ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzrwish A. Al-lmn / M / 30 yrs.
Referred by : Dr. Abc Xyzoshipura.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

C/O pain in both knees since 2 years.

EXAMINATION :

M.R.I of the _left knee joint was performed using the following parameters :

4 mm thick T1 Weighted, proton and GRASS sagittal images.

4 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick GRASS axial images (with fat saturation).

OBSERVATION :

Menisci

There is a curvilinear hyperintense signal on all the pulse sequences within the posterior horn of the medial meniscus reaching upto the inferior articular surface and would represent Grade III meniscal signal (a meniscal tear).

The anterior horn of the medial meniscus and anterior and posterior horn of the lateral menisci show hyperintense signal on the T1 Weighted images not reaching upto the articular surface and would represent a Grade I meniscal signal (meniscal degeneration).

Cruciate Ligaments :

The anterior and posterior cruciate ligaments show normal contour and signal characteristics.


Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.

Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

The articular cartilage overlying the patella, tibia and femur appears normal.

IMPRESSION :

The MRI features are suggestive of :

1. Altered signal within the posterior horn of the medial meniscus reaching upto the inferior articular surface would represent Grade III meniscal signal (a meniscal tear).

2. Grade I meniscal signal (meniscal degeneration) within anterior horn of medial meniscus and anterior and posterior horns of the lateral menisci.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz G. Slmn / M / 65 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache 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 loss of normal lumbar lordosis and loss of water content of the lumbar intervertebral discs.

Posteriorly herniated discs with posterior peridiscal osteophytes are noted at the L2-L3, L3-L4, L4-L5 and L5-S1 levels with bilateral neural foraminal narrowing. Bilateral far lateral disc bulges are also noted at these levels. There is indentation on the traversing L5 and S1 nerve roots at the L4-L5 and L5-S1 levels, respectively. Slight facetal hypertrophy is noted at the L4-L5 and L5-S1 levels.

The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions.

Anterior disc herniations with anterior peridiscal osteophytes are noted in the lumbar region.

Hemangiomas with fat content are noted in the L3 and L1 vertebral bodies and Type II degenerative changes in the L5 and S1 vertebrae adjacent to the L5-S1 intervertebral disc is also noted.


The rest of the lumbar vertebral bodies reveal normal signal intensity. The remaining 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 :

14.0 mm at L1-L2
13.0 mm at L2-L3
13.0 mm at L3-L4
12.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. Posteriorly herniated discs with posterior peridiscal osteophytes and bilateral far lateral disc bulges at the L2-L3, L3-L4, L4-L5 and L5-S1 levels with bilateral neural foraminal narrowing. Indentation on the traversing L5 and S1 nerve roots is noted at the L4-L5 and L5-S1 levels, respectively.

2. Slight facetal hypertrophy at the L4-L5 and L5-S1 levels.

3. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions, with lumbar canal stenosis.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzSuleman Melmn / M / 45 yrs.
Referred by : Dr. Abc Xyzvade.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (right more than left) with paresthesias since 3-4 years which has increased since 10-12 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 D12-L1, L1-L2, L4-L5 and L5-S1 intervertebral discs.

There is minimal forward translation of the L5 over the S1 vertebra with probable spondylolysis at L5 (kindly correlate with plain radiographs).

A small, postero-central disc herniation is noted at the L5-S1 level, indenting the dural theca anteriorly. Facetal hypertrophy is noted at this level bilaterally.

A small postero-central and right paracentral disc herniation is seen at the L4-L5 level with indentation on the traversing right L5 nerve root at that level. Facetal hypertrophy is also noted at this level.

Minimal posterior disc bulge with peridiscal osteophyte is noted at the L1-L2 level.
..2/.








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 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
15.0 mm at L3-L4
11.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. Minimal forward translation of the L5 over the S1 vertebra with probable spondylolysis at L5 (kindly correlate with plain radiographs).

2. A small, postero-central disc herniation at the L5-S1 level, with facetal hypertrophy at this level bilaterally.

3. A small postero-central and right paracentral disc herniation at the L4-L5 level with indentation on the traversing right L5 nerve root. Facetal hypertrophy is also noted at this level.

4. Tight lumbar canal at the L4-L5 and L5-S1 levels.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzree Sulmn / F / 30 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

H/O weight gain and hoarseness of voice. Detected to be hypothyroid with diminished Serum TSH levels.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.
3 mm thick T1 Weighted and T2 Weighted sagittal images.
The brain was screened with 5 mm thick T2 Weighted axial images.

After contrast administration, 3 mm thick T1 Weighted coronal and sagittal images were obtained through the sella and perisellar region and 5 mm thick T1 Weighted axial images (with magnetization transfer) were obtained through the brain.

OBSERVATION :

The pituitary gland is normal in its size, contour and location and reveals normal signal intensity. The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. No focal mass lesion is identified in the pituitary gland. The pituitary stalk is in the midline. The hypothalamus is unremarkable.

The cavernous sinuses and the suprasellar cisterns are unremarkable. T2 Weighted axial images of the brain do not reveal any significant feature of note.

After contrast administration, there is no focal area of abnormal enhancement in the pituitary gland, the brain parenchyma or the meninges.

IMPRESSION :

No significant abnormality is detected on this study.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzehman Talmn / M / 60 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O backache (since 0000) neck pain radiating to the LUE with paresthesias 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.

IMAGE QUALITY IS SLIGHTLY DEGRADED AS THE PATIENT WAS OVERWEIGHT AND HAD A SHORT NECK. THE STUDY COULD, HENCE, NOT BE CARRIED OUT IN THE REGULAR CERVICAL SPINE-COIL.

OBSERVATION :

There is loss of water content of the cervical intervertebral discs.

A right postero-lateral peridiscal osteophtye is noted at the C3-C4 level with resultant right neural foraminal narrowing.

A small, right paracentral protruded disc is noted at the C4-C5 level, indenting the dural theca anteriorly.

Small, postero-central protruded discs are noted at the C5-C6 and C6-C7 levels.
Scan-00001


The cervical vertebral bodies show spotty fatty marrow changes. 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. A right postero-lateral peridiscal osteophtye at the C3-C4 level with resultant right neural foraminal narrowing.

2. A small, right paracentral protruded disc at the C4-C5 level.

3. Small, postero-central protruded discs at the C5-C6 and C6-C7 levels.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzhdas Kaplmn / M / 70 yrs.
Referred by : Dr. Abc Xyz Shah / Dr. Abc Xyzthari.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tonic/clonic convulsion at 10.00 pm on 00.00.00.
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.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and in the deep white matter in the fronto-parietal regions bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images.

Lacunar infarcts are noted in the left cerebellar hemisphere and head of right caudate nucleus.

There is mild to moderate dilatation of both the lateral and third ventricles and slight prominence of the fourth ventricle. There is prominence of the cerebral cortical sulci, 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.

The hippocampal complex is unremarkable on either side.

Anterior falx calcification is noted in the interhemispheric fissure.

IMPRESSION :

1. Altered signal in the periventricular white matter bilaterally and in the deep white matter in the fronto-parietal regions bilaterally represent ischemic changes.

2. Lacunar infarcts in the left cerebellar hemisphere and head of right caudate nucleus.

3. Cerebral cortical with cerebellar atrophy with mild to moderate dilatation of both the lateral and third ventricles.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / M / 43 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O sudden loss of memory with disorientation for 15 minutes, 5 months back.
Now C/O heaviness of head and eyes with increase sleep.
H/O DM/HT. Irregular Rx.

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 T1 Weighted and FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen an approximately 2.7 x 3.4 x 6.0 cms sized well marginated, extra-axial mass lesion in the right high fronto-parietal, parafalcine region (in the interhemispheric fissure on the right). This lesion follows CSF signal on all the pulse sequences. Resultant indentation on the underlying brain parenchyma is noted.

There are ill-defined, hyperintense areas on the proton T2 Weighted and FLAIR images in the subcortical white matter in the frontal regions bilaterally and in the left posterior parietal region. These lesions appear isointense to normal white matter on the T1 Weighted images.







There is an ill-defined, hyperintense signal on the T1 Weighted images in the globus pallidus bilaterally, extending into the subthalamic region and into the cerebral peduncles bilaterally. This lesion appears isointense to normal grey matter on the proton, T2 Weighted and FLAIR images.

Both the lateral, third and the fourth ventricles are normal. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. An approximately 2.7 x 3.4 x 6.0 cms sized CSF signal intensity, extra-axial mass lesion in the right high fronto-parietal, parafalcine region (in the interhemispheric fissure) as described, most likely represents an arachnoid cyst.

2. Altered signal in the subcortical white matter in the frontal regions bilaterally and in the left posterior parietal region may represent ischemic changes.

3. Altered signal in the globus pallidus bilaterally, extending into the subthalamic region and into the cerebral peduncles bilaterally may represent paramagnetic substance deposition. Such changes are seen in the hepato-cerebral syndrome.

As compared to the previous MRI dated 00.00.0000, there is no significant change noted in the size of the right high fronto-parietal parafalcine lesion.

Date : 00.00.00

Name of the Patient : Abc Xyzhai D. Jhalmn / M / 75 yrs.
Referred by : Dr. Abc Xyz Mehta.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O seizures since 5 years back.
C/O giddiness with ? seizure on 00.00.00.
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.

3 mm thick T2 Weighted coronal images.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

BRAIN :

There are small bright foci on the proton, T2 Weighted and FLAIR images in the right frontal deep white matter and in the left cerebellar hemisphere (scans 106.13, 17, 18, 102.4). These lesions appear isointense to hypointense to normal white matter on the T1 Weighted images and most likely represents ischemic changes.

There is mild to moderate dilatation of both the lateral and third ventricles. The fourth ventricle is normal.

There is prominence of the cerebral cortical sulci, cerebellar folia and basal cisternal spaces bilaterally.
..2/.





There is no shift of the midline structures.

Prominent perivascular spaces are noted in the centrum semiovale bilaterally.

The hippocampal complex is unremarkable on either side.

INTRACRANIAL MRA :

There is ectasia of the vertebro-basilar system and the left middle cerebral artery. The intracranial segment of the right vertebral artery is not visualized.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, right 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 in the neck is also not visualized. The left vertebral artery, common carotid arteries and their bifurcations are unremarkable.

There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Small bright foci on the proton, T2 Weighted and FLAIR images in the right frontal deep white matter and in the left cerebellar hemisphere most likely represent ischemic changes.

2. Ectatic vertebro-basilar system and left middle cerebral artery.

3. Non-visualization of the right vertebral artery in its entirety.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzi T. Glmn / F / 60 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O giddiness with paresthesias on the right side of the body since 1 day with slurred speech.
Known hypertensive.

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 and loss of water content of the cervical intervertebral discs.

Small postero-central protruded discs with peridiscal osteophytes are noted at the C4-C5 and C5-C6 levels.

There is slight wedging of the C4 and C5 vertebral bodies with spotty fatty marrow changes.

Slight hypertrophy of the facet joints is noted at the C4-C5 and C5-C6 levels.

The upper cervical vertebral bodies show spotty fatty marrow changes.

The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

Hyperintense signal is seen in the spinal cord over the C5 to the C7 levels predominantly in the centre on the Fast scan (T2 *) images.

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

Incidentally noted is an enlarged thyroid gland.

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

IMPRESSION :

1. Small postero-central protruded discs with peridiscal osteophytes at the C4-C5 and C5-C6 levels.

2. Slight hypertrophy of the facet joints at the C4-C5 and C5-C6 levels.

3. Altered signal in the cord over the C5 to C7 levels may be seen with myelitis/demyelination.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyza Galmn / F / 65 yrs.
Referred by : Dr. Abc Xyzhacker.
Examination : M.R.I. of the Abdomen.

CLINICAL PROFILE :

C/O pain in the abdomen with nausea and fever.
C/O jaundice since 1 month.
H/O cirrhosis with portal HT.

EXAMINATION :

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

8 mm thick T1 Weighted and T2 Weighted axial images.

6 mm thick STIR coronal images.

MRCP was also performed.

OBSERVATION :

The liver appears slightly shrunken and small in size. The margin of the liver appears slightly irregular. No focal or diffused signal alteration is noted in the hepatic parenchyma. There is no dilatation of the intrahepatic biliary radicles. The common bile duct shows normal calibre and measures approximately 6.0 mms in maximum transverse dimensions. No obvious intrinsic lesion is noted in the CBD.

The gall bladder is not well-identified on this study.

The pancreas is normal in bulk and signal intensity. The pancreatic duct is unremarkable.










The spleen and both adrenals are normal.

Both the kidneys show multiple cortical and parenchymal cysts.

No lymphadenopathy is detected. Mild ascites is noted in the perihepatic region.

IMPRESSION :

1. Small sized liver with nodular margin may suggest cirrhosis of liver.

2. Mild free fluid in the perihepatic region.

3. Multiple cortical and parenchymal renal cysts.

4. There is no dilatation of the intrahepatic biliary radicles or the common bile duct. No obvious intrinsic lesion is noted in the common bile duct.