ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyz Calmn / M / 28 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of Pelvis & Both Hips.

CLINICAL PROFILE :

C/O pain right hip and difficulty in walking since 1 month.

EXAMINATION :

M.R.I of pelvis & 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 loss of normal contour of the right femoral head. There is a well-marginated, hyperintense area on the T1 Weighted images in the antero-superior quadrant of the right femoral head. This lesion appears hypointense on the T2 Weighted and STIR images (follows fat signal) and represents an area of avascular necrosis. A hypointense signal on all the pulse sequences is also noted in the right femoral head, which may represent an area of sclerosis. Perilesional, ill-defined, hyperintense signal on the T2 Weighted and STIR images in the head and neck of the right femur may represent bone edema. A small right hip joint effusion is noted. The atricular cartilage overlying the right femoral head is slightly irregular. The right acetabulum is unremarkable. Slight decrease in bulk of the muscles around the right hip joint is noted.

A focal, fat signal intensity lesion on all the pulse sequences is also noted in the anterior quadrant of the left femoral head. Perilesional bone edema is noted. The left femoral head shows normal contour. The left acetabulum is unremarkable. Small, left hip joint effusion is noted.
..2/.



- 2 - scan-00000

IMPRESSION :

1. Altered signal in the head of right femur suggests class A and Class D avascular necrosis of the right femoral head. Small joint effusion is noted.

2. Class A avascular necrosis of left femoral head. Small joint effusion is noted.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Blmn / F / 74 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzdar.
Examination : Limited M.R.I. of the Brain.

CLINICAL PROFILE :

C/O subarachnoid haemorrhage. Shunt surgery was done on 00.00.00.
For ventricular size estimation.

EXAMINATION :

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

5 mm thick T1 Weighted, proton density and T2 Weighted axial images to check the size of the ventricles.

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

OBSERVATION :

There is evidence of a left fronto-temporal craniectomy.

There is still seen, mild to moderate dilatation of both the lateral and the third ventricles. The fourth ventricle is unremarkable.

The tip of the shunt tube is noted in the body of the right lateral ventricle. Minimal fluid level is noted in the occipital horns of the lateral ventricles bilaterally with presence of subarachnoid blood as previously described.

Note is made of inflammatory changes in the mastoid air cells bilaterally and left maxillary sinus.

IMPRESSION :

1. Post-shunt status.

2. As compared to the previous MRI dated 00.00.00 (study no:00002), there is minimal decrease in the size of the ventricles.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzram Salmn / M / 40 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neck pain radiating to the LUE with tingling since 6-7 months.

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 curvature and loss of water content of the cervical intervertebral discs.

There is slight forward subluxation of the C4 over the C5 vertebra with a pseudo-posterior disc herniation at the C4-C5 level and anterior indentation of the thecal sac. The C4-C5 facet joint on the left side shows hypertrophic degenerative changes with left neural foraminal narrowing. A large posterior osteophyte is seen on the right side at this level with right neural foraminal narrowing.

A posterior disc herniation with peridiscal osteophyte is seen at the C3-C4 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. The C3-C4 facet joints show hypertrophic degenerative changes, bilaterally, left more than right. The joints of Luschka also show degenerative changes, bilaterally.

Diffuse, posterior disc herniations with peridiscal osteophytes are noted at the C2-C3, C5-C6 and C6-C7 levels with anterior indentation of the thecal sac. The C2-C3 and C5-C6 facet joints show degenerative changes.
..2/.



- 2 - scan-00007

Fatty marrow changes are seen in the upper cervical vertebrae with slight wedging of the C5 and C6 vertebral bodies.

The rest of the cervical vertebral bodies show normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord and visualized upper dorsal spinal cord show normal signal intensity.

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

IMPRESSION :

1. Slight forward subluxation of the C4 over the C5 vertebra with a pseudo-posterior disc herniation at the C4-C5 level. There is a hypertrophic facetal arthropathy on the left side with a large osteophyte is seen on the right side at this level.

2. A posterior disc herniation with peridiscal osteophyte
at the C3-C4 level with hypertrophic facetal arthropathy, bilaterally, left more than right at this level.

3. Diffuse, posterior disc herniations with peridiscal osetophytes at the C2-C3, C5-C6 and C6-C7 levels with facetal arthropathy at these levels.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyz Borlmn / M / 17 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O giddiness with blackouts (momentary) since 1 year.

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.

The clivus appears horizontal. The atlanto dens interval measures 6.0 mms.

Occipital synchondrosis is noted.

INTRACRANIAL MRA :

There is hypoplasia of the P1 segment of the right posterior cerebral artery.

The right vertebral artery is hypoplastic.
scan-00006


The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar and left vertebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The right vertebral artery in the neck also appears hypoplastic.

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

IMPRESSION :

1. Horizontal clivus with the atlanto dens interval measursing 6.0 mms.

2. Occipital synchondrosis.

3. Hypoplastic right vertebral artery.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyz V. Slmn / F / 53 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Pelvis & S. I. Joints.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias and difficulty in bending since April 0000.

EXAMINATION :

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

7 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick T1 Weighted and STIR coronal images.

6 mm thick T2 Weighted (with fat saturation) sagittal images.

OBSERVATION :

Irregularly defined areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted and STIR images are seen to involve sacral vertebral bodies, right sacral ala, right sacro-iliac joint, the right iliac wing and the lamina and articular pillar of the L5 vertebra on the right side. There is extension of this infective process into the paraspinous soft tissues at the L5 vertebral level and in the sacral region. Also seen is extension anteriorly into the pelvis. There is also seen extension into the spinal canal over the S1 to S3 vertebral levels.

Areas with similar signal characteristics are seen to involve the acetabulum and ischal tuberocity with involvement of the obturator internus muscle on the right side and the acetabulum roof, iliac wing and the iliacus muscle on the left side.

The uterus is bulky and anteverted and shows multiple hypointensities which may represent fibroids. A cyst is noted in the region of the right ovary.
..2/.





There is lateral subluxation of the L4 vertebra over the L5 vertebra on the left side and retroplacement of the L5 vertebra over the S1 vertebra.

There appear to be enlarged lymphnode in the visualized lumbar prevertebral region.

The bladder is seen to be distended.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the various pelvic bones with soft tissue extensions as described. This is not specific for a single etiology.

The differential diagnosis would include,

1. Infective process like tuberculosis.

2. Neoplastic process like small cell tumors or secondaries.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Cholmn / F / 19 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O fever with chills and backache since 6 months.

EXAMINATION :

M.R.I of the dorsal 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.

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

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images and the cervical spine was screened with 4 mm thick T1 Weighted sagittal images.

OBSERVATION :

The L5 vertebra appears to be sacralized. The D11 vertebra appears as marked on the film. Please correlate with plain radiographs.

Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images are seen to involve the D6 to D11 vertebral bodies and the right pedicles of the D7 to D10 vertebrae. There is a decrease in height of the D10 vertebral body with erosion of its superior surface. The D9-D10 disc shows a hyperintense signal on the T2 Weighted images suggestive of its involvement with erosion of its adjacent cortical endplates.
Scan-00004


There is a large soft tissue lesion which is hypointense with a hyperintense rim on the T1 Weighted images and turns hyperintense with a hypointense rim on the T2 Weighted images within the pre and paravertebral soft tissues over the D5-D6 to D11-D12 levels. This most likely represents an abscess.

Pleural effusion is noted on the right side.

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

The conus medullaris terminates at the D12 level.

The screening images of the cervico-dorsal and the lumbo-sacral spine do not reveal any diagnostic feature of note.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the D6 to D11 vertebrae with a soft tissue lesion (most likely an abscess) extending over the D5-D6 to D11-D12 levels as described. This most likely represents an infective process like tuberculosis.

The possibility of this being a neoplastic process like a small cell tumor is less likely.

hs/bv
Date : 00.00.00

Name of the Patient : Abc XyzPlmn / M / 63 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache on the right side since 15 days.

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 except L1-L2 and L3-L4 intervertebral discs.

here is mild retroplacement of the L4 over the L5 and L2 over the L3 vertebrae.

A postero-central disc herniation is seen to indent the thecal sac at the L5-S1 level.

There is a postero-central disc protrusion at the L4-L5 level and a posterior disc bulge with small posterior peridiscal osteophytes at the L2-L3 level.

Bilateral far lateral (extraforaminal) disc bulges are noted at the L3-L4, L4-L5 and L5-S1 levels.

The L5-S1 facet joints show mild degenerative changes.



A focal area of hyperintensity on all the pulse sequences is seen within the L1 vertebral body and this may represent a hemangioma with high fat content.

There are spotty areas of fatty replacement of normal marrow within the lumbar vertebral bodies.

Anterior disc herniations with peridiscal osteophytes are seen over the D10-D11 to L2-L3 levels.

The remaining 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-S3 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
17.0 mm at L2-L3
17.0 mm at L3-L4
16.0 mm at L4-L5
15.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A postero-central disc herniation with mild facetal arthropathy at the L5-S1 level.

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

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzevi Trilmn / F / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tingling on the right side of the body since 1 1/2 years.
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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are small bright foci on the FLAIR images within the white matter in the frontal lobes 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.

IMPRESSION :

The MRI features are suggestive of foci of altered signal within the white matter in the frontal lobes bilaterally and these are most likely ischemic in etiology.

Date : 00.00.00

Name of the Patient : Abc Xyzhan Chaurlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzctor.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O stiffness of BUE and BLE with slurred speech since 3-4 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.
5 mm thick FLAIR coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is prominence of the cerebral cortical sulci, Sylvian fissures and basal cisternal spaces bilaterally. Also seen is marked prominence of the cerebellar folia bilaterally. The caudate and lentiform nuclei also appear smaller in volume as compared to the normal.

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

There is fullness of the third and both the lateral ventricles. Note is made of an empty sella.

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

IMPRESSION :

The MRI features are suggestive of :

1. Mild cerebral atrophy
2. Cerebellar atrophy.

A neurodegenerative disorder should be ruled out.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Tlmn / F / 24 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O slurred speech with giddiness since 2-3 days.
Bilateral cerebellar signs.

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 is mild prominence of the cerebellar folia bilaterally. Also seen is mild fullness of the fourth ventricle.

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

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

Both the lateral and third 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 mild cerebellar atrophy.