Date : 00.00.00

Name of the Patient : Abc Xyz S. Ralmn / F / 17 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain with radiation to the LUE and LLE since 1 year. Paresthesias in BLE.

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.

4 mm thick T1 Weighted coronal images.

OBSERVATION :

There is seen a well marginated, intermediate signal intensity mass lesion on the T1 Weighted images in the region of the foramen magnum and cervico-medullary junction. This lesion appears heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images with a central hypointensity. The lesion is intradural-extramedullary in location and extends from just above the foramen magnum, upto the mid segment of C2. This lesion measures approximately 2.5 x 2.0 x 3.3 cms and is located posterior to the cervical cord at the C. V. junction. There is resultant cord compression and anterior displacement of the cord at the cervico-medullary junction. The cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images suggesting cord edema/ischemia. Slight extension of the lesion along the left lateral margin of the cord is also noted.


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 atlanto-axial region is unremarkable.

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

IMPRESSION :

An approximately 2.5 x 2.0 x 3.3 cms sized intradural-extramedullary mass lesion posterior to the cervical spinal cord at the foramen magnum and cervico-medullary junction as described is not specific for a single etiology. This most likely represents a nerve sheath tumor. There is resultant cord compression and cord signal alteration suggesting cord edema/ischemia.

A contrast enhanced scan would be worthwhile (patient refused contrast scan).

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 Right 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 right 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 right knee joint, reaching upto the inferior articular margin. This may represent a horizontal flap tear. A probable corner tear along the postero-superior margin of the medial meniscus, medially, is noted (scans 102.12/13).

The anterior and posterior horn of the lateral meniscus and the anterior horn of the medial meniscus show Grade II meniscal signal (Meniscal degeneration).
Scan-00006


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 right knee joint with a probable corner tear along the postero-superior margin of the medial meniscus, medially.

2. Minimal fluid in the patello-femoral joint.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Slmn / F / 50 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O numbness from knee downwards in BLE since 2 months.
H/O fever prior to this.

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 scoliosis of the lumbar spine with convexity to the left.

There is slight loss of water content of the L4-L5 intervertebral disc.

A posteriorly herniated disc is noted at the L4-L5 level indenting the dural theca anteriorly. A right postero-lateral and far lateral disc herniation is also noted at this level with right neural foraminal narrowing and indenting the extraforaminal segment of the right L4 nerve root.

A minimal posterior disc bulge is seen at the L3-L4 level.

Left far lateral peridiscal osteophytes are noted at the L2-L3 and L1-L2 levels.


Slight facetal arthropathy is noted at the L4-L5 and L5-S1 levels, more on the right side.

The visualized dorso-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 visualized lower dorsal spinal cord shows normal signal intensity.

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 :

15.0 mm at L1-L2
15.0 mm at L2-L3
14.0 mm at L3-L4
10.0 mm at L4-L5
12.0 mm at L5-S1.

The cervical and dorsal spines were screened with 5 mm thick T2 Weighted sagittal images and do not reveal any significant feature of note.

IMPRESSION :

1. Scoliosis of the lumbar spine with convexity to the left.

2. A posteriorly herniated disc with a right postero-lateral and far lateral disc herniation at the L4-L5 level indenting the extraforaminal segment of the right L4 nerve root.

3. Left far lateral peridiscal osteophytes at the L2-L3 and L1-L2 levels.

4. Slight facetal arthropathy at the L4-L5 and L5-S1 levels, more on the right side.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz K. Kallmn / M / 70 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyz
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O low back pain since 18 years, increased since 2 years with difficulty in bending forward.

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 scoliosis of the lumbar spine with convexity to the left. There is reduction in height and loss of water content of the lumbar intervertebral discs.

The lumbar discs show evidence of calcium/vacuum phenomena.

There is a postero-central and right postero-lateral disc herniation with peridiscal osteophyte at the L4-L5 level with right neural foraminal narrowing and indentation on the extraforaminal segment of the right L4 nerve root.

Posterior and bilateral far lateral peridiscal osteophytes are noted at the L5-S1 level.

Small, posterior peridiscal osteophytes are noted at the L1-L2, L2-L3 and L3-L4 levels.

Anterior disc herniatoins with anterior peridiscal osteophytes are noted in the lumbar region.
..2/.





- 2 - scan-00004


The right facet joints at the L5-S1 level appears slightly hypertrophied.

Haemangiomas with fatty content are seen at the L2 and L3 vertebral levels on the right side.

Type III degenerative marrow changes (sclerosis) are noted adjacent to the L2-L3 disc.

The rest of the lumbar vertebral bodies 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 L1 level and the thecal sac terminates at the 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
16.0 mm at L3-L4
13.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. Scoliosis of the lumbar spine with convexity to the left.

2. A postero-central and right postero-lateral disc herniation with peridiscal osteophyte at the L4-L5 level indenting the extraforaminal segment of the right L4 nerve root.

3. Small, posterior peridiscal osteophytes at the L1-L2, L2-L3 and L3-L4 levels.

Date : 00.00.00

Name of the Patient : Abc Xyzha V. Tholmn / F / 2 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall from 7 feet height 1 year back with injury to head and fracture of parieto-occipital bone.
Now C/O gait imbalance with ? weakness of the RLE.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

3 mm thick T1 Weighted coronal images.

5 mm thick FLAIR coronal images.

OBSERVATION :

There is seen a small, CSF intensity lesion on all the pulse sequences in the right frontal cortex. This lesion represents an area of cystic encephalomalacia.

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.

Thickening of the right frontal bone is noted.

IMPRESSION :

1. An area of cystic encephalomalacia in the right frontal cortex (? due to previous contusion/vascular insult).

2. Thickening of the right frontal bone.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzka Mlmn / F / 21 yrs.
Referred by : Dr. Abc Xyz. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O low back pain, radiating to the LLE since 15 days. Occasional paresthesias.

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.

IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is loss of water content of the L5-S1 intervertebral disc.

There is a small postero-central and right paracentral disc herniation with peridiscal osteophyte at the L5-S1 level. Slight inferior migration of the disc fragment is noted with minimal indentation on the traversing right S1 nerve root.

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-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 :

21.0 mm at L1-L2
19.0 mm at L2-L3
16.0 mm at L3-L4
14.0 mm at L4-L5
12.0 mm at L5-S1.

Screening T1 Weighted coronal images of the S. I. joints and hip joints, do not reveal any significant feature of note.

IMPRESSION :

Degenerated L5-S1 disc with a small postero-central and right paracentral disc herniation with peridiscal osteophyte at the L5-S1 level, with minimal indentation on the traversing right S1 nerve root.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyz Panlmn / M / 14 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 2 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is a hyperintense signal on the T2 Weighted images in the right hippocampus.

The left hippocampus complex is unremarkable.

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 left mastoid air cells and enlarged adenoids.

IMPRESSION :

Altered signal in the right hippocampus may suggest right hippocampal sclerosis.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzai Ylmn / F / 45 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 1 year.

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 L4-L5 and L5-S1 discs.

Small, postero-central protruded discs are noted at the L4-L5 and L5-S1 levels.

Type II degenerative marrow changes are seen in the L5 vertebra adjacent to the L4-L5 disc, anteriorly.

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-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 :

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

IMPRESSION :

Degenerated L4-L5 and L5-S1 discs with small, postero-central protruded discs at these levels.

Date : 00.00.00

Name of the Patient : Abc Xyz Selmn / M / 49 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 6-7 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 a postero-central disc herniation compressing upon the thecal sac at the L3-L4 level. There is facetal arthropathy at this level.

There is a small posterior disc bulge at the L4-L5 level.

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

A small postero-central disc herniation is seen at the L2-L3 level.

The L4-L5 facet joints bilaterally and on the right side at the L2-L3 level show degenerative changes.

Bilateral far lateral (extraforaminal) disc bulges are noted at the L3-L4, L2-L3, and L4-L5 levels.

The L2-L3, L3-L4 and L5-S1 intervertebral discs show loss of water content.






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 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 :

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

IMPRESSION :

1. A postero-central disc herniation with facetal arthropathy and canal stenosis at the L3-L4 level.

2. A small left paracentral disc protrusion indenting the traversing left S1 nerve root at the L5-S1 level.

3. A small postero-central disc herniation at the L2-l3 level.

4. Facetal arthropathy on the right side at the L2-L3 level and bilaterally at the L4-L5 level.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzAli lmn / F / 40 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Operated for a suprasellar and planumsphenoidal meningioma on 00.00.00. Patient developed right hemiparesis. 1 episode of seizure and diminished vision in the right eye since 1 day and drowsiness since 1 to 2 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.

4 mm thick T1 Weighted, STIR and Fast Scan (T2 *) coronal images.

4 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a right frontal craniotomy with post-operative changes in the soft tissues in the right frontal region. A small, epidural collection is also noted in the right frontal region, deep to the craniotomy flap.

There is seen an ill-defined, hyperintense signal on the proton and T2 Weighted images in the inferior frontal cortex, bilaterally, right frontal cortex, left parathird ventricular region, left cerebral peduncle and in the posterior limb of the left internal capsule. This lesion appears hypointense to normal grey matter on the T1 Weighted images. A focal hyperintense signal on the T1 Weighted images in the left inferior frontal region may represent hemoglobin breakdown products.





There is an ill-defined, hyperintense signal on the T1 Weighted images in the suprasellar cistern, which remains hyperintense on the proton, T2 Weighted and STIR images. The pituitary stalk is not well-identified from the lesion which is seen to indent the optic chiasma to the left of the midline. The left optic nerve appears slightly atrophied and shows a hyperintense signal on the STIR images in its proximal segment. The pituitary gland is well identified on the present study. The cavernous sinuses on either side are unremarkable. The visualized right optic nerve shows normal signal.

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

Inflammatory changes are noted in the mastoid air cells bilaterally. Subgaleal edema is seen in the high parietal region.

IMPRESSION :

1. Post-operative status.

2. Altered signal in the inferior frontal cortex, bilaterally, right frontal cortex, left parathird ventricular region, left cerebral peduncle and in the posterior limb of the left internal capsule as described, most likely represent ischemic changes. (It is difficult to distinguish the frontal lesions from post-operative changes).

3. Altered signal in the suprasellar cistern, more to the left of the midline, may represent haemorrhage/hemostatic material like gel foam, in the given clinical setting.

4. Left optic nerve atrophy. Visualized right optic nerve is unremarkable.
..3/.






- 3 - scan-00007


As compared to the previous MRI (study no:00009) dated 00.00.00, the patient is now status post-operative with near complete excision of the previously identified tumor. There is no significant change in the size of the ventricles on the present study.