sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzn lmn / F / 60 yrs.
Referred by : Dr. Abc XyzR. Shah.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in left pubic area and hip region and LLE with numbness since 4-6 months which has increased since 1 month.
H/O fall 3 months ago.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick GRASS sagittal images.

OBSERVATION :

The pubic symphisis appears slightly irregular and shows marginal osteophytosis which may suggest osteitis pubis. The adjacent pubic bones show a hypointense signal on all pulse sequences suggesting sclerosis.

There is an ill-defined, hypointense signal on the T1 Weighted images in the right sacrum and iliac bones adjacent to the right sacro-iliac joints, inferiorly. This lesion appears hyperintense on the STIR images. The right sacro-iliac joint space per se is unremarkable.

The visualized hip joints on either side are also unremarkable. No hip joint effusion is noted.

Sacralization of the L5 vertebra is noted on the left.

The visualized pelvic musculature is unremarkable.
..2/.







IMPRESSION :

1. Osteitis pubis.

2. Altered signal sacrum and iliac bones adjacent to the right sacro-iliac joint, inferiorly, is not specific for a single etiology. This may suggest sacro-ilitis or may be post-traumatic in etiology.

3. Sacralized L5 vertebra on the left.

Date : 00.00.00

Name of the Patient : Abc Xyzwari Kaslmn / F / 58 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right facio-brachial paralysis with aphasia.
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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is seen a well-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images along the gyri in the left temporo-parietal region including the insular cortex. This lesion appears hypointense on the T1 Weighted images. On the Fast Scan (T2 *) images, there is a predominant hypointense signal along the left temporal cortex. This lesion most likely represents a recent cortical infarct with evidence of acute hemorrhage. Resultant effacement of the left Sylvian cistern and the sulcal spaces in the left temporo-parietal region is noted. Minimal effacement of the left lateral ventricle is also noted.

The right 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 suggest an acute haemorrhagic infarct involving the left temporo-parietal cortex as described.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzo Sequlmn / M / 33 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Right Shoulder.

CLINICAL PROFILE :

C/O pain in the right shoulder since 6 years.

EXAMINATION :

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

4 mm thick T1 Weighted and GRASS axial images.

4 mm thick T1 Weighted sagittal images.

4 mm thick T1 Weighted, Proton and T2 Weighted coronal images.

OBSERVATION :

There is seen a well marginated linear, hyperintense signal on the T2 Weighted and GRASS images in the head of the right humerus extending upto the anterior cortical margin. This lesion follows fluid signal intensity and appears hypointense on the T1 Weighted images. There is no perilesional bone edema noted.

The head of the right humerus shows normal contour and the upper shaft of the right humerus shows normal signal intensity.

The visualized scapula appears normal. The glenoid labrum is unremarkable. The biceps tendon in the biciptical groove shows normal signal intensity.







The articular cartilage of the head of the right humerus appears normal. There is no joint effusion.

The tendinous insertion of the supraspinatous muscle shows normal signal intensity. There is no evidence of fluid in the subdeltoid bursa. There is no evidence of a tear of the supraspinatous muscle. The soft tissues around the right shoulder joint are unremarkable.

The acromio-clavicular joint is normal. The acromion process is seen to be sloping slightly posteriorly and laterally.

The visualized axilla is unremarkable.

IMPRESSION :

Linear altered signal in the head of the right humerus extending upto the anterior cortical margin, is not specific for a single etiology. This may be the result of previous trauma.

sb/bv
Date : 00.00.00

Name of the Patient : Abc XyzJ. Glmn / F / 11 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O swelling in the lumbo-sacral region since birth. Operated on 00.00.00. Histopathology s/o ? fibrolipoma, ? infundibular cyst.
On 00.00.00, excision of intradural lesion at L4 and L5 levels was done.
For follow up.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick T1 Weighted coronal images.

OBSERVATION :

There is seen an open lumbo-sacral canal over the L2 to S2 vertebral levels. Susceptibility artifacts at the S1 vertebral level to the left of the midline, may be the sequelae of previous surgery.

There is still seen an intermediate signal intensity mass lesion on the T1 Weighted images within the thecal sac at the L4 and L5 vertebral levels, along the posterior and right lateral margin of the spinal cord. This lesion appears relatively hypointense on the T2 Weighted images. Along the left lateral margin of the lesion, there is a focal hyperintense lesion on the T1 Weighted images which appears relatively hypointense on the T2 Weighted images and may represent fatty tissue. The intrathecal nerve roots of the conus-cauda region are clumped. The tip of the conus medullaris is not well identified separately from the
..2/.






lesion but may terminate at the L5 vertebral level. The spinal cord is low-lying. The distal spinal cord over L3 to L5 vertebral levels shows evidence of a deep ventral comissure.

Scalloping of the posterior margins of the lumbar vertebrae is noted with probable dural ectasia in the lower lumbar region.

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

IMPRESSION :

As compared to the previous MRI dated 00.00.00 (study no.00002), there is significant reduction in the size of the intrathecal lesion though, minimal residual lesion is noted along the posterior and right lateral margin of the spinal cord.

The patient is status post-operative.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzbai Plmn / F / 66 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 6 months.

EXAMINATION :

M.R.I of the dorso-lumbar 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 visualized dorso-lumbar intervertebral discs.

There is central and slight anterior wedging of the D4, D6, D11, D12, L1, L2 and L3 vertebral bodies.

The L1 vertebral body shows a diffuse hypointense signal on the T1 Weighted images which appears slightly hyperintense on the T2 Weighted images. Some areas continue to remain hypointense on the T2 Weighted images and represents compressed trabeculae. The cortical endplates appear intact. The adjoining intervertebral discs appear unremarkable. Generalized bulge of the L1 vertebral body is noted laterally due to the vertebral body compression.

The rest of the visualized dorso-lumbar vertebral bodies show fatty marrow changes suggesting osteoporosis.

Posterior peridiscal osteophytes are noted at the D10-D11, D11-D12, L1-L2 and L2-L3 levels, minimally indenting the dural theca anteriorly.


Schmorls nodes are identified on the superior surface of D11 and D12 vertebrae.

Posterior and bilateral far lateral disc bulges are seen at the L5-S1 level.

A small postero-central protruded disc is noted at the L4-L5 level.

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

The visualized pre and paravertebral soft tissues are unremarkable.

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

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
14.0 mm at L3-L4
13.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. Diffuse fatty marrow changes in the visualized dorso-lumbar vertebral bodies (except the L1 vertebra) suggests osteoporotic changes. Altered signal of the L1 vertebra most likely represents bone bruise.
..3/.










- 3 - Scan-00000


2. Central and slight anterior wedging of the D4, D6, D11, D12, L1, L2 and L3 vertebral bodies represent compression fractures superimposed upon an osteoporotic spine.

3. Posterior peridiscal osteophytes at the D10-D11, D11-D12, L1-L2 and L2-L3 levels.

4. Posterior and bilateral far lateral disc bulges at the L5-S1 level.

5. A small postero-central protruded disc at the L4-L5 level.

6. Slight hypertrophy of the facet joints at the L4-L5 and L5-S1 levels.

sb/bv
Date : 00.00.00

Name of the Patient : Abc XyzKlmn / F / 32 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias 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 :

There is an exaggerated lumbar lordosis. There is loss of water content of the L5-S1 intervertebral disc.

There is Grade I spondylolisthesis of the L5 over the S1 vertebra, without obvious spondylolysis.

There is a right postero-lateral disc herniation at the L5-S1 level with right neural foraminal narrowing and indentation on the traversing right S1 nerve root. The facet joints at the L5-S1 level appear slightly hypertrophied, more on the right side.

A small posterior disc bulge is identified at the L4-L5 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-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
16.0 mm at L2-L3
16.0 mm at L3-L4
12.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L5 over the S1 vertebra, without obvious spondylolysis.

2. A right postero-lateral disc herniation at the L5-S1 level with right neural foraminal narrowing and indentation on the traversing right S1 nerve root with hypertrophy of the facet joints, more on the right side.

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyzben Sukhlmn / F / 44 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches.

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.

3 mm thick T1 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a lacunar infarct (isointense to hyperintense to CSF) in the left lentiform nucleus.

Small bright foci on the proton, T2 Weighted and FLAIR images are seen in the left centrum semiovale and these are most likely ischemic in etiology.

There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

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.
scan-00008


IMPRESSION :

The MRI features are suggestive of :

1. A lacunar infarct in the left lentiform nucleus.

2. Small bright foci in the left centrum semiovale most likely are ischemic in etiology.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzlgani Shlmn / M / 8 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O TBM with hydrocephalus.
VP shunt done 2 months back. Shunt removed.

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 a linear, hyperintense signal on the proton and T2 Weighted images in the left parietal region, extending from the lateral ventricular wall upto the cerebral cortex. This lesion is hypointense on the T1 Weighted images and most likely represents a shunt tube tract. A burrhole is noted in the left parietal bone (scans 102.14-15, 103.14-15, 104.14-15).

There is mild to moderate dilatation of both the lateral, third and the fourth ventricles. There is a hypointense signal, more pronounced on the proton and T2 Weighted images in the third ventricle, aqueduct and fourth ventricle, suggesting increased CSF flow.

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 seen in the mastoid air cells bilaterally.






IMPRESSION :

1. Post-shunt status with subsequent removal of the shunt. A shunt tube tract is noted in the left parietal region.

2. Mild to moderate communicating hydrocephalus.

As compared to the previous CT Scan dated 00.00.00, there is decrease in the size of the ventricles.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzra Mlmn / M / 45 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

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

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick GRASS sagittal images.

OBSERVATION :

There is evidence of a small, approximately 5.0 mms diameter sized hypointense lesion on the T1 Weighted images in the subcortical region along the anterior margin of the neck/base of the head of the right femur. This lesion appears hyperintense on the T2 Weighted and STIR images. No obvious cortical erosion or bone destruction is noted. A small right hip joint effusion is noted. The right femoral head shows normal contour. The right acetabulum and the articular cartilage overlying the right femoral head are unremarkable.

The visualized left hip joint is unremarkable, except for the minimal fluid in the left hip joint space.








Muscles around the hip joints on either side are unremarkable.

Screening, T1 Weighted sagittal images of the lumbar spine reveal small, postero-central protruded discs at the L4-L5 and L5-S1 levels.

IMPRESSION :

1. A 5.0 mms diameter sized lesion in the subcortical region at the neck/base of the head of the right femur, along its anterior margin, as described most likely represents a femoral herniation pit (? subchondral cyst).

2. A small right hip joint effusion.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzam Tamhalmn / M / 48 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to BLE 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 :

The lumbar intervertebral discs except at the L5-S1 level show loss of water content. There is loss of normal lumbar lordosis.

A large posterior disc extrusion, more to the left of the midline is seen to compress upon the thecal sac and narrow both neural foramina at the L3-L4 level.

A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramen at the L4-L5 level.

A small postero-central disc protrusion is seen at the L2-L3 level.

Bilateral far lateral (extraforaminal) disc herniations are noted over the L1-L2 to L4-L5 levels.

There are posterior disc bulges at the L1-L2 and L5-S1 levels.

The pedicles of the lumbar vertebrae are congenitally short in their antero-posterior dimensions.
..2/.







A hemangioma with high fat content (hyperintense on all the pulse sequences) is seen within the D12 vertebral body on the right side.

A probable conjoint nerve root is noted on the left side at the L5-S1 level. Also seen is a small Tarlovs cyst on the right side at the S2 level.

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 S2 level.

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

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

IMPRESSION :

The MRI features are suggestive of :

1. A large posterior disc extrusion, more to the left of the midline with canal stenosis at the L3-L4 level.

2. A posterior disc herniation at the L4-L5 level.

3. A small postero-central disc protrusion at the L2-L3 level.

4. Tight lumbar canal at the L3-L4 and L4-L5 levels.

5. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.