sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzt lmn / F / 30 yrs.
Referred by : Dr. Abc Xyzashe.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since January 0000.
H/O fall in December 0000.

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 L4-L5 and L5-S1 intervertebral discs. Slight retroplacement of the L5 over the S1 vertebra is noted.

There is a fairly large right paracentral extruded disc at the L5-S1 level indenting the traversing right S1 nerve root.

A postero-central disc herniation is noted at the L4-L5 level indenting the dural theca anteriorly.

The facet joints at the L5-S1 level appear slightly hypertrophied.

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 :

18.0 mm at L1-L2
18.0 mm at L2-L3
18.0 mm at L3-L4
11.0 mm at L4-L5
6.0 mm at L5-S1.

IMPRESSION :

1. A fairly large right paracentral extruded disc at the L5-S1 level indenting the traversing right S1 nerve root.

2. A postero-central disc herniation at the L4-L5 level.

3. Slight hypertrophy of the facet joints at the L5-S1 level.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 48 yrs.
Referred by : Dr. Abc XyzSingh / Dr. Abc Xyzatankar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the LLE since 1 year.

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 loss of normal cervical lordosis.

There is reduction in height of the C5-C6 disc and loss of water content of the C2-C3, C5-C6 and C6-C7 intervertebral discs.

There is a fairly large, posterior peridiscal osteophyte (hard disc) at the C5-C6 level, with cord compression. The cervical spinal cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images suggesting cord edema/ischemia. The cervical spinal cord appears triangular in shape at this level. There is also ligamentum flavum hypertrophy noted at the C5 vertebral level. Type I/III degenerative marrow changes are noted adjacent to the C5-C6 disc.

A small posterior disc bulge is noted at the C6-C7 level.

The facet joints at the C5-C6 level show hypertrophic changes.

Small posterior peridiscal osteophytes are noted at the C3-C4 and C4-C5 levels.
..2/.







Slight degenerative changes of the joint of Luschka on the left is noted at the C3-C4 level.

The rest of the cervical vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The rest of 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.

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

IMPRESSION :

A fairly large, posterior peridiscal osteophyte (hard disc) with canal stenosis at the C5-C6 level, with cord compression and cord signal alteration at this level suggesting cord edema/ischemia.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzHirllmn / M / 52 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE 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 loss of water content of the D10-D11, L3-L4 and L4-L5 intervertebral discs.

There is seen a posteriorly herniated disc with a posterior peridiscal osteophyte at the L4-L5 level, with bilateral neural foraminal narrowing. A sequestered disc fragment is noted in the left lateral recess of L5, indenting the traversing left L5 nerve root.

A small posterior disc bulge with slight left neural foraminal narrowing is noted at the L3-L4 level.

Facetal hypertrophy is noted at the D10-D11, D11-D12, L3-L4 and L4-L5 levels.






Focal fatty changes are seen in the L3 and L4 vertebral bodies.

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 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 :

17.0 mm at L1-L2
16.0 mm at L2-L3
12.0 mm at L3-L4
11.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. A posteriorly herniated disc with a posterior peridiscal osteophyte at the L4-L5 level, with bilateral neural foraminal narrowing. A sequestered disc fragment is noted in the left lateral recess of L5, indenting the traversing left L5 nerve root.

2. A small posterior disc bulge with slight left neural foraminal narrowing at the L3-L4 level.

3. Facetal hypertrophy at the D10-D11, D11-D12, L3-L4 and L4-L5 levels.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzline Fernalmn / F / 69 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness since 3-4 months with hearing loss on the left side.
Known hypertensive.

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.

MR cisternogram was obtained in the coronal plane.

OBSERVATION :

There are small bright foci on the proton and T2 Weighted images in the right posterior parietal deep white matter and in the right thalamus. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and may represent ischemic changes.

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

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

IMPRESSION :

Altered signal in the right posterior parietal deep white matter and in the right thalamus may represent ischemic changes.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Ralmn / F / 20 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache and neckpain with occasional fever since 1 year.
Detected to have Potts spine with psoas abscess at the L2-L3 level on 00.00.00. Received AKT for 6 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 an ill-defined, hypointense signal on the T1 Weighted images involving the marrow of the L2, L3 and L4 vertebral bodies. These vertebrae show a subtle, hyperintense signal on the T2 Weighted images. The L3-L4 intervertebral disc is reduced in height and shows a hyperintense signal on the T2 Weighted images. The intranuclear cleft is not well-identified at this level. Irregularity of the cortical endplates adjacent to the L3-L4 disc is noted.

There is seen a fairly large intermediate signal intensity mass lesion on the T1 Weighted images along the left psoas muscle extending over about L2 vertebral level upto the left lateral pelvic wall. This lesion appears hyperintense on the T2 Weighted images and represents a psoas abscess. The left psoas muscle is not well-identified separately from the lesion. Similar signal intensity lesion is also noted in the left neural foramen at the L2-L3 and L3-L4 levels and in the anterior epidural space at the L2 and L3 vertebral levels. Minimal indentation on the exiting left L2 and L3 nerve roots is noted.
..2/.







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

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

Screening of the dorsal and cervical spines reveals no feature of note.

IMPRESSION :

1. Altered signal of L2, L3 and L4 vertebral bodies with involvement of the L3-L4 intervertebral disc suggest osteitis with discitis, most likely tuberculous in etiology.

2. Soft tissue lesion in the left paravertebral region extending from the L2 vertebral level into the pelvis as described represents a psoas abscess.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 68 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O severe pain in the left hemi-thorax since 5 days with breathlessness and fever.
Known hypertensive.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

8 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick Fast Scan (T2 *) coronal images.

OBSERVATION :

There is slight loss of water content of some of the dorsal intervertebral discs.

Posterior peridiscal osteophytes with posterior disc bulges are identified at the D11-D12, L1-L2 and L2-L3 levels.

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

The visualized dorsal spinal cord reveals normal signal intensity. There is no cord compression.

The conus medullaris terminates at the L1-L2 level.


There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the pleural space and retrocrural space along the right posterior and lateral chest wall. This lesion appears hyperintense on the T2 Weighted images.

There are multiple, lobulated, soft tissue lesions in the subcarinal region, paraaortic region in the lower thorax, paraaortic, retrocaval and interaortico-caval regions in the visualized abdomen. These most likely represents enlarged lymph nodes.

Note is also made of mild splenomegaly.

Screening, T1 Weighted sagittal images of the lumbar spine reveal degenerative changes in the lower lumbar region with fatty changes of marrow. Multiple enlarged lymph nodes are also noted in the lumbar region.

IMPRESSION :

1. No significant abnormality is detected in the dorsal spinal cord and the dorsal vertebrae per se.

2. Pleural based lesion in the right hemithorax and retrocrural region with multiple enlarged lymph nodes in the subcarinal region, paraaortic region, retrocaval and interaortico-caval regions in the visualized abdomen
with splenomagaly as described is not specific for a single etiology. Small cell tumor or metastasis may be considered as differential diagnosis. The possibility of an infective etiology seems less likely.

It is difficult to assess involvement of the ribs in the right hemithorax.

Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 62 yrs.
Referred by : Dr. Abc Xyzl.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

Known C/O Potts spine detected in October 0000. On Rx since September 0000.
C/O weakness of BUE and BLE with bladder/bowel involvement.
H/O V.P. shunt done in January and February 0000.

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.

6 mm thick T1 Weighted and T2 Weighted axial images.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

The MRI scan was compared to the previous scans dated 00.00.00 and 00.00.00 and the vertebral bodies were labelled accordingly.

The L2 and L3 vertebral bodies adjacent to the L2-L3 intervertebral disc appears hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The L2-L3 intervertebral disc is not well-defined. Hyperintense signal is seen in the paravertebral soft tissue and the psoas muscle on the T2 Weighted images at the L3 level suggestive of extension of the pathologic process. Generalized bulge of the L2-L3 disc with peridiscal osteophyte is noted.

Small posterior disc bulges are noted at the L3-L4 and L4-L5 levels. Facetal hypertrophy is noted at the L3-L4 and L4-L5 levels.
..2/.







The CSF within the thecal sac in the lower dorsal and lumbar regions appears slightly more hyperintense than normal on the T1 Weighted images. There is seen an intradural lesion in the upper dorsal region over the C7 to D4 vertebral levels anterior to the dorsal spinal cord. This lesion follows CSF signal and represents an intradural arachnoid cyst. The dorsal spinal cord is displaced posteriorly at these levels. The dorsal spinal cord at the D5, D6 and D7 levels shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia/gliosis.

There is probable evidence of surgical intervention in the dorsal spine over the D3 to D5 vertebral levels.

The dorsal intervertebral discs show loss of water content.

The rest of the visualized dorso-lumbar vertebral bodies show normal signal intensity.

The conus medullaris terminates at the D12-L1 level.

IMPRESSION :

1. Altered signal of the L2 and L3 vertebral bodies and the L2-L3 intervertebral disc, most likely represents the sequelae of previous osteitis and discitis.

2. Small posterior disc bulges at the L3-L4 and L4-L5 levels.

3. Facetal hypertrophy at the L3-L4 and L4-L5 levels.

4. An intradural arachnoid cyst over the C7 to D4 vertebral levels with probable surgical intervention in the dorsal spinal canal over the D3 to D5 vertebral levels.

5. Altered signal of the dorsal spinal cord at the D5, D6 and D7 levels suggests cord edema/ischemia/gliosis.

6. Altered signal of the CSF in the lower dorsal and lumbar regions suggests arachnoiditis.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 62 yrs.
Referred by : Dr. Abc Xyzl.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O potts spine detected in October 0000. On Rx since September 0000.
C/O weakness of BUE and BLE with bladder/bowel involvement.
H/O V.P. shunt done in January and February 0000.

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 seen moderate dilatation of both the lateral, third and the fourth ventricles. There are ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally which represents periventricular CSF ooze, in the given clinical setting. A shunt tube is seen to traverse the right lateral ventricle with its tip extending slightly beyond the body of the right lateral ventricle. A hypointense signal, more pronounced on the proton and T2 Weighted images is noted in the posterior third ventricle, aqueduct and the proximal fourth ventricle which may suggest increased CSF flow. The sulcal spaces are effaced bilaterally.

Small bright foci on the proton, T2 Weighted and FLAIR images are noted in the subcortical white matter in the fronto-parietal regions bilaterally.





The prepontine and paramedullary cisterns are prominent. A mega cisterna magna is noted.

There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

C1-C2 anomaly is noted (? old fracture, ?? occipitalized atlas).

IMPRESSION :

1. Post-shunt status with a shunt tube traversing the right lateral ventricle.

2. Moderate communicating hydrocephalus with periventricular CSF ooze and sulcal space effacement.

As compared to the previous MRI dated 00.00.00, there is no significant change in the size of the ventricles.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzati lmn / F / 55 yrs.
Referred by : Dr. Abc Xyzlkar.
Examination : M.R.I. of the IAM.

CLINICAL PROFILE :

C/O tinnitus in the left ear with decreased hearing since 1 year.

EXAMINATION :

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

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

3 mm thick T1 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

MR Cisternogram was also obtained.

OBSERVATION :

There is a small bright focus on the proton and T2 Weighted images in the medulla oblongata on the right. This lesion appears hypointense on the T1 Weighted images (scans 102.4,5)

There is no other focal area of altered signal intensity within the brain parenchyma.

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

Both the lateral, third and the fourth ventricles are normal. There is slight prominence of the cortical sulcal spaces in the fronto-parietal regions bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
- 2 - scan-00004


Incidental note is made of mild inflammatory changes in the left mastoid air cells.

IMPRESSION :

1. Altered signal in the midbrain on the right may be ischemic in etiology.

2. Mild inflammatory changes in the left mastoid air cells.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzen Plmn / F / 20 yrs.
Referred by : Dr. Abc XyzBhojraj.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

H/O anterior spinal decompression with internal gibbectomy at the D6-D7 level on 00.00.00.
C/O weakness of the LLE since 1 year.

EXAMINATION :

M.R.I of the dorsal 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 probable segmentation anomalies of the D4, D5 and D6 vertebrae with an angular kyphus at these levels. There is evidence of surgical intervention at these levels with partial excision of the vertebral bodies and probably the pedicles on the left, at these levels.

There is an intermediate signal intensity lesion on the T1 Weighted images in the anterior epidural space over the D4 to D6 vertebral levels which appears hyperintense on the T2 Weighted images. These changes are most likely post-operative in etiology and this lesion may represent surgical hemostatic material/fibrous tissue.

The dorsal spinal cord over the D4 to D6 vertebral levels appears smaller in calibre and shows a hyperintense signal on the T2 Weighted images which may represent cord ischemia/gliosis.




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

The conus medullaris terminates at the D12 level.

IMPRESSION :

1. Post-operative status.

2. Probable segmentation anomalies at the D4, D5 and D6 vertebrae with a kyphus at these levels.

3. Soft tissue lesion in the anterior epidural space over the D4 to D6 vertebral levels may represent surgical hemostatic material/fibrous tissue.

4. Decreased calibre of the dorsal spinal cord over the D4 to D6 vertebral levels with altered signal may suggest cord ischemia/gliosis.

As compared to the previous MRI dated 00.00.00, the patient is now status post-operative with excision of gibbus in the mid dorsal region. There is however, no significant change in the calibre of the dorsal spinal cord at that level.