hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzwas Molmn / M / 34 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias in the LUE and LLE since 5 months.
Alleged H/O fall prior to this.

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 vertebra over the S1 vertebra. There is a break of the pars interarticularis of the L5 vertebra bilaterally.

There is slight retroplacement of the L1 vertebra over the L2 vertebra. There is anterior wedging of the L1 vertebral body and it shows areas of fatty replacement of the normal marrow. A large Schmorls node is noted at its inferior aspect and a smaller one at its superior aspect.

A posterior disc bulge with peridiscal osteophytes is noted at the L5-S1 level. A left postero-lateral disc herniation with peridiscal osteophytes is seen to narrow the left neural foramen and impinge the foraminal left L5 nerve root at the L5-S1 level. A small disc portion is seen to lie posterior to the L5 vertebra.



A posterior disc bulge with peridiscal osteophytes is seen to indent the thecal sac at the L1-L2 level.

Mild posterior disc bulges with small peridiscal osteophytes are noted at the D12-L1 and L4-L5 levels with resultant indentation upon the thecal sac at these levels.

The D11-D12, D12-L1, L1-L2, L4-L5 and L5-S1 intervertebral discs show loss of water content. The D11-D12, D12-L1 and L1-L2 intervertebral discs are reduced in height.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. 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 S2 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
17.0 mm at L3-L4
17.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L5 vertebra over the S1 vertebra with spondylolysis of the L5 vertebra bilaterally.

2. Anterior wedging of the L1 vertebral body with fatty changes
most likely is the result of previous trauma.

3. A left postero-lateral disc herniation with peridiscal osteophytes impinging the foraminal left L5 nerve root at the L5-S1 level.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzhaturlmn / F / 65 yrs.
Referred by : Dr. Abc Xyz Sampat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O progressive dementia with right focal findings.

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.

SOME IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

Areas of hyperintensity on the T2 Weighted images are noted within the periventricular white matter, corona radiata and centrum semiovale bilaterally. These are most likely ischemic in etiology.

Lacunar infarcts (iso to hyperintense to CSF) are seen within the pons, thalamus, lentiform nuclei and corona radiata bilaterally.

The left cerebellar hemisphere appears smaller with ? indentation upon it ? arachnoid cyst ? hypoplastic.

There is fullness of the ventricular system. Note is made of an empty sella. There is prominence of the Sylvian fissures and cerebral cortical sulci bilaterally, basal cisternal spaces and the folia of the right cerebellar hemisphere. There is slight thinning of the corpus callosum.
Scan-00008


There is no shift of the midline structures.

INTRACRANIAL MRA :

The right vertebral artery is hypoplastic.

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

NECK MRA :

The right vertebral artery is hypoplastic.

The carotid and vertebral arteries are ectatic.

IMPRESSION :

1. Areas of altered signal within the periventricular white matter, corona radiata and centrum semiovale bilaterally are most likely ischemic in etiology.

2. Lacunar infarcts within the pons, thalamus, lentiform nuclei and corona radiata bilaterally.

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

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Almn / M / 19 yrs.
Referred by : Dr. Abc Xyzaj.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

Known C/O potts spine. Transthoracic decompression of D9 and D10 was done on 00.00.00.
C/O backache with slight weakness of the RLE since 1 year.

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 still seen destruction and collapse of the D10 and D11 vertebral bodies with partial destruction of the D12 vertebra and angular kyphus at that level. The superior and inferior cortical endplates of the D12 and D10 vertebrae and both endplates of D11 are breached with involvement of the D10-D11 and D11-D12 intervertebral discs.There is replacement of the normal marrow by hypointense areas on the T1 Weighted images of the L1, D12, D11, D10, D9 and D8 vertebral bodies on the T1 Weighted images. These are seen to turn heterogenously hyperintense on the T2 Weighted images. There is pre and paravertebral soft tissue extension over the D8 to D12 vertebral levels. This lesion is hyperintense to normal muscle but hypointense to fat on the T1 Weighted images and turns hyperintense on the T2 Weighted images and most probably represents an abscess. The costo-vertebral and costo-transverse joints at the D9-D10, D10-D11 and D11-D12 levels are involved by the pathology. The pedicles of the D10, D11 and D12 vertebrae are also involved. Anterior and lateral epidural lesion is seen
..2/.




- 2 - scan-00007


over the D10 and D11 levels with anterior compression of the cord. The spinal cord at the D10-D11 level shows a subtle hyperintense signal on the T2 Weighted images and which is isointense to cord on the T1 Weighted images and represents cord edema/ischemia/myelitis.
Suspectibility artifacts are noted in the D11 vertebral body on the right side.

The rest of the visualized dorsal vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The conus medullaris terminates at the L1 level.IMPRESSION :
The patient is now status post-oprative (exact details not available).

In a known C/O Potts spine, the MRI features are suggestive of altered signal of the L1, D12, D11, D10, D9 and D8 vertebrae with a large anterior and lateral epidural lesion over the D10 and D11 levels compressing the cord anteriorly and altered signal of the spinal cord at the D10-D11 level represents cord edema/ischemia/myelitis.
As compared to the previous MRI (scan no.0000) dated 00.00.00
there is reduction in the size of the pre and paravertebral abscess as well as the epidural extension.

ke/bv
Date : 00.00.00

Name of the Patient : Abc XyzLaklmn / F / 71 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzmpat.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

H/O fall and injury to the back on 00.00.00.
C/O no control over bladder/bowel since 10-15 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.

OBSERVATION :

There is a small posterior disc bulge at the C4-C5 level. Mild ligamentum flavum hypertrophy is identified at the C5 vertebral level.

The cervical intervertebral discs show loss of water content.

The cervical vertebral bodies show spotty fatty changes suggesting osteoporosis. 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.
Scan-00006



The dorsal spine was screened with 5 mm thick T2 Weighted sagittal images which does not reveal any diagnostic feature of note. The visualized brainstem is unremarkable.

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images which shows fracture of the S2 and S3 vertebral bodies with a intermediate soft tissue lesion (probably a hematoma) located anterior to the S2 and S3 sacral segments.

IMPRESSION :

No significant abnormality is detected within the cervical spine on this study.

Fracture of the S2 and S3 vertebral bodies with a probable hematoma anteriorly at this level.

ke/bv
Date : 00.00.00

Name of the Patient : Abc XyzA. Divlmn / F / 58 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain with radiating pain and weakness of the RUE since 2 years.
H/O right mastectomy. Received 6 cycles of chemotherapy.

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 T2 Weighted axial images.

4 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

Enlarged supra clavicular lymphnodes are visualized along the course of the brachial plexus on the right side (scans 106.18 to 20, 109.16 to 109.19). Note is also made of enlarged deep cervical lymph nodes.

Suspicious thickening of the right C6, C7 and C8 nerve roots is visualized (scans 106.15, 106.18, 109.20).

Multiple lesions are seen in the lung fields bilaterally of varying size and would represent metastasis in the given clinical setting.

An intermediate signal intensity lesion on the T1 Weighted images is seen in the region of the right axilla (scans 106.21-23) may represent local recurrence/metastasis.


Small posterior disc bulges are seen at the C3-C4 and C4-C5 levels.

The cervical and upper dorsal intervertebral discs show loss of water content.

The cervical vertebral bodies show fatty changes suggestive of osteoporosis. 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 :

1. Enlarged deep cervical lymph nodes and enlarged supra clavicular lymphnodes along the course of the brachial plexus on the right side may represent metastasis in the given clinical setting.

2. Multiple metastasis in both lung fields.

3. No significant abnormality is seen in the cervical spine.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzakant N. Ghadlmn / M / 73 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc XyzBR> Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O memory lapses since 1 1/2 years.
C/O retention of urine since 2-3 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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular deep white matter, bilateral fronto-parietal deep white matter and thalami. These are hypointense to the white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.

Lacunar infarcts which are hyperintense to CSF on all the pulse sequences are seen in the left corona radiata, pons and bilateral thalami and lentiform nuclei.

There is moderate dilatation of both the lateral and the third ventricles. The fourth ventricle is normal. There is prominence of the cortical sulcal spaces in the fronto-parietal and temporal regions, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Scan-00004


Incidental note is made of right maxillary sinusitis and inflammatory changes in the right mastoid air cells.

Both eyes are aphakik.

IMPRESSION :

1. Altered signal in the periventricular deep white matter, bilateral fronto-parietal deep white matter and thalami suggestive of areas of ischemia/infarction.

2. Lacunar infarcts in the left cerebral hemisphere, pons and bilateral thalami and lentiform nuclei.

3. Cerebral and cerebellar atrophy, more marked in both the temporal lobes.

Alzeihmers disease should be ruled out.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzra Tilmn / M / 30 yrs.
Referred by : Dr. Abc Xyzidya.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with tingling since 1 year.
H/O I & D done for abscess over the left gluteal region 6 months back with sinus discharge since then. On AKT since 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.

7 mm thick T1 Weighted sagittal images.

6 mm thick T1 Weighted and STIR coronal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the S1 to S4 vertebral bodies. There is extension of this pathologic process into the prevertebral soft tissues in the sacral region. This lesion is hypointense with a hyperintense rim on the T1 Weighted images and turn hyperintense with a hypointense rim on the T2 Weighted images images and most likely represents an abscess. Also seen is extension into the left puriformis and left gluteal muscles and into the right iliacus muscle.

The L5-S1 intervertebral disc is involved as is the L5 vertebral body.
- 2 - scan-00003


Hypointense areas on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the D11, D12, L1, L3 and L4 vertebral bodies. Also seen is extension into the left paravertebral soft tissues over the L3-L4 to L5-S1 level.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the sacrum and dorso-lumbar vertebrae with soft tissue extensions as described. This most likely represents an infective process like tuberculous (less likely to be a neoplastic prcess).

Date : 00.00.00

Name of the Patient : Abc Xyzsh Dandlmn / M / 12 yrs.
Referred by : Dr. Abc Xyznkharia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O neurogenic bladder.
To r/o spinal dysraphism.

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 vertebral bodies and the intervertebral discs 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.

There is evidence of moderate hydronephrosis bilaterally.

IMPRESSION :

Moderate hydronephrosis, bilaterally. There is no evidence of tethering of the spinal cord on this study.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzakant Blmn / M / 58 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neck pain radiating to LUE and both shoulder (occasionally) since 5-6 months.
H/O injury to neck in 0000.
Known hypertensive. On Rx.

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 water content of the cervical intervertebral discs and loss of normal cervical lordosis.

There is evidence of continuous ossification of the posterior longitudinal ligament over C3-C4 disc level to the C6-C7 disc level.

Small postero-central disc herniations with posterior peridiscal osteophytes are noted at the C3-C4, C4-C5, C5-C5 and C6-C7 levels indenting the anterior dural theca at these levels.

Slight degenerative changes of the joints of Luschka is noted at the C5-C6 level bilaterally.

Type II degenerative marrow changes are noted adjacent to the C6-C7 intervertebral disc.
..2/.







The rest of the cervical vertebral bodies show normal signal intensity. The rest of 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 :

1. Continuous ossification of the posterior longitudinal ligament over C3-C4 disc level to the C6-C7 disc level.

2. Small postero-central disc herniations with posterior peridiscal osteophytes at the C3-C4, C4-C5, C5-C6 and C6-C7 levels.

3. Slight degenerative changes of the joints of Luschka at the C5-C6 level bilaterally.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzash Dlmn / M / 34 yrs.
Referred by : Dr. Abc Xyzosle.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE 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 loss of water content of the L3-L4 and L4-L5 intervertebral discs.

There is a fairly large, right paracentral extruded disc at the L4-L5 level with thecal sac compression. Slight inferior migration of the disc fragment is noted indenting the traversing right L5 nerve root.

Focal fatty marrow changes are noted along the antero-superior margin of the L4 vertebral body with an anterior disc herniation
at that level.

The rest of the lumbar vertebral bodies and the remaining intervertebral discs 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 :

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

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

IMPRESSION :

A fairly large, right paracentral extruded disc at the L4-L5 level with slight inferior migration of the disc fragment indenting the traversing right L5 nerve root.