hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzhan Dhalmn / F / 63 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Left Shoulder.

CLINICAL PROFILE :

C/O pain in the left shoulder region with inability to lift the LUE since 2-3 months.

EXAMINATION :

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

4 mm thick T1 Weighted, Proton and T2 Weighted (with fat saturation) oblique coronal images.

4 mm thick T1 Weighted oblique sagittal images.

4 mm thick T1 Weighted and GRASS (with fat saturation) axial images.

OBSERVATION :

Subtle hyperintense signal is seen on the T2 Weighted images in the distal portion of the supraspinatus tendon.

Few hypointense foci on the T1 Weighted images which turn hyperintense on the T2 Weighted and GRASS images are seen within the head of the left humerus and may represent cystic changes.

Hypointense areas on the T1 Weighted images which turn hyperintense on the T2 Weighted and GRASS images are seen within the left shoulder joint space, subscapularis bursa and along the tendon of the long head of the biceps within the bicipital groove and this may represent fluid. A very small amount of fluid is seen within the subacromial bursa.



The visualized upper shaft of the left humerus shows normal signal intensity. The visualized scapula appears normal. The glenoid labrum is unremarkable.

The articular cartilage of the head of the left humerus appears normal.

The acromio-clavicular joint is normal.

An enlarged lymphnode is seen in the left axilla.

IMPRESSION :

The MRI features are suggestive of :

1. Altered signal within the distal portion of the supraspinatus tendon may suggest tendinosis.

2. Fluid/effusion within the left shoulder joint space, subscapularis bursa and along the tendon of the long head of the biceps within the bicipital groove and within the subacromial bursa.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzed Patralmn / M / 50 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided trigeminal neuralgia.

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 T1 Weighted sagittal images.

A limited MRA sequence was obtained through the midbrain.

OBSERVATION :

A large vascular loop (ectatic basilar artery) is seen to indent the right ventral aspect of the pons and deform the cisternal component of the right trigeminal nerve. Also seen is indentation upon the root entry zone of the right trigeminal nerve (scans 105.6 to 105.8, 102.6-7, 665.6-7).

Small areas of hyperintensity on the proton and T2 Weighted images are seen within the white matter in the fronto-parietal lobes bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is fullness of both the lateral ventricles.

The diploic space of the skull is more prominent than usual.


IMPRESSION :

The MRI features are suggestive of a large vascular loop (ectatic basilar artery) indenting the right ventral aspect of the pons and deform the cisternal component of the right trigeminal nerve and indentation upon the root entry zone of the right trigeminal nerve.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzh Lulmn / M / 39 yrs.
Referred by : Dr. Abc Xyzndesha.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tingling sensations in the head and forgetfullness.

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 T1 Weighted sagittal images.

OBSERVATION :

There is no focal area of altered signal intensity in the brain parenchyma.

There is evidence of an empty sella.

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.

Mucosal thickening is seen in the left maxillary sinus.

IMPRESSION :

The MRI features are suggestive of an empty sella.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzbegum Shlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE and 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.

OBSERVATION :

The L4 vertebral body is decreased in height and is seen to bulge posteriorly with indentation upon the thecal sac. It shows areas of hypointensity on the T1 Weighted images, a few of which turn mildly hyperintense on the T2 Weighted images. Few linear hypointensities on all the pulse sequences are also seen within this vertebral body and these may represent compressed trabeculae. There is erosion of the inferior cortical endplate with involvement of the L4-L5 intervertebral disc. The intranuclear cleft is not clearly identified. Few areas with similar signal characteristics are seen to involve the L5 vertebral body.

There is extension of this pathologic process into the anterior epidural space and paravertebral soft tissues over the L3-L4 to L4-L5 levels. Also seen is encroachment into the L4-L5 neural foramina with encasement of the exiting L4 nerve roots bilaterally.

The L4-L5 facet joints show degenerative changes.


The rest of the lumbar intervertebral discs show loss of water content.

The rest of the lumbar vertebral bodies reveal normal signal intensity. The remaining facet joints and the visualized prevertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1-S2 level.

Screening of the dorsal spine reveals no significant feature of note.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the L4 and L5 vertebrae and the L4-L5 intervertebral disc as described. This may represent an infective process like tuberculosis.

The possibility of this being a neoplastic process seems less likely.

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzti K. lmn / F / 54 yrs.
Referred by : Dr. Abc Xyz. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O radicular pain to the RLE 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.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There appears to be partial sacralization of the L5 vertebra on the left side. There appears to be fusion of the D8, D9, D10 and D11 vertebral bodies with a D10 hemivertebra.

A small postero-central disc herniation is seen to indent the thecal sac at the L4-L5 level. A posterior disc bulge is noted at the L5-S1 level.

The L3-L4 and L4-L5 facet joints show degenerative changes.

The lumbar intervertebral discs more so at the L4-L5 and L5-S1 levels show loss of water content.

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 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 :

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

IMPRESSION :

1. Partial sacralization of the L5 vertebra on the left side.

2. Fusion of the D8, D9, D10 and D11 vertebral bodies with a D10 hemivertebra.

3. A small postero-central disc herniation at the L4-L5 level.

4. Facetal arthropathy at the L3-L4 and L4-L5 levels.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Palmn / F / 45 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

Known C/O Kochs spine with paraplegia since April 0000.
On AKT.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is near complete collapse of the D2 vertebral body with retropulsion and a resultant kyphus at this level.

Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the D1, D2 and D3 vertebral bodies and the apendages of the D2 and D3 vertebrae. Also seen is involvement of the D1-D2 and D2-D3 intervertebral discs.

There is extension of this pathologic process into the anterior and left lateral epidural space and the pre and paravertebral soft tissues over the D1 to D3 levels. The cord is seen to be compressed at the D2/D3 levels. The spinal cord at these levels shows a hyperintense signal on the T2 Weighted images and this would be suggestive of cord edema/ischemia/myelitis.

The costo-vertebral joints on the left side at the D2 and D3 levels are involved by the pathologic process.
..2/.







Small postero-central disc herniations are seen at the C5-C6 and C6-C7 levels. Ligamentum flavum hypertrophy is also seen at these levels.

The cervical intervertebral discs show loss of water content.

The rest of the visualized cervico-dorsal vertebral bodies and the remaining dorsal intervertebral discs show normal signal intensity.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the D1, D2 and D3 vertebrae and the D1-D2 and D2-D3 intervertebral discs with soft tissue extensions and cord compression with cord edema/ischemia/myelitis as described. This most likely represents an infective process like tuberculosis.

The possibility of this being a neoplastic process like a small cell tumor is less likely.

As compared to the previous MRI dated 00.00.00, there is no significant change in the degree of cord compression.

hs/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz V. Glmn / F / 18 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 7 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 T2 Weighted coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

Areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images are seen within the periatrial white matter bilaterally with a decrease in the bulk of the white matter. These would represent gliotic changes. The atria of the ventricles have an irregular wavy outline and are seen to nearly abut the gray matter. There is ex-vacuo dilatation of the atrium and occipital horn of both the lateral ventricles. Also seen is a slight decrease in the size of the posterior body and splenium of the corpus callosum.

Smaller areas with similar signal characteristics are seen within the the corona radiata bilaterally and right cerebellar hemisphere.

The 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.

Note is made of pansinusitis.

IMPRESSION :

The MRI features are suggestive of periventricular leukomalacia as described.

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzm lmn / M / 8 yrs.
Referred by : Dr. Abc Xyzvadekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall with 2 episodes of seizures and gait imbalance 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.

3 mm thick T1 Weighted and FLAIR coronal images.

The cervical spine was scanned with 4 mm thick T2 Weighted sagittal images and 5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There is no focal area of altered signal intensity in the brain
parenchyma.

The hippocampal complex on either side 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.

Note is made of enlarged adenoids.

There is evidence of a well-circumscribed lesion which is hypointense on the T1 Weighted, T2 Weighted, Fast Scan (T2 *) and FLAIR images with a hyperintense rim on the T2 Weighted, Fast Scan (T2 *) and FLAIR images within the spinal cord at the C1/C2 level.



IMPRESSION :

1. No abnormality detected within the brain per se on this study.

2. A space occupying lesion within the spinal cord at the C1/C2 level and having a diameter of approximately 1.0 cms.

In the given clinical setting this represents a haemorrhagic contusion.

However granulomas may have similar appearances on MRI.

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzddin Adamjilmn / M / 70 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias since 15-20 days.

EXAMINATION :

M.R.I of the dorsal 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.

The lumbo-sacral spine was screened with 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

The D7 vertebra appears to be as marked on the film. Please correlate with plain radiographs.

Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted and Fast Scan (T2 *) images are seen to involve the D4, D5 and D6 vertebral bodies and their pedicles. Also seen is involvement of the D5-D6 intervertebral disc with erosion of the adjacent cortical endplates. This disc appears hyperintense on the T2 Weighted images.

There is extension of this pathologic process into the epidural space, more so posteriorly over the D2 to D6 vertebral levels with resultant cord compression. Also seen is extension into the paravertebral soft tissues over the D4 to D6 vertebral levels.
Scan-00008



There is encroachment of the pathologic process into the D4-D5 and D5-D6 neural foramina bilaterally with involvement of the costo-vertebral joints at these levels. There is also encasement of the D5 and D6 nerve roots at this level, bilaterally.

The visualized dorsal intervertebral disc show loss of water content.

The rest of the visualized dorsal vertebral bodies reveal normal signal intensity.

Anterior peridiscal osteophytes are seen in the mid dorsal region.

The visualized dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the D4, D5 and D6 vertebrae and the D5-D6 intervertebral disc as described. This most likely represents an infective process like tuberculosis.

The possibility of this being a neoplastic process is less likely.

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 35 yrs.
Referred by : Dr. Abc Xyzsari.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (left more than right) with paresthesias since 2-3 years.

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 mild retroplacement of the L4 vertebra over the L5 vertebra.

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

A posterior disc herniation with peridiscal osteophytes is seen to indent the thecal sac and narrow both neural foramina at the L5-S1 level. Bilateral far lateral (extraforaminal) disc bulges are seen at this level.

A small postero-central disc herniation is seen to indent the thecal sac at the L4-L5 level. The facet joints at this level show degenerative changes.

The L5-S1 facet joints show hypertrophic degenerative changes.

Type I (hypointense on the T1 Weighted and hyperintense on the T2 Weighted images) and Type II (isointense to fat) degenerative changes are seen within the L5 and S1 vertebral bodies adjacent to the L5-S1 intervertebral disc.
..2/.




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The uterus appears to be slightly bulky.

The rest of 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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. A posterior disc herniation with peridiscal osteophytes at the L5-S1 level.

2. Hypertrophic facetal arthropathy at the L5-S1 level.

3. A small postero-central disc herniation with facetal arthropathy at the L4-L5 level.