Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 29 yrs.
Referred by : Dr. Abc Xyztchha / Dr. Abc Xyzergamkar.
Examination : M.R.I. of the Right Wrist.

CLINICAL PROFILE :

C/O pain in the right wrist since August 0000 which has increased since 2 months.
Alleged H/O fall in August 0000 with injury to the right wrist.
Also H/O giant cell tumor in the left knee. Operated in March 0000.

EXAMINATION :

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

3 mm thick T1 Weighted and GRASS coronal images.

3 mm thick T1 Weighted, T2 Weighted and STIR axial images (with fat saturation).

3 mm thick T1 Weighted and T2 Weighted sagittal images (with fat saturation).

OBSERVATION :

The visualized carpal bones of the right wrist show normal alignment.

Fluid is noted in the distal radio-ulnar joint, in the radio-carpal joint, between the radius and the scaphoid bone and deep to the extensor tendons laterally at the level of the radio-carpal joint. Probable slight synovial thickening is noted in these regions.





- 2 - Scan-00004


Focal subcentimeter, hypointense lesions on T1 Weighted images are noted in the capitate, lunate and triquetrial bones. These lesions appear hyperintense on the T2 Weighted, STIR and GRASS images and may represent degenerative cysts.

The rest of the visualized carpal bones and intercarpal ligaments are unremarkable. The visualized radius and ulna bones are also unremarkable. The visualized carpal tunnel shows no significant feature of note.

IMPRESSION :

1. Fluid in the distal radio-ulnar joint, in the radio-carpal joint between the radius and the scaphoid bone and deep to the extensor tendons laterally at the level of the radio-carpal joint with probable slight synovial thickening in these regions. Synovitis is a likely possibility.

2. Focal subcentimeter, altered signal intensity lesions
in the capitate, lunate and triquetrial bones may represent degenerative cysts.

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyzath Malmn / M / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O inability to lift the LUE since 00.00.00 and pain in the neck and back of head.
H/O weakness of the RUE in 0000 which recovered in 4-5 months.
Known hypertensive. On Rx.

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.

There is 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.

INTRACRANIAL MRA :

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
..2/.





- 2 - Scan-00003


NECK MRA :

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

IMPRESSION :

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

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzh P. lmn / F / 62 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with tingling 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 slight loss of water content of the lumbar intervertebral discs.

There is a left paracentral disc herniation at the L5-S1 level indenting the traversing left S1 nerve root.

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-L2 level and the thecal sac terminates at the S2 level.

The sacral nerve-root sleeves appear slightly baggy.




- 2 - scan-00002


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

17.0 mm at L1-L2
19.0 mm at L2-L3
19.0 mm at L3-L4
19.0 mm at L4-L5
15.0 mm at L5-S1.

IMPRESSION :

A left paracentral disc herniation at the L5-S1 level indenting the traversing left S1 nerve root.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyznd lmn / M / 36 yrs.
Referred by : Dr. Abc Xyzhatt.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of left half of the body.
Chronic alcoholic and cirrhosis of liver.

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 are hyperintense areas on the T1 Weighted images within the lentiform nuclei bilaterally and these may represent deposition of paramagnetic substances.

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.

A polyp is noted in the right maxillary sinus. Note is made of enlarged adenoids.

IMPRESSION :

The MRI features are suggestive of altered signal intensity within the lentiform nuclei bilaterally and this may be seen with acquired hepatocerebral syndrome.

hs/ke
/71 Date : 00.00.00

Name of the Patient : Abc Xyza B. Tlmn / F / 22 yrs.
Referred by : Dr. Abc Xyzka.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O left sided TIAs.

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.

INTRACRANIAL MRA :

The left posterior communicating artery is prominent and the left posterior cerebral artery appears to be a continuation of it.

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






NECK MRA :

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

IMPRESSION :

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

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyzh Plmn / M / 19 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

Known C/O TBM for which a VP Shunt was placed in 0000 with excision of tuberculoma.
Was also operated upon the dorsal spine (D6 to D10 levels) for tuberculosis.
Patient has paresthesias in BLE.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

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

OBSERVATION :

There is evidence of laminectomy of the D7 to D11 vertebrae with post-operative changes in the posterior soft tissues over these levels.

The dorsal spinal cord over the D6 to D9 levels shows a hypointense signal on the T1 Weighted images which turn hyperintense on the T2 Weighted images and which may suggest gliotic/ischemic changes. The cord margins over these levels shows an irregular margin which may be the result of arachnoidits.
Scan-00008


The visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1-L2 level.

On the screening the brain, there is a cystic lesion (isointense to CSF) within the left basal ganglia and left temporal lobe. There is perilesional edema with indentation upon the left cerebral peduncle. The exact etiology of this lesion is undetermined (? _trapped cyst/ventricle). A dedicated study of the brain with contrast may be worthwhile.

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. Altered cord signal with irregular cord margins over the D6 to D9 levels may represent gliotic/ischemic changes, probably the result of arachnoiditis.

3. The lesion in the brain needs to be further evaluated.

Date : 00.00.00

Name of the Patient : Abc Xyz Almn / M / 12 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O high grade fever, loss of consciousness for 24 hours, generalized dystonia and involuntary movements of head and BUE since then.

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

There is beaking of the cerebellar tonsils and are seen to lie at the level of the foramen magnum.

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.

Incidental note is made of inflammatory changes in the maxillary sinuses, left more than right and enlarged adenoids.

IMPRESSION :

No significant abnormality is detected in the brain parenchyma per se.

Date : 00.00.00

Name of the Patient : Abc Xyzr G. Plmn / M / 30 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

H/O fall from a height on 00.00.00.
C/O neck pain with weakness of BUE and BLE since then.

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 reversal of the normal cervical lordotic curve.

There is slight subluxation of the C3 vertebra over the C4 vertebra, more so on flexion.

Posterior disc bulges are noted at the C2-C3, C4-C5 and C6-C7 levels.

Hyperintnse signal is seen on the T2 Weighted images within the spinal cord at the C5 and C6 levels suggestive of cord edema/contusion (in the ginen clinical setting of trauma). Also seen is a hyperintense signal on the T2 Weighted images within the prevertebral soft tissues over the C4 to C6 levels may suggests soft tissue edema/contusion (? haemorrhage).

A slight tight spinal canal noted over the C3-C4 to C6-C7 levels.


The cervical vertebral bodies and the intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.

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

The brain was screened with 5 mm thick T2 Weighted axial images and does not reveal any significant feature of note.

IMPRESSION :

The MRI features are suggestive of :

1. Reversal of the normal cervical lordotic curve.

2. Slight subluxation of the C3 vertebra over the C4 vertebra.

3. Posterior disc bulges at the C2-C3, C4-C5 and C6-C7 levels.

4. Altered signal in the spinal cord at the C5 and C6 levels suggestive of cord edema/contusion (in the ginen clinical setting of trauma).

5. Altered signal within the prevertebral soft tissues over the C4 to C6 levels may suggests soft tissue edema/contusion (? haemorrhage).

6. A slight tight spinal canal over the C3-C4 to C6-C7 levels.

hs/ke
/65 Date : 00.00.00

Name of the Patient : Abc Xyz Muklmn / M / 42 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O giddiness and vomiting with alleged H/O fall 2 months ago.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted coronal 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.

There is slight fullness of the temporal horn of both the lateral ventricles. The rest of the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

INTRACRANIAL MRA :

The left posterior cerebral artery is seen to be a continuation of the left posterior communicating artery.

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




NECK MRA :

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

IMPRESSION :

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

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzh Phlmn / M / 2 1/2 yrs.
Referred by : Dr. Abc Xyzgrankar.
Examination : M.R.I. of the Left Thigh.

CLINICAL PROFILE :

C/O inability to bend the left leg with pain and swelling over the left femur since 20 days.

EXAMINATION :

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

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

5 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick T1 Weighted and STIR sagittal images.

OBSERVATION :

There is evidence of a well-defined space-occupying lesion antero-medial to the left femoral shaft. This lesion is hypointense with a hyperintense rim on the T1 Weighted images and turns hyperintense with a hypointense rim on the T2 Weighted and STIR images. The vastus intermedius and medialis muscles cannot be identified separately from this lesion. Edema is seen adjacent to this lesion. The superior pole of this lesion is approximately 5.0 cms from the hip joint and the inferior pole is approximately 4.0 cms from the knee joint.







There is erosion of the medial femoral cortex with scalloping. The proximal metaphysis and upper diaphysis of the left femur shows a hypointense signal on the T1 Weighted images which turns hyperintense on the T2 Weighted and STIR images. The endosteum is also irregular and slightly thickened.

The visualized right thigh is unremarkable.

IMPRESSION :

The MRI features are suggestive of a space-occupying lesion within the left thigh measuring approximately 3.0 x 4.5 x 11.0 cms with signal changes in the left femur. This most likely represents osteomyelitis with abscess formation.

The possibility of this being a neoplastic process (like Ewings sarcoma) though less likely cannot be entirely excluded.