sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzben Palmn / F / 72 yrs.
Referred by : Dr. Abc Xyz. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with numbness since 1 1/2 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 water content of the L3-L4, L4-L5 and L5-S1 discs and slight loss of water content of the L1-L2 disc.

Posteriorly bulging discs with posterior peridiscal osteophytes are noted at the L3-L4, L4-L5 and L5-S1 levels. Bilateral far lateral disc bulges are noted at the L5-S1 level. A small, left postero-lateral protruded disc is noted at the L4-L5 level, narrowing the left neural foramen.

A small postero-central disc herniation is seen at the L1-l2 level.

Hypertrophic facetal arthropathy is noted at the L4-L5 and L5-S1 levels bilaterally.








Type II degenerative marrow changes are noted adjacent to the L5-S1 intervertebral disc.

The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. 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
21.0 mm at L2-L3
17.0 mm at L3-L4
14.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. Posteriorly bulging discs with posterior peridiscal osteophytes at the L3-L4, L4-L5 and L5-S1 levels. Bilateral far lateral disc bulges are noted at the L5-S1 level.

2. A small, left postero-lateral protruded disc at the L4-L5 level, narrowing the left neural foramen.

3. A small postero-central disc herniation at the L1-L2 level.

4. Hypertrophic facetal arthropathy at the L4-L5 and L5-S1 levels bilaterally.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyz O. Relmn / F / 13 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neck pain with wasting of the LUE since 6-7 months.
Also C/O diplopia since 2 months.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

The cervical vertebral bodies and the intervertebral discs show normal signal intensity. 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.

The dorsal spine was screened with 4 mm thick T1 Weighted and T2 Weighted sagittal images and does not reveal any obvious extrinsic compression upon the visualized dorsal spinal cord.

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

IMPRESSION :

No abnormality detected within the cervical spine on this study.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzya Dlmn / M / 37 yrs.
Referred by : Dr. Abc Xyzais.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O hypothyroidism and hypogonadism.
To r/o pituitary tumor.

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

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. No obvious vascular anomaly is identified on this study.

The height of the pituitary gland is 5.0 mms. 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. The pituitary stalk is in the midline. The hypothalamus is unremarkable. The cavernous sinuses and suprasellar cistern are unremarkable.

IMPRESSION :

Normal unenhanced study of the sella and Brain.

ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzMurulmn / M / 64 yrs.
Examination : M.R. Cholangiogram.

CLINICAL PROFILE :

C/O jaundice.

EXAMINATION :

The upper abdomen was scanned with 7 mm thick T1 Weighted and T2 Weighted axial images and 8 mm thick T2 Weighted coronal images.

MR cholangiogram was also obtained.

OBSERVATION :

There is a large hypointense lesion within the terminal portion of the CBD which measures approximately 1.8 x 1.5 cms. on the T1 Weighted images which is seen to remain so on the T2 Weighted images and would represent a calculus. A similar but smaller lesion is seen just superior to the above mentioned stone. There is dilatation of the common bile duct which has a its maximum diameter of 1.3 cms. There is slight dilatation of the right and left hepatic ducts.

A hypointense lesion is seen on the T2 Weighted images having a diameter of 8.0 mm in the region of the Hartmanns pouch on all the pulse sequences and would represent a stone. A very small, similar lesion is seen in the neck of the gall bladder. A suspicious small calculus is noted in the common hepatic duct.

The gall bladder is well-distended and shows normal wall thickness. There is no fluid collection in the gall bladder fossa.

There is slight prominence of the intrahepatic biliary radicles.

The pancreatic duct is well-visualized and there is a suggestion of ? anamolous origin of the pancreatic duct.


Cortical renal cysts are noted in the left kidney. The right kidney is unremarkable.

The liver, spleen and the adrenal glands are unremarkable.

There are no abnormally enlarged abdominal lymph nodes or free fluid noted.

IMPRESSION :

1. A large calculus within the terminal portion of the CBD measuring approximately 1.8 x 1.5 cms. with a smaller calculus just superior to this lesion.

2. Dilatation of the common bile duct having a maximum diameter of 1.3 cms. Mild dilatation of intrahepatic biliary
radicles and right and left hepatic ducts is also noted.

3. A stone having a diameter 8.0 mm in the region of the Hartmanns pouch and a similar smaller lesion in the neck of the gall bladder.

ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzBhlmn / F / 45 yrs.
Referred by : Dr. Abc Xyzhacker.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with occasional vomiting since 6 months which has increased since 3 months.
C/O bilateral papilloedema.

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.

After administration of contrast, 5 mm thick T1 Weighted axial images and 5 mm thick T1 Weighted coronal images (with magnetization transfer) and 5 mm thick T1 Weighted sagittal images were obtained.

OBSERVATION :

There is an extracerebral (extradural)_ collection along the right frontal convexity which measures 2.0 cms in its maximum width and 5.5 cms in its antero-posterior dimensions. This lesion is of mixed signal intensity characteristics on the T1 Weighted images and is seen to turn predominantly hypointense on the proton, T2 Weighted and FLAIR images. There is resultant compression upon the underlying brain parenchyma.

There are ill-defined hypointense areas in the right frontal region adjacent to above mentioned extradural lesion on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images. There is surrounding white matter edema with mass effect and compression upon the body and frontal horn of the right lateral ventricle. There is resultant shift of the midline structures to
..2/.







the left with compression upon the body and frontal horn of the left lateral and third ventricles. There is effacement of the right Sylvian fissure and the adjacent cortical sulcal spaces. The edema is also seen to encroach into the external capsule and the clostrum and genu of the corpus callosum on the right side.

After administration of contrast, there is thin, peripheral homogeneous enhancement of the right frontal extradural lesion. Subtle enhancement of the adjacent meninges is also noted. Nodular enhancement which is irregular in outline is seen in the right frontal region just medial to the extradural lesion. Enhancement of the meninges in the frontal regions bilaterally is noted with subtle enhancement along the interhemispheric fissure.

There is slight dilatation of the posterior part of the body and occipital horn of the left lateral ventricle. The fourth ventricle is normal. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of

1. An extradural collection in the right frontal region measuring 2.0 cms. in its maximum width and 5.5 cms in its antero-posterior dimensions, most likely a chronic inflammatory lesion.

2. Nodular, enhancing lesions, along the medial margin of the above described extracerebral lesion in the right frontal lobe are most likely granulomas.

The signal characteristics of the above described extracerebral lesion and nodular enhancing lesions, favours the diagnosis of tuberculous lesions. The possibility of a neoplasm seems less likely.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzen Milmn / F / 70 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided hemiplegia.
H/O hypertension.

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 a hypointense area in the left thalamus on the T1 Weighted images which is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images and would represent a recent infarct.

Hyperintense areas are seen in the periventricular deep white matter, right thalamus, bilateral corona radiata, the left centrum semiovale, the head of the caudate nucleus on the left side and subcortical white matter in the fronto-temporal regions bilaterally on the proton, T2 Weighted and FLAIR images. These are iso to hypointense to normal white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.

A lacunar infarct which is hyperintense to CSF on all the pulse sequences is seen in the left cerebellar hemisphere.









There is slight prominence of the cerebral cortical sulcal spaces in the fronto-parietal regions.

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 left maxillary sinusitis and inflammatory changes in the ethmoidal air cells.

IMPRESSION :

1. A recent infarct in the left thalamus.

2. Altered signal in the periventricular deep white matter, right thalamus, bilateral corona radiata, the left centrum semiovale, the head of the caudate nucleus on the left side and subcortical white matter in the fronto-temporal regions bilaterally are suggestive of areas of ischemia/infarction.

3. A lacunar infarct in the left cerebellar hemisphere.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzThlmn / M / 30 yrs.
Referred by : Dr. Abc Xyzdy.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

C/O pain in both the knee joints, right more than left since 4 months.
H/O fall 3-4 months back.

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.

4 mm thick T1 Weighted and GRASS axial images.

OBSERVATION :

Menisci

There is a linear, hyperintense signal on all the pulse sequences in the posterior horn of the medial meniscus of the left knee joint, reaching upto the inferior articular margin. This represents a horizontal flap tear.

The anterior and posterior horn of the lateral meniscus and the anterior horn of the medial meniscus show Grade II 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.

Minimal fluid is noted in the patello-femoral joint.

IMPRESSION :

1. Horizontal flap tear in the posterior horn of the medial meniscus of the left knee joint.

2. Minimal fluid in the patello-femoral joint.

Date : 00.00.00

Name of the Patient : Abc Xyzati Muruglmn / F / 28 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O low back pain radiating to the LLE since 3-4 years which has increased since 1 week.

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 L5-S1 disc.

There is a right paracentral disc herniation with a peridiscal osteophyte at the L5-S1 level, with indentation on the traversing right S1 nerve root.

There is a postero-central and right postero-lateral disc herniation with a peridiscal osteophyte at the L4-L5 level with indentation upon the thecal sac and slight right neural foraminal narrowing.

Slight facetal hypertrophy is noted at the L5-S1 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.
Scan-00000


The conus medullaris terminates at the L1-L2 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 :

15.0 mm at L1-L2
15.0 mm at L2-L3
16.0 mm at L3-L4
12.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. A right paracentral disc herniation with a peridiscal osteophyte at the L5-S1 level, with indentation on the traversing right S1 nerve root.

2. A postero-central and right postero-lateral disc herniation with a peridiscal osteophyte at the L4-L5 level.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzm S. lmn / M / 73 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of giddiness and tendency to fall on the right with numbness since 1 day.
H/O similar complaints 1 month back from which patient recovered.

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 a small area of hypointensity on the T1 Weighted images which turns hyperintense on the proton, T2 Weighted and FLAIR images within the left thalamus with involvement of the posterior limb of the left internal capsule.

Foci with similar signal characteristics are noted within the pons and white matter in the fronto-parietal lobes bilaterally and these are most likely ischemic in etiology.

There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally. A lacune is seen in the right thalamus.

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 fresh ischemic lesion/infarct in the left thalamus as described.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzuklmn / F / 26 yrs.
Referred by : Dr. Abc Xyzrvekar / Dr. Abc Xyzdam.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O low backpain, radiating to BLE (RLE more than the LLE) since 00.00.00.

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 L4-L5 and L5-S1 intervertebral discs.

A small, postero-central herniated disc with posterior peridiscal osteophytes, more to the right of the midline is noted at the L4-L5 level.

A mild posterior disc bulge with small posterior peridiscal osteophytes are noted at the L5-S1 level.

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 S1 level.

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

19.0 mm at L1-L2
18.0 mm at L2-L3
17.0 mm at L3-L4
14.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. A small, postero-central herniated disc with posterior
peridiscal osteophytes, more to the right of the midline at the L4-L5 level.

2. A mild posterior disc bulge with small posterior peridiscal osteophytes at the L5-S1 level.