidental note is made of bulky uterus.

IMPRESSION :

A right paracentral disc extrusion at the L5-S1 level with inferior migration of the disc in the right lateral recess of the S1 vertebra impinging the right S1 nerve root with canal stenosis.


Sunday, 27 December 2015 16:48

14771

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzZ. Kshirslmn / M / 38 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O twitching over the right eye since 3 years.

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.

Incidental note is made of pansinusitis.

INTRACRANIAL MRA :

The A1 segment of the right anterior cerebral artery is hypoplastic.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized left anterior cerebral, middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified. A vascular loop (the left vertebral artery) is seen to indent the root exit zone of the left seventh and eighth cranial nerve complex.
..2/.







NECK MRA :

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

IMPRESSION :

A vascular loop (left vertebral artery) indenting the root exit zone of the left seventh and eighth cranial nerve complex.

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

Sunday, 27 December 2015 16:48

14770

ke/bv/nl/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to the LLE with numbness 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 slight retroplacement of the L5 over the S1 vertebral body.

The lumbar intervertebral discs show loss of water content.

A pseudoposterior disc herniation is seen at the L5-S1 level with peridiscal osteophytes and anterior indentation of the thecal sac and mild left neural foraminal narrowing. There is inferior migration of the disc with indentation on the S1 nerve roots, bilaterally more on the left side.

A small posterior and left far lateral disc bulge is seen at the L4-L5 level.

The facet joints at the L4-L5 and L5-S1 levels show hypertrophic changes.

A posterior disc herniation is noted at the L3-L4 level and a postero-central disc protrusion at the L2-L3 level with peridiscal osteophytes.
..2/.







A small left far lateral disc bulge is seen at the L1-L2 level. Schmorls node is noted in the superior aspect of the L4 vertebral body.

Type II degenerative changes are noted in the antero-inferior aspect of the L5 vertebral body.

The rest of the lumbar vertebral bodies 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 :

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

IMPRESSION :

1. Slight retroplacement of the L5 over the S1 vertebral body.

2. A pseudoposterior disc herniation at the L5-S1 level with inferior migration of the disc indenting the S1 nerve roots (more on the left side).

3. A small posterior and left far lateral disc bulge at the L4-L5 level.

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

5. A postero-central disc protrusion with peridiscal osteophytes at the L2-L3 level.





Sunday, 27 December 2015 16:48

14769

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 30 yrs.
Referred by : Dr. Abc Xyzewal.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O vomiting, giddiness and memory impairment since 2 months.
H/O fall in childhood.

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 in 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. The seventh and eighth cranial nerve complex is unremarkable on either side.

Incidental note is made of bilateral maxillary mucosal thickening.

IMPRESSION :

Normal study of the Brain.













Sunday, 27 December 2015 16:48

14768

ke/bv/.nl/rg.

Date : 00.00.00

Name of the Patient : Abc Xyzi Kalulmn / F / 10 yrs.
Referred by : Dr. Abc Xyzvadekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever since 00.00.00 with gait ataxia and slurred speech since 00.00.00.
Now C/O mild slurring of 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 FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is no focal area of abnormal signal intensity in the brain parenchyma. Hyperintense areas seen in both posterior parietal regions represent areas of terminal myelination (scans 103.14, 102.14).

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 in the mastoid air cells bilaterally.

Incidental note is made of mildly enlarged adenoids.

IMPRESSION :

Normal study of the Brain.













Sunday, 27 December 2015 16:48

14767

ke/bv/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to the RLE with numbness since 1 month.

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

There is a posterior disc herniation, slightly to the right of the midline at the L4-L5 level with anterior indentation of thecal sac and bilateral neural foraminal narrowing. Inferior migration of the disc posterior to L5 is noted with indentation upon the L5 nerve roots, bilaterally, more on the right side. The L4-L5 facet joints show slight degenerative changes. Ligamentum flavum hypertrophy is noted at the L5 level, with tight lumbar canal.

Small posterior disc bulges are seen at the L3-L4 and L5-S1 levels. A right far lateral disc bulge is seen at the L1-L2 level.

Anterior disc herniation is seen at the L1-L2 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 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
16.0 mm at L3-L4
11.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of a posterior disc herniation, slightly to the right of the midline at the L4-L5 level with inferior migration of the disc posterior to L5 with indentation on the traversing L5 nerve roots bilaterally, (right more than left) with facetal arthropathy, ligamentum flavum hypertrophy at the L5 level and tight lumbar canal.