hs/sb
Date : 00.00.00

Name of the Patient : Abc XyzDhilmn / M / 43 yrs.
Referred by : Dr. Abc Xyzhah / Dr. Abc Xyzta.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain radiating to the RUE since 15 days.

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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is evidence of a large right postero-lateral disc extrusion indenting the right ventro-lateral aspect of the cord and the right C6 nerve root at the C5-C6 level. Slight right neural foraminal narrowing is noted at this level.

A postero-central disc protrusion is noted at the C4-C5 level. Mild posterior disc bulges are noted at the C2-C3 and C3-C4 levels.

Hyperintense striations on the T1 Weighted images are noted within the D1 vertebral body and this may represent a hemangioma. The C2 and C3 vertebrae show areas of fatty replacement of normal marrow. The rest of the cervico-dorsal vertebral bodies are more hypointense than normal on the T1 Weighted images and this may reflect preponderance of hematopoeitic marrow (? anemic).




The C3-C4, C4-C5 and C5-C6 intervertebral discs show loss of water content.

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

The cervical spinal cord shows normal signal intensity.

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

IMPRESSION :

The MRI features are suggestive of a large, right postero-lateral disc extrusion indenting the right C6 nerve root at the C5-C6 level.

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyz. Glmn / M / 70 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O wasting of the RUE since 1 1/2 years.

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.

4 mm thick STIR coronal images.

OBSERVATION :

There are large posterior peridiscal osteophytes (hard discs) and posterior disc bulges indenting the cord at the C3-C4 and C4-C5 levels. There is bilateral neural foraminal narrowing at these levels. The cord over the C3-C4 to the C4-C5 level shows hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images and which may represent cord edema/ischemia.

Posterior disc bulges with peridiscal osteophytes are noted at the C5-C6 and C6-C7 levels.

The facet joints at the C2-C3, C3-C4 and C4-C5 levels show hypertrophic degenerative changes bilaterally.

The C3-C4, C4-C5, C5-C6 and C6-C7 intervertebral discs are decreased in height. The cervical intervertebral discs show loss of water content. The cervical vertebral bodies show areas of fatty replacement of normal marrow.
..2/.







There are anterior disc herniations with peridiscal osteophytes over the C3-C4 to C6-C7 levels.

The odontoid process is irregularly defined and this may be due to degenerative changes (?? pannus). A mass lesion which is predominantly hypointense with a few hyperintense areas within it on the STIR images is noted in the posterior soft tissues in the neck on the right side. This is most likely a fat containing tumor.

Also seen are soft tissue intensity lesions in the upper lobes of both lungs.

IMPRESSION :

The MRI features are suggestive of large posterior peridiscal osteophytes with posterior disc bulges at the C3-C4 and C4-C5 levels with cord edema/ischemia over the C3-C4 to the C4-C5 level. Also seen is canal stenosis at the C3-C4 and C4-C5 levels.

Smaller posterior disc bulges with peridiscal osteophytes are noted at the C5-C6 and C6-C7 levels.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzra Shelmn / M / 30 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures with MR and diminished vision of both eyes.

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 are ill-defined hypointense areas in bilateral parieto-occipital region which are seen to follow CSF signal characteristics on all the pulse sequences. Perilesional hyperintense areas are seen on the proton, T2 Weighted and FLAIR images bilaterally which are hypointense to the normal white matter on the T1 Weighted images and would represent areas of gliosis. There is dilatation of the occipital horns and the atrium of both the lateral ventricles which are seen to abut the grey matter in the occipital lobes bilaterally.

There is thinning of the corpus callosum, especially the body and splenium.

There is mild dilatation of both the lateral ventricles. The 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 :

The MRI features are suggestive of periventricular leukomalacia in the parieto-occipital regions bilaterally as described.

hs/sb
Date : 00.00.00

Name of the Patient : Abc XyzNanilmn / M / 51 yrs.
Referred by : Dr. Abc Xyzsbekar / Dr. Abc Xyzkhwa.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O loss of hearing on the right side since 1 1/2 months.

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 coronal images.
5 mm thick T1 Weighted sagittal images.
MR cisternogram was obtained in the coronal plane.

OBSERVATION :

There is evidence of a fairly well-defined extra-axial mass lesion located in the right cerebello-pontine angle cistern and measuring approximately 2.9 x 2.1 x 2.9 cms. This lesion is hypointense on the T1 Weighted images and turns heterogeneously hyperintense on the proton and T2 Weighted images. It is seen to extend into the right internal auditory canal. Also seen is indentation upon the pons and middle cerebellar peduncle on the right side with slight deformation of the fourth ventricle.

There is mild fullness of both the lateral ventricles. The third ventricle is normal. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of an extra-axial mass lesion
located in the right cerebello-pontine angle cistern and measuring approximately 2.9 x 2.1 x 2.9 cms. This most likely represents an acoustic neurinoma (less likely to be an epidermoid).

A contrast enhanced scan may be worthwhile.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzshna Sahasrabulmn / M / 67 yrs.
Referred by : Dr. Abc Xyzvade.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the right hip since 2 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 a large posterior disc herniation with peridiscal osteophytes indenting the thecal sac and narrowing both neural foramina at the L4-L5 level. A right far lateral (extraforaminal) disc herniation is seen to indent the extraforaminal portion of the exiting right L4 nerve root at this level. The L4-L5 facet joints show degenerative changes.

A postero-central disc protrusion is noted at the L5-S1 level. Left postero-lateral and left far lateral disc herniations are seen to narrow the left neural foramen indenting the left exiting L5 nerve root at this level. Also seen is a right far lateral (extraforaminal) disc bulge at this level.

A posterior disc bulge is seen to indent the thecal sac and cause mild neural foraminal narrowing bilaterally at the L3-L4 level. Anterior disc herniations are noted at the L2-L3, L3-L4 and L4-L5 levels.




Type I/II degenerative changes are noted within the L4 and L5 vertebral bodies adjacent to the L4-L5 intervertebral disc. The lumbar vertebral bodies show areas of fatty replacement of normal marrow which may suggest osteoporosis. The lumbar intervertebral discs show loss of water content.

The remaining 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 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
12.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A large posterior disc herniation with peridiscal osteophytes and facetal arthropathy with a tight canal at the L4-L5 level.

2. A postero-central disc protrusion at the L5-S1 level.

3. Left postero-lateral and left far lateral disc herniations indenting the exiting left L5 nerve root at the L5-S1 level.

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

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzhotlmn / F / 57 yrs.
Referred by : Dr. Abc Xyzhansali.
Examination : M.R.I. of the Right Thigh.

CLINICAL PROFILE :

H/O being operated for a myxoid liposarcoma Grade I on 00.00.00.
For follow-up.

EXAMINATION :

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

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

6 mm thick T1 Weighted sagittal images.

6 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There is a post-operative scar in the antero-lateral aspect of the right thigh with susceptibility artifacts. The bulk of the right thigh appears small.

There is seen an ill-defined lesion in the anterior compartment of the right thigh deep to the quadriceps muscles and measures approximately 3.0 x 2.8 x 6.0 cms. This lesion is located approximately 4.0 cms cranially from the right knee joint. This lesion is hyperintense on the T1 Weighted images and is heterogenously hyperintense (predominantly hypointense) on the T2 Weighted and STIR images.



An ill-defined hyperintense area is seen in the right antero-lateral aspect of the vastus lateralis muscle on the T2 Weighted and STIR images and is of intermediate signal intensity on the T1 Weighted images.

Subtle hyperintense signal seen in the vastus intermedius and lateralis muscle on the T2 Weighted images in the right thigh would be due to fatty change.

The visualized portion of the right femur shows normal signal intensity. There is no obvious bone destruction or erosion.

IMPRESSION :

In a known C/O myxoid liposarcoma Grade I, the MRI features are suggestive of :

1. Post-operative status.

2. Altered signal in the right vastus lateralis muscle and in the right vastus intermedius muscle, in some places, in the middle third of the right thigh as described and deep to the quadriceps muscle 6.0 cms cranially from the knee joint, most likely is the sequelae of previous surgery (post-operative fibrosis). The possibility of these signal intensity changes being due to tumor recurrence is less likely.

As compared to the previous MRI (scan no:00005) dated 00.00.00, there is no significant change noted.

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyzsh lmn / M / 8 1/2 yrs.
Referred by : Dr. Abc Xyzrmar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O pyogenic meningitis with neurocysticercosis.
H/O epilepsy since 10 months of age.
C/O headaches and fever since 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is evidence of a well circumscribed lesion having a diameter of approximately 5.0 mms and located in the right cerebellar hemisphere. This lesion is hypointense on the T1 Weighted images and turns hyperintense with a hypointense rim on the proton and T2 Weighted images. There is a punctate hypointensity on the T2 Weighted images supero-medial to this lesion and is probably calcified. There is no perilesional edema.

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 :

The MRI features are suggestive of a 5.0 mms diameter sized lesion in the right cerebellar hemisphere and most probably represents a neurocysticercus in the granular-nodular stage. A calcific focus is noted along the supero-medial margin of this lesion.

As compared to the previous MRI (study no:00007) dated 00.00.00, there is a decrease in the size of lesion and absence of perilesional edema.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyz M. lmn / M / 46 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O pain in the upper back with radiation to the chest since 1 month.
H/O low grade fever with generalized weakness since 3 months.

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.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is seen an ill-defined, hypointense signal on the T1 Weighted images involving the D1, D2 and D3 vertebral bodies and pedicles. This lesion shows a subtle hyperintense signal on the T2 Weigthed images. The adjacent intervertebral discs are unremarkable.

There is seen an intermediate signal intensity, soft tissue mass lesion on the T1 Weighted images in the prevertebral and right paravertebral region extending over the C7 to D3 vertebral levels. Slight extension is also seen into the left paravertebral soft tissues. This lesion appears hyperintense on the T2 Weighted images. Involvement of the right costo-vertebral joint at the D1 and D2 vertebral levels is noted. Extension of the soft tissue lesion into the right neural foramen at the D1-D2 and D2-D3 levels is noted.
Scan-00003


The rest of the visualized cervico-dorsal vertebral bodies and intervertebral discs reveal normal signal intensity.

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

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

IMPRESSION :

Altered signal in the D1, D2 and D3 vertebrae, most likely represents osteitis, probably tuberculous osteitis. Prevertebral and right paravertebral soft tissue lesion over the C7 to D3 vertebral levels represents an abscess/granulation tissue.

The possibility of this lesion representing a neoplasm like a small cell tumor seems less likely.

ke/hs
Date : 00.00.00

Name of the Patient : Abc Xyzhlmn / M / 35 yrs.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in BLE.

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 postero-central disc herniation at the L5-S1 level with anterior indentation of the thecal sac.

The L5-S1 facet joints bilaterally and at the L4-L5 level on the left side show mild degenerative changes.

The L3-L4 intervertebral disc shows slight loss of water content.

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.




- 2 - Scan-00002


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

13.0 mm at L1-L2
13.0 mm at L2-L3
15.0 mm at L3-L4
12.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. A postero-central disc herniation at the L5-S1 level with slight central canal stenosis.

2. Mild facetal arthropathy at the L5-S1 level bilaterally and on the left side at the L4-L5 level.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 17 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with vomiting. On AKT since 22 days.
For follow-up.

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 seen a fairly large, approximately 3.5 x 2.2 x 3.5 cms sized conglomeration of multiple rim-enhancing lesions in the cerebellar vermis extending slightly to the right of the midline.
This lesion appears iso to slightly hypointense to normal white matter on the T1 Weighted images and is relatively more hypointense on the proton and T2 Weighted images. There is perilesional edema with compression of the fourth ventricle.
Resultant mild dilatation of the third and both the lateral ventricles is noted.









The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

IMPRESSION :

A conglomeration of multiple lesions in the cerebellar vermis as described follow the signal characteristics of multiple tuberculomas. Mild dilatation of both the lateral and third ventricles is also noted.

As compared to the previous MRI (study no:00006) dated 00.00.00, there is a slight increase in the size of the third and both the lateral ventricles.