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Regular User

Sunday, 27 December 2015 16:48

11861

hs/hs
Date : 00.00.00

Name of the Patient : Abc XyzL. Plmn / M / 55 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O weakness of BUE and BLE with bladder incontinence.

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.


The patient was unable to co-operate for the study and the image quality obtained was not satisfactory. On conferring with the resident, it was not possible for the patient to be sedated in the given condition.

From what we can infer from the images obtained, there appears to be a space-occupying lesion anterior to the spinal cord over the C2 to C7 vertebral levels. There is resultant cord compression (However the cord signal cannot be ascertained with any degree of confidence). This lesion may represent granulation tissue/abscess (? tuberculous) or a neoplastic process like a small cell tumor or metastasis. There is a suspicion that the signal of the C4 and C5 vertebrae may be altered.

However, we feel that if feasible, the patients study needs to be repeated under sedation, preferably with the use of contrast material.

Thanking you,


Sunday, 27 December 2015 16:48

11860

hs/sb
w Date : 00.00.00

Name of the Patient : Abc Xyz C. Malmn / F / 55 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with 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 L1 vertebra appears to be as marked on the film. Please correlate with plain radiographs.

A postero-central disc extrusion is seen to indent the thecal sac at the L4-L5 level. A disc portion is seen to lie within the left lateral recess of L5 vertebra with resultant impingement of the traversing left L5 nerve root.

A postero-central disc herniation is seen to indent the thecal sac at the L2-L3 level.

Bilateral far lateral (extraforaminal) disc herniations are noted at the L5-S1 level with resultant indentation upon the extraforaminal portion of the exiting right L5 nerve root at this level.







The right L5-S1 facet joint shows hypertrophic degenerative changes. Mild facetal hypertrophy is also noted on the left side at this level. The L4-L5 facet joints bilaterally and the left facet joint at the L3-L4 level show mild degenerative changes.

The lumbar intervertebral discs show loss of water content. The paraspinal muscles in the lower lumbar region show slight atrophy.

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 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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. A postero-central disc extrusion at the L4-L5 level with a disc portion lying within the left lateral recess of L5 vertebra with resultant impingement of the traversing left L5 nerve root.
..3/.









- 3 - Scan-00000




2. A postero-central disc herniation at the L2-L3 level.

3. Bilateral far lateral (extraforaminal) disc herniations at the L5-S1 level with resultant indentation upon the extraforaminal portion of the exiting right L5 nerve root at this level.

4. Hypertrophic facetal arthropathy on the right side at the L5-S1 level.






Sunday, 27 December 2015 16:48

11859

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyz Ylmn / M / 65 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tremors in BUE and BLE since 6 months.

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 are small bright foci on the FLAIR images within the right periatrial white matter and white matter in the left frontal lobe.

There is mild fullness of the third and both the lateral ventricles. There is prominence of the basal cisternal spaces, Sylvian fissures and cerebral cortical sulci bilaterally. Also seen is mild prominence of the cerebellar folia bilaterally.

The odontoid process is seen to be angulated posteriorly and this may suggest an old fracture at the base of the odontoid.

The fourth ventricle is 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 foci of altered signal within the right periatrial white matter and white matter in the left frontal lobe and these are most likely ischemic in etiology.

Sunday, 27 December 2015 16:48

11858

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzb Shlmn / M / 1 yr.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O a small swelling at the root of the nose since birth.

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 STIR coronal images.
5 mm thick T1 Weighted sagittal images.

SOME IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

There is a fairly well-defined space-occupying lesion which is near isointense to CSF on all the pulse sequences in the region of the nasal cavity/ethmoidal air cells on the right side. The neck of this lesion is seen to communicate with the CSF space in the frontal regions via a defect in the floor of the cribriform plate of the ethmoid bone.

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.

IMPRESSION :

The MRI features are suggestive of a fronto-ethmoidal cephalocele (meningocele) as described.


Sunday, 27 December 2015 16:48

11856

hs/sb
Date : 00.00.00

Name of the Patient : Abc XyzJ. lmn / F / 37 yrs.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness.
H/O HT.

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 T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There are few foci which are near isointense to CSF on all the pulse sequences within the right periatrial white matter. These may represent prominent Virchow-Robin spaces or may be due to an ischemic insult.

Small bright foci on the proton and T2 Weighted images (iso to hypointense to white matter on the T1 Weighted images) are seen within the white matter in the frontal lobes bilaterally and these may be ischemic in etiology.

Prominent perivascular (Virchow-Robin) spaces are seen in both cerebral hemispheres. There is mild fullness of both the lateral ventricles. Also seen is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.







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.

Mild inflammatory changes are seen within both the maxillary sinuses.

IMPRESSION :

The MRI features are suggestive of :

1. Foci of altered signal intensity within the right periatrial white matter and may represent prominent Virchow-Robin spaces or may be due to an ischemic insult.

2. Foci of altered signal intensity within the white matter in the frontal lobes bilaterally and these may be ischemic in etiology.

3. Mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.


Sunday, 27 December 2015 16:48

11855

hs/sb
/57 Date : 00.00.00

Name of the Patient : Abc Xyz Vishnupurlmn / M / 25 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O sudden onset of right sided hemiparesis with inability to speak since 11.30 am on 00.00.00. Paresis recovered but speech defect persists.
Similar complaint 1 week back, recovered.

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 an ill-defined, hyperintense signal on the T2 Weighted images in the left temporo-parietal cortex and left lentiform nucleus, extending into the left corona radiata. This represents a recent infarct, which is increased in size since the previous MRI dated 00.00.00.

The ventricular system is unremarkable. There is no midline shift.

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.


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.

The left temporo-parietal and left lentiform nucleus infarct has increased in size since the previous MRI dated 00.00.00.
Sunday, 27 December 2015 16:48

11854

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyz V. Wakchlmn / F / 10 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 3 months.

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.

SOME IMAGES SHOW PATIENT MOTION.

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.

Inflammatory changes are noted in the sphenoid sinus, ethmoidal air cells and both maxillary sinuses.

IMPRESSION :

No significant abnormality is detected within the brain parenchyma on this study.

Sunday, 27 December 2015 16:48

11853

hs/sb
Date : 00.00.00

Name of the Patient : Abc XyzAnilklmn / F / 25 yrs.
Referred by : Dr. Abc Xyznawane.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 3-4 months.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick GRASS sagittal images.

OBSERVATION :

The femoral head and the acetabulum reveal normal signal intensity bilaterally. There is no obvious bony destruction or erosions noted. The articular cartilages are unremarkable. There is no effusion within both the hip joints.

The musculature surrounding both the hip joints and the visualized pelvis is normal.

The sacro-iliac joints are unremarkable bilaterally.

Small, luteal cysts are noted in the ovaries, bilaterally.

IMPRESSION :

Normal study of both Hip Joints.

Sunday, 27 December 2015 16:48

11852

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyz Glmn / F / 19 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures at the age of 3 years (for 2 years) and 3 episodes in last 6 months.
H/O pulmonary kochs since 6 months. On AKT 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 T2 Weighted coronal 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.

IMPRESSION :

Normal study of the brain.
Sunday, 27 December 2015 16:48

11851

sb/hs
Date :00.00.00

Name of the Patient : Abc Xyzralmn / M / 38 yrs.
Referred by : Dr. Abc Xyzabhat / Dr. Abc Xyzpadia.
Examination : M.R.I. of the Pelvis & Sacro-iliac Joints.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 3-4 months.

EXAMINATION :

M.R.I of the pelvis and sacro-iliac joints was performed using the following parameters :

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

6 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted sagittal images through the lumbo-sacral spine.

OBSERVATION :

There is an ill-defined hypointense signal on the T1 Weighted images involving the S1 and S2 vertebral segments and the ala of the sacrum on the left. This lesion appears hyperintense on the T2 Weighted and STIR images. There is seen a fairly large, intermediate signal intensity (on the T1 Weighted images) mass lesion in the presacral soft tissues extending over the S1 to S3 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Ill-defined hyperintense signal on the T1 Weighted images is also noted within the lesion. The lesion measures approximately 6.0 x 5.0 x 7.0 cms. There is extension of this soft tissue lesion into the anterior epidural space to the left of the midline at the S1 vertebral level with indentation on the traversing left S1 nerve root. The rectum is displaced anteriorly by this lesion.


The left sacro-iliac joint per se is unremarkable. The right sacro-iliac joint and the hip joints on either side are unremarkable.

The visualized dorso-lumbar spine is also unremarkable. Probable involvement of the L5-S1 and S1-S2 intervertebral discs is noted.

There are no abnormally enlarged pelvic lymphnodes identified.

IMPRESSION :

Altered signal in the S1 and S2 vertebral segments and the ala of the sacrum on the left with a fairly large presacral soft tissue mass lesion as described is not specific for a single etiology. This most likely is a neoplastic lesion. A round cell tumor or a sacral chordoma may be considered as a differential diagnosis. The possibility of an infective etiology seems less likely,

Slight extension of the lesion into the anterior epidural space to the left at the S1 vertebral level is noted with indentation on the traversing left S1 nerve root.