sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzJajlmn / F / 25 yrs.
Referred by : Dr. Abc Xyzsrani.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache since October 0000.
H/O low grade fever, with loss of weight and appetite since 3 months.

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 :

The D12 and right half of the L1 vertebral bodies show an ill-defined, hypointense signal on the T1 Weighted images which appears hyperintense on the T2 Weighted images. The right pedicle of L1 and the right pedicle, transverse process, both laminae and spinous process of the D12 vertebra seem to be involved by the lesion. The D12-L1 intervertebral disc appears intact.

There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the right paravertebral region and in the right posterior spinal region, extending into the anterior and right lateral epidural space at the D12 and L1 levels. This lesion appears hyperintense on the T2 Weighted images. There is no cord compression. The visualized lower dorsal spinal cord shows normal signal intensity.
Scan-00005



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

The visualized dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

IMPRESSION :

Altered signal of the D12 and L1 vertebral bodies with involvement of their posterior elements, most likely represents osteitis, probably tuberculous osteitis. Right paravertebral, posterior paraspinal and epidural soft tissue lesion as described may represent granulation tissue/abscess.

The possibility of a neoplasm is less likely.

sb/ke
/26 Date : 00.00.00

Name of the Patient : Abc Xyz Karilmn / F / 42 yrs.
Referred by : Dr. Abc Xyzpta.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches, nausea, vomiting and giddiness since 1 1/2 months.
Known hypertensive.

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 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 slight prominence of the cerebellar folia bilaterally. There is no shift of the midline structures.

Polyps are noted in the maxillary antra bilaterally with inflammatory changes in the right ethmoidal air cells.

Incidentally noted is an empty sella.








- 2 - Scan-00004/26


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.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzand Thlmn / M / 59 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tingling in the RUE and on the right side of face with numbness in the RUE since 8 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.

5 mm thick FLAIR coronal images.

OBSERVATION :

There is a well marginated, hyperintense lesion on the proton, T2 Weighted and FLAIR images in the left thalamus. This lesion appears hypointense to normal grey matter on the T1 Weighted images.

Ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images are noted in the posterior parietal periventricular white matter bilaterally, in the left fronto-parietal and right frontal deep white matter.

There is mild fullness of both the lateral ventricles. The third and 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 right maxillary antrum.

IMPRESSION :

Altered signal in the left thalamus represents an ischemic lesion, most likely recent, in the given clinical setting.

Altered signal in the posterior parietal periventricular white matter bilaterally, in the left fronto-parietal and right frontal deep white matter may also represent ischemic changes.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzakash Goslmn / M / 35 yrs.
Referred by : Dr. Abc Xyz.
Examination : M.R.I. of the Lumbo-sacral Spine and
Sacrum.

CLINICAL PROFILE :

Operated for a lymphoma of the left S. I. joint on 00.00.00. Received 25 sittings of radiation and 6 cycles of chemotherapy. Still C/O pain in the LLE with paresthesias.

EXAMINATION :

M.R.I of the lumbo-sacral spine and sacrum was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T2 Weighted axial images.

6 mm thick T1 Weighted and T2 Weighted axial images.

4 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There is an ill-defined, hypointense signal on the T1 Weighted images in the marrow of the sacral ala, bilaterally, in the left half of the sacral segments and in the left iliac bone. This signal appears hyperintense on the T2 Weighted and STIR images. Erosion of the posterior margin of the left iliac bone and part of the sacral segments is noted.







There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images anterior and posterior to the left sacro-iliac joint. This lesion appears hyperintense on the T2 Weighted and STIR images. Extension into the left lateral epidural space and into the upper sacral foramina is noted over the S1 to S3 sacral segments, with resultant encasement of the corresponding sacral nerve roots. The left S. I. joint is involved by the lesion.

The left gluteus maximus muscle shows a hyperintense signal on the T2 Weighted and STIR images. Atrophy of the left gluteus muscle is also noted.

The lower lumbar vertebrae, right half of sacral segments and visualized right iliac bone show fatty marrow changes, the sequelae of previous radiotherapy.

No significant discal herniation is noted in the lumbar region. The conus medullaris terminates at the L1 level.

The right S. I. joint is unremarkable.

IMPRESSION :

Altered signal involving the sacral segments and the left iliac bone as described most likely represents residual/recurrent lesion, in a known C/O lymphoma. Soft tissue extension is noted anterior and posterior to the left S. I. joint and into the left sacral foramina over the S1 to S3 segments with encasement of the corresponding sacral nerve roots. The patient is status post-operative and post-radiotherapy.

As compared to the previous CT Scan dated 00.00.00, there is a decrease in the soft tissue posterior to the left S. I. joint.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzti Malmn / F / 48 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O major depression with involuntary movements and speech difficulty since 4 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 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 prominence of the cerebellar folia bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Prominent cerebellar folia bilaterally.

No other significant abnormality is detected on this study.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyza Ibrlmn / F / 43 yrs.
Referred by : Dr. Abc Xyzwalla.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain, radiating to the LUE and LLE since 1 year with paresthesias.

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.

OBSERVATION :

There is loss of water content of the cervical intervertebral discs.

There is ossification of the posterior longitudinal ligament at the C4 vertebral level.

Small postero-central protruded discs are noted at the C3-C4 and C4-C5 levels.

A posterior disc bulge with a fairly large, posterior peridiscal osteophyte is noted at the C5-C6 level, more to the left of the midline, indenting the dural theca anteriorly. Slight left neural foraminal narrowing is noted at this level.






A hemangioma with fat content is noted in the C7 vertebral body.

The rest of the cervical vertebral bodies 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.

IMPRESSION :

1. Ossification of the posterior longitudinal ligament at the C4 vertebral level.

2. Small postero-central protruded disc at the C3-C4 and C4-C5 levels.

3. A posterior disc bulge with posterior peridiscal osteophyte at the C5-C6 level, more to the left of the midline.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyza M.U. lmn / F / 17 yrs.
Referred by : Dr. Abc Xyz. Sidhwa.
Examination : M.R.I. of the Abdomen.

CLINICAL PROFILE :

C/O pain in the costo-phrenic region since October 0000.

EXAMINATION :

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

8 mm thick T1 Weighted and T2 Weighted axial images.

6 mm thick T1 Weighted coronal images.

5 mm thick STIR coronal images.

OBSERVATION :

The liver is normal in size, shape and position. There is no focal or diffuse area of altered signal intensity. There is no intrahepatic biliary radicle dilation. The intrahepatic venous architexture is normal.

The gall bladder is normal and reveals no intrinsic abnormality.

The pancreas is normal in size and shape.

The spleen and both adrenals are normal.

Both the kidneys are normal in size and shape.








No lymphadenopathy is detected. There is no evidence of free fluid within the abdomen.

No significant abnormality is detected in the costo-phrenic and cardio-phrenic angles on either side, on this study.

There is seen an ill-defined, hypointense signal on the T1 Weighted images in the D10 and D11 vertebral bodies which appears hyperintense on the T2 Weighted images. The D10-D11 disc is also involved. Paravertebral and anterior epidural soft tissue lesion is noted at this level with mild cord compression.

IMPRESSION :

No significant abnormality is detected in the abdominal viscerae on this study.

Altered signal in the D10 and D11 vertebral bodies and the D10-D11 intervertebral disc most likely represents osteitis with discitis, most likely tuberculous in etiology. Paravertebral and anterior epidural soft tissue may represent granulation tissue/abscess. There is resultant cord compression. The possibility of this lesion representing a neoplasm seems less likely.

A dedicated study of the dorso-lumbar spine is indicated to evaluate this region and cord signal alteration, if any.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzB. lmn / F / 47 yrs.
Referred by : Dr. Abc Xyzvadekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in BLE.

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 intervertebral disc. A small posterior disc bulge is noted at this 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 L2 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








18.0 mm at L2-L3

19.0 mm at L3-L4

16.0 mm at L4-L5

14.0 mm at L5-S1.

Screening, T1 Weighted sagittal images of the cervico-dorsal and dorso-lumbar regions do not reveal any significant feature of note.

IMPRESSION :

Degenerated L5-S1 disc with a small posterior disc bulge at that level.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyz. Chalmn / F / 86 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall on 00.00.00, followed with backache and loss of appetite.
C/O loss of bladder/bowel control since 00.00.00.
C/O headaches since 00.00.00, and drowsiness since the morning of 00.00.00.
Known hypertensive.

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 are ill-defined hyperintense areas in the centrum semiovale bilaterally, left more than right and in the frontal deep white matter 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.

Similar areas are also noted in the periventricular deep white matter.

There is mild to moderate dilatation of the ventricular system. There is slight prominence of the cerebral cortical sulci, cerebellar folia and basal cisternal spaces bilaterally.





There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. Areas of altered signal in the centrum semiovale bilaterally, left more than right, in the frontal deep white matter and in the periventricular deep white matter are suggestive of ischemic changes.

2. Cerebral and cerebellar atrophy.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz. Jlmn / F / 56 yrs.
Referred by : Dr. Abc Xyzrekh.
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 :

There is slight loss of water content of the lower lumbar intervertebral discs.

There is minimal forward translation of the L5 over the S1 vertebra without obvious spondylolysis.

Minimal posterior and left far lateral disc bulges are noted at the L4-L5 and L5-S1 levels.

There is hypertrophic facetal arthropathy at the L5-S1 level, more on the right side and at the L4-L5 level on the left with slight right neural foraminal narrowing at the L5-S1 level. Slight ligamentum flavum hypertrophy is also noted at these levels.

The lumbar vertebral bodies show spotty fatty marrow changes. A hemangioma with fat content is noted in the L5 vertebral body.






The remaining intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L2 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 :

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

IMPRESSION :

1. Minimal forward translation of the L5 over the S1 vertebra without obvious spondylolysis.

2. Minimal posterior and left far lateral disc bulges at the L4-L5 and L5-S1 levels.

3. Hypertrophic facetal arthropathy at the L5-S1 level, more on the right side and at the L4-L5 level on the left.