hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyz Maknlmn / F / 25 yrs.
Referred by : Dr. Abc Xyz Kazerouni.
Examination : M.R.I. of the Abdomen.

CLINICAL PROFILE :

C/O backache.
H/O left lymphadenitis, ? psoas abscess, 2 1/2 years ago. Also H/O pulmonary kochs 1 year ago. On AKT since then.

EXAMINATION :

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

7 mm thick T1 Weighted and T2 Weighted axial images.

6 mm thick T1 Weighted and T2 Weighted coronal images.

6 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a fairly large, lobulated mass lesion in the prevertebral region to the left of the midline, just anterior to the left psoas muscle extending over the D11 to L4 vertebral levels. This lesion is of intermediate signal on the T1 Weighted images and appears relatively hypointense on the T2 Weighted images and appears relatively hypointense on the T2 Weighted images. This represents a conglomerate lymph node mass. Multiple, enlarged lymphnodes are also noted in the preaortic region, interaortico-caval region and in the retrocrural regions. The aorta is displaced slightly anteriorly. The renal vessels are stretched over the lymphnodal mass. The axis of the left kidney is deviated slightly anteriorly.

Hypointensity on all the pulse sequences within the gall bladder would represent calculi. The liver is slightly enlarged.


Multiple hypointense lesions on all the pulse sequences in the spleen may represent calcified granulomas.

The liver is normal in position. There is no intrahepatic biliary radicle dilation. The intrahepatic venous architexture is normal.

The pancreas is normal in bulk and signal characteristics.

Both adrenals are normal.

Both the kidneys are normal in size and shape.

There is no evidence of free fluid within the abdomen.

IMPRESSION :

1. Multiple enlarged lymphnodes in the abdomen as described. These may be of tuberculous etiology, in the given clinical setting of past history of pulmonary tuberculosis.

2. Gall stones.

3. Probable calcified granulomas in the spleen, posteriorly.

Similar MRI findings may also be seen with neoplastic processes like small cell tumor like lymphoma.

As compared to the previous MRI (study no:0000) dated 00.00.00, there is no significant change noted in the lymphnodal mass.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzah lmn / M / 38 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 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 a posterior and a right postero-lateral disc herniation at the L4-L5 level with anterior indentation of the thecal sac and the traversing right L5 nerve root. A sequestered disc fragment is seen to lie in the left lateral recess of the L5 vertebra with indentation on the traversing left L5 nerve root. Posterior peridiscal osteophytes are also noted at this level.

Posterior disc bulges are seen at the L2-L3 and L3-L4 levels with right far lateral disc bulge at the L3-L4 level.

Schmorls nodes are seen in the dorso-lumbar region. The L2-L3, L3-L4 and L4-L5 intervertebral discs show loss of water content.











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

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 S1 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
19.0 mm at L2-L3
17.0 mm at L3-L4
16.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. A posterior and a right postero-lateral disc herniation with posterior peridiscal osteophytes at the L4-L5 level indenting the traversing right L5 nerve root. A sequestered disc is seen to lie in the left lateral recess of the L5 vertebra with indentation on the traversing left L5 nerve root.

2. Posterior disc bulges at the L2-L3 and L3-L4 levels with a right far lateral disc bulge at the L3-L4 level.

3. Degenerative changes of the L2-L3 and L4-L5 facet joints bilaterally and the L3-L4 facet joint on the right side.

Date : 00.00.00

Name of the Patient : Abc Xyzbai Klmn / F / 57 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 2-4 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 loss of normal lumbar lordosis and loss of water content of the lumbar intervertebral discs except the L5-S1 disc.

There is a posterior and a left postero-lateral disc herniation at the L4-L5 level with anterior indentation of the thecal sac and left neural foraminal narrowing. There is indentation upon the foraminal portion of the left L4 nerve root. The L4-L5 facet joints show mild degenerative changes.

A posterior and a left far lateral disc herniation is seen at the L3-L4 level, with anterior indentation of the thecal sac, left neural foraminal narrowing and indentation upon the extraforaminal and foraminal portion of the left L3 nerve root. The L3-L4 facet joint on the left side shows hypertrophic degenerative changes.







A diffuse posterior disc herniation with bilateral far lateral disc bulges is seen at the L1-L2 and L2-L3 levels with indentation of the thecal sac. There is bilateral neural foraminal narrowing at the L1-L2 level. A sequestered disc fragment is noted along the right, postero-lateral margin of the L1 vertebral body.

A small posterior disc bulge is noted at the D12-L1 level. The lumbar facet joints show degenerative changes.

The pedicles of the lumbar vertebrae are congenitally short in their antero-posterior dimensions.

The L3 vertebral body shows evidence of a hemangioma with fat content.

The rest of the lumbar vertebral bodies 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 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
10.0 mm at L2-L3
11.0 mm at L3-L4
9.0 mm at L4-L5
7.0 mm at L5-S1.

IMPRESSION :

1. A posterior and a left postero-lateral disc herniation at the L4-L5 level with indentation upon the foraminal portion of the left L4 nerve root.
..3/.











- 3 - Scan-00008



2. A posterior and a left far lateral disc herniation at the L3-L4 level, with indentation upon the extraforaminal and foraminal portion of the left L3 nerve root. Hypertrophic degenerative changes of the L3-L4 facet joint on the left side is noted.

3. A diffuse posterior disc herniation with bilateral far lateral disc bulges at the L1-L2 and L2-L3 levels. A sequestered disc fragment is noted along the right postero-lateral margin of L1.

4. A small posterior disc bulge at the D12-L1 level.

5. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions with lumbar canal stenosis.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyz A. Salmn / M / 11 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O petimal seizures, off and on since 1 year.

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 within the brain parenchyma.

The hippocampus is unremarkable on either side.

There is slight prominence of the temporal horn of the right lateral ventricle which may be a normal variant.

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. No obvious vascular anomaly is identified on this study.

Incidental note is made of enlarged adenoids.

IMPRESSION :

No significant abnormality is detected on this study.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzam Badlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain radiating to the LUE with paresthesias since 8-9 months.

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.

IMAGES SHOW PATIENT MOTION.

OBSERVATION :

A small posterior disc bulge with peridiscal osteophyte is seen at the C5-C6 level with anterior indentation of the cord. The cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images which is isointense to the normal cord on the T1 Weighted images, suggestive of cord edema/ischemia.

Small posterior disc bulges are seen at the C2-C3 and C4-C5 levels.

A large intermediate signal intensity mass lesion is seen in the left paravertebral region at the D1 and D2 levels on the T1 Weighted images which is seen to turn heterogeneously hyperintense on the Fast Scan (T2 *) images. There is a suggestion of destruction of the, left rib at the D1 level.



Gross inhomogeneity of the marrow is seen in the cervical and dorsal vertebrae. The lower cervical, upper and lower dorsal vertebrae show an ill-defined hyperintense signal on the T2 Weighted images.

There is destruction of the lateral segment of the left ribs in the mid-dorsal region (se/im109/12), with a soft tissue mass lesion.

The cervico-dorsal and dorso-lumbar spines were screened with 5 mm thick T2 Weighted sagittal images which shows a small disc herniation with peridiscal osteophyte at the D12-L1 level. Marrow changes are also noted as described.

The cervical intervertebral discs show loss of water content.

The joints of Luschka and the visualized prevertebral soft tissues are unremarkable.

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

Incidental note is made of enlarged lymph nodes in the paratracheal region on the left side.

IMPRESSION :

1. A small posterior disc bulge with peridiscal osteophyte at the C5-C6 level with cord signal alteration at this level suggesting cord edema/ischemia.
..3/.












- 3 - Scan-00006



2. Small posterior disc bulges at the C2-C3 and C4-C5 levels.

3. A large mass lesion in the left paravertebral region at the D1 and D2 levels with a suggestion of destruction of the left rib at the D1 level and destruction of the lateral segments of the left ribs in the middorsal region may be due to a neoplastic process, ? metastasis. However an infective process cannot be ruled out.

4. Gross inhomogeneity of the marrow in the cervical and dorsal vertebrae as described is also ? due to metastasis (less likely to tbe infective in etiology).

Date : 00.00.00

Name of the Patient : Abc XyzVlmn / M / 28 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O limp on the left side since 6 days.

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 axial images.
5 mm thick GRASS sagittal images.

OBSERVATION :

There is seen a well marginated, hypointense signal on the T1 Weighted images in the antero-superior quadrant of the left femoral head. This lesion appears heterogenously hyperintense on the STIR and GRASS images. Few hypointense areas are seen on the STIR and GRASS images. The lesion is demarcated from the rest of the femoral head by a hypointense rim on all the pulse sequences. Ill-defined, hyperintense signal on the STIR images in the neck of the left femur may represent bone edema. Slight loss of normal contour of the left femoral head is noted with slight irregularity of the overlying articular cartilage. The left acetabulum is unremarkable. There is minimal left hip joint effusion. Slight decrease in bulk of the muscles around the left hip joint is noted.

The visualized right hip joint is unremarkable.

IMPRESSION :

The MRI features suggest Class C & Class D avascular necrosis of the left femoral head.

The visualized right femur is unremarkable.

Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 27 yrs.
Referred by : Dr. Abc Xyzengsarkar.
Examination : M.R.I. of the Right Ankle & Foot.

CLINICAL PROFILE :

H/O fall from a vehicle with pain in the right ankle since 1 1/2 years.

EXAMINATION :

M.R.I. of the right ankle and foot was performed using the following parameters :

3 and 4 mm thick T1 Weighted and 3 mm thick STIR coronal images.

3 mm thick T1 Weighted and STIR axial images.

4 mm thick T1 Weighted and GRASS sagittal images.

OBSERVATION :

There is a small hypointense area in the subchondral region at the superior and medial aspect of the right talor dome on the T1 Weighted images which measures approximately 1.0 x 0.5 cms. This lesion is seen to turn hyperintense on the GRASS and STIR images. There is surrounding edema in the adjacent marrow of the talus. Slight thinning of the articular cartilage in the medial aspect of the tibio-talor joint is seen. Minimal fluid is noted in the tendon sheath of the flexor hallucis longus.

No obvious bone destruction or erosion is evident.

The fibres of the tibio-talor ligament (deltoid ligament) are not well-identified (? partial/complete tear). Fibres of the tibio-calcaneal ligament are however intact.
- 2 - scan-00004


IMPRESSION :

In the given clinical setting of trauma, the MRI features are suggestive of an osteochondral lesion of the talus, corresponding to stage IIB, i.e. incomplete separation of the fragment. Fibres of the tibio-talor ligament are not well-identified. Fluid is noted in the tendon sheath of the flexor hallcuis longus.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Slmn / M / 54 yrs.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the right hip since 1 1/2 years.

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 (with fat saturation) axial images.

5 mm thick GRASS oblique coronal 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 unremarkable.

IMPRESSION :

Normal study of both Hip Joints.

sb/ke




DUPLICATE REPORT

Date : 00.00.00

Name of the Patient : Abc Xyzli Anlmn / M / 55 yrs.
Referred by : Dr. Abc Xyzwalla.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias since 6-7 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 scoliosis of the lumbar spine with convexity to the right.

There is reduction in height and loss of water content of all the lumbar intervertebral discs except the L5-S1 disc. Some of the lumbar intervertebral discs show a hypointense signal on all the pulse sequences suggesting calcium/vacuum phenomena.

Posterior disc bulges with posterior peridiscal osteophytes are noted at the L1-L2, L2-L3, L3-L4 and L4-L5 levels with bilateral neural foraminal narrowing. Left far lateral disc bulges with peridiscal osteophytes are also noted at these levels.







A right postero-lateral and far lateral disc herniation is seen at the L3-L4 level indenting the traversing right L4 nerve root.

The right facet joint at the L4-L5 level and the facet joints at the L3-L4 level bilaterally show hypertrophic degenerative changes.

Type II degenerative marrow changes are noted adjacent to the L2-L3 and L4-L5 intervertebral discs.

A small hypointense focus on all the pulse sequences in the right sacral ala most likely represents a bone island. Similar lesion is noted in the D11 vertebral body, posteriorly.

The rest of the lumbar vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12-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 :

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

IMPRESSION :

Degenerative disease of the lumbar spine with :

1. Scoliosis of the lumbar spine with convexity to the right.
..3/.









- 3 - Scan-00002




2. Posterior disc bulges with posterior peridiscal osteophytes over the L1-L2 to L4-L5 levels with bilateral neural foraminal narrowing. Left far lateral disc bulges with peridiscal osteophytes are also noted at these levels.

3. A right postero-lateral and far lateral disc herniation at the L3-L4 level indenting the traversing right L4 nerve root.

4. Hypertrophic facetal arthropathy at the L4-L5 level on the right side and at the L3-L4 level bilaterally.

5. Lumbar canal stenosis at the L3-L4 and L4-L5 levels.

Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 42 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches since 2 months.
C/O right UMN facial palsy with decreased hearing on the right side.

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 hyperintense areas in the frontal periventricular and deep white matter bilaterally, right more than left, 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.

There is mild fullness of both the lateral ventricles. 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 gross inflammatory changes in the frontal sinuses and mild inflammatory changes in the ethmoidal air cells and maxillary sinuses. The frontal sinuses appear large. There is an approximately 1.5 x 1.0 x 2.5 cms sized mass lesion in the left frontal, epidural space, just superior to the left frontal sinus. Probably erosion of the left frontal bone at that site is noted with slight swelling of the subgaleal tissues in the left frontal region, overlying the erosive lesion in the bone. It is difficult to evaluate erosion of the roof of the left frontal sinus.

IMPRESSION :

1. Altered signal in the frontal periventricular and deep white matter bilaterally, right more than left is suggestive of areas of ischemia/infarction.

2. Inflammatory changes in the paranasal sinuses bilaterally. Mucocele of the frontal sinuses is a likely possibility.

3. An approximately 1.5 x 1.0 x 2.5 cms sized epidural lesion in the left frontal region, with suspicious erosion of the left frontal bone and overlying soft tissue swelling is most likely an inflammatory lesion in the given clinical setting.