sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Thlmn / M / 52 yrs.
Referred by : Dr. Abc Xyztdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided headaches since 2 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 proton, T2 Weighted and FLAIR images in the subcortical white matter in the fronto-parietal regions bilaterally and in the left periatrial region. These lesions appear isointense to normal white matter on the T1 Weighted images.

There is mild asymmetric fullness of the left lateral ventricle as compared to the right.

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.

Inflammatory changes are noted in the right maxillary antrum.

IMPRESSION :

Altered signal in the subcortical white matter in the fronto-parietal regions bilaterally and in the left periatrial region most likely represent ischemic changes. The possibility of demyelinating plaques is less likely.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzDelmn / F / 32 yrs.
Referred by : Dr. Abc Xyz/ Dr. Abc Xyzatt.
Examination : M.R.I. of the Abdomen.

CLINICAL PROFILE :

Left sided radical nephrectomy done for a left sided abdominal mass on 00.00.00. Histopathology s/o ? adrenal cortical carcinoma, ? pheochromocytoma. Now C/O pain in the left iliac bone and left sacro-iliac joint since 6 months.

EXAMINATION :

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

6 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen an approximately 2.5 x 3.0 x 4.8 cms sized, lobulated intermediate signal intensity mass lesion on the T1 Weighted images in the left paraaortic region along the left antero-lateral margin of the vertebral body at about the D11 to L1 vertebral levels. This lesion appears hyperintense on the T2 Weighted and STIR images with a central hypointense signal in the lesion, superiorly. This lesion is retrocrural in location and is seen posterior to the left crus of the diaphragm. The crus of the diaphragm is displaced laterally.

The left kidney is not visualized, the sequelae of previous nephrectomy.





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 bulk and signal intensity.

The spleen and the right adrenal gland are normal.

The right kidney is normal in size and signal intensity.

There is no evidence of free fluid within the abdomen.

IMPRESSION :

An approximately 2.5 x 3.0 x 4.8 cms sized, lobulated mass lesion in the left para-aortic region along the left antero-lateral margin of the vertebral bodies over about the D11 to L1 vertebral levels as described is not specific for a single etiology. The retrocrural location of the mass favours this lesion to be a lypmphnodal mass, probably metastasis from the previous left adrenal lesion.

The possibility of recurrence of the tumor is less likely.

The patient is status post-left nephrectomy.

The preoperative scans were not available for review.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 53 yrs.
Referred by : Dr. Abc Xyznna / Dr. Abc Xyzlkan.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

H/O trauma to low back.
C/O low back pain radiating to the LLE since 2 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.

4 mm and 5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

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

A small, postero-central protruded disc is noted at the L4-L5 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 L1 level and the thecal sac terminates at the S2 level.

The sacro-coccygeal segments show normal signal. The coccygeal segments appear slightly retroplaced in relation to the sacral segments, with a posterior osteophyte at the sacro-coccygeal junction, ? due to old trauma at the sacro-coccygeal junction.





No bone erosion or destruction is seen.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

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

IMPRESSION :

1. Degenerated L4-L5 disc with a small, postero-central protruded disc at that level.

2. Slight retroplacement of the coccygeal segments in relation to the sacrum with a posterior osteophyte at the sacro-coccygeal junction, ? due to old trauma at the sacro-coccygeal junction.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzDelmn / F / 32 yrs.
Referred by : Dr. Abc Xyz/ Dr. Abc Xyzatt.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

Left sided radical nephrectomy done for a left sided abdominal mass on 00.00.00. Histopathology s/o ? adrenal cortical carcinoma, ? pheochromocytoma. Now C/O pain in the left iliac bone and left sacro-iliac joint since 6 months.

EXAMINATION :

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

6 mm thick T1 Weighted and T2 Weighted axial images.

6 mm thick T1 Weighted and STIR coronal images.

6 mm thick T2 Weighted sagittal images.

OBSERVATION :

The urinary bladder shows no intrinsic abnormality.

The uterus is retroverted and shows normal signal intensity. No adnexal mass lesion is identified.

The ischio-rectal fossae on either side appear normal.

There are no abnormally enlarged pelvic lymph nodes identified. No obvious vascular anomaly is noted. There is no free fluid in the pelvis.

The visualized sacro-iliac joints and the hip joints on either side are unremarkable.

IMPRESSION :

No significant abnormality is detected on this study.

/830 Date : 00.00.00

Name of the Patient : Abc XyzLaklmn / F / 71 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

H/O trauma 4 days back. X-rays suggest fracture of pubic ramus.
C/O backache and bilateral hip pain.
C/O incontinence of urine since 1 day.

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.

3 mm thick T1 Weighted coronal images.

OBSERVATION :

There appears to be a fracture of the right sacral ala and vertebral body at the S2/S3 level with a kyphus.

Posterior disc bulges are noted at the L4-L5 and L5-S1 levels.

The L5-S1 facet joints show degenerative changes. Also seen is facetal hypertrophy at the L4-L5 level.

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

The lumbar vertebral bodies reveal spotty fatty changes suggesting osteoporosis. 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 S1 level.
..2/.






The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

22.0 mm at L1-L2
20.0 mm at L2-L3
21.0 mm at L3-L4
14.0 mm at L4-L5
15.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of a fracture of the S2/S3 vertebrae as described.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzed Ayub Anlmn / M / 65 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O chest pain since 2 days.
C/O loss of consciousness on 00.00.00.
C/O right facial droop, with slurred speech and drowsy state.
Known C/O IHD.

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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There are irregularly defined areas of hyperintensity on the proton, T2 Weighted and FLAIR images within the periventricular white matter and centrum semiovale bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and these are most likely ischemic in etiology.

Smaller areas with similar signal characteristics are noted within the pons, lentiform nuclei and white matter in the fronto-parietal lobes bilaterally.

Few well-defined areas which are iso to hyperintense to CSF on all the pulse sequences are noted within the lentiform nuclei bilaterally and these most likely represent lacunar infarcts.





There is mild fullness of the third and both the lateral ventricles. Also seen is mild prominence of the Sylvian fissures and cerebral cortical sulci bilaterally.

Note is made of an empty sella.

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 :

1. Areas of altered signal intensity within the periventricular white matter and centrum semiovale bilaterally and within the pons, lentiform nuclei and white matter in the fronto-parietal lobes bilaterally and these are most likely ischemic in etiology.

2. Lacunar infarcts within the lentiform nuclei bilaterally.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzakant S. Kawalmn / M / 67 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the LUE with mild headaches since 1 day from which patient has recovered.
Known diabetic.

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 is gyral thickening with effacement of the adjacent sulci in the right temporo-parietal lobe. These gyri are hypointense on the T1 Weighted images and turn hyperintense on the proton, T2 Weighted and FLAIR images. This would represent an area of ischemia/infarction.

Smaller areas with similar signal characteristics are noted within the medial and inferior aspect of the right temporal lobe, right corona radiata and head of the right caudate nucleus.

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







Note is made of an empty sella.

The third 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 :

1. An area of ischemia/infarction in the right temporo-parietal lobe as described.

2. Smaller areas of altered signal within the medial and inferior aspect of the right temporal lobe, right corona radiata and head of the right caudate nucleus and these are most likely ischemic in etiology.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzn Plmn / M / 68 yrs.
Referred by : Dr. Abc XyzBR> Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias 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 is a evidence of a posterior disc herniation with peridiscal osteophytes, more to the right of the midline and indenting the thecal sac at the L4-L5 level. There is bilateral neural foraminal narrowing and impingement of the exiting L4 nerve roots bilaterally (right more than left) at this level. There is probable inflammation of the exiting right L4 nerve root.

The L4-L5 facet joints show hypertrophic degenerative changes. Also seen is ligamentum flavum hypertrophy with a resultant tight canal at this level.

A postero-central disc protrusion is seen to indent the thecal sac at the L5-S1 level.







There is a right far lateral (extraforaminal) disc herniation at the L4-L5 level. Also seen are far lateral (extraforaminal) disc bulges bilaterally over the D12-L1 to L3-L4 levels and on the left side at the L4-L5 level.

The lumbar intervertebral discs show loss of water content. The superior cortical endplate of the L5 vertebra is irregularly defined and shows evidence of Type I degenerative changes.

There appears to be conjoint nerve roots on the left side at the S1 vertebral level.

The rest of 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 S1-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

16.0 mm at L2-L3

14.0 mm at L3-L4

12.0 mm at L4-L5

14.0 mm at L5-S1.
..3/.
















- 3 - Scan-00007


IMPRESSION :

1. A posterior disc herniation with peridiscal osteophytes, more to the right of the midline with impingement of the exiting L4 nerve roots bilaterally, right more than left at the L4-L5 level. There is probable inflammation of the exiting right L4 nerve root.

2. Hypertrophic facetal hypertrophy and ligamentum flavum hypertrophy with canal stenosis at the L4-L5 level.

3. A right far lateral (extraforaminal) disc herniation at the L4-L5 level.

4. A postero-central disc protrusion at the L5-S1 level.

hs/ke
Date : 00.00.00

Name of the Patient : Abc XyzBharlmn / F / 44 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias since 00.00.00.

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 :

A right postero-lateral (foraminal) disc protrusion is seen to narrow the right neural foramen and indent the exiting right L4 nerve root at the L4-L5 level. Also seen is a right far lateral (extraforaminal) disc bulge at this level.

The right L4-L5 facet joint shows mild degenerative changes.

A mild posterior disc bulge is noted at the L5-S1 level.

The L2-L3 and L4-L5 intervertebral discs show mild loss of water content. Small anterior disc herniations with anterior osteophytes are noted at the L2-L3, L3-L4 and L4-L5 levels.








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 :

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

IMPRESSION :

1. A right postero-lateral (foraminal) disc protrusion indenting the exiting right L4 nerve root at the L4-L5 level.

2. Mild facetal arthropathy on the right side at the L4-L5 level.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyz.lmn / F / 28 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Right Thigh.

CLINICAL PROFILE :

C/O pain in the right thigh since 1 year.

EXAMINATION :

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

8 mm thick T1 Weighted and T2 Weighted axial images.

8 mm thick STIR and T2 Weighted coronal images.

4 mm thick Proton sagittal images.

OBSERVATION :

There is replacement of the normal marrow in the upper shaft of the right femur from the level of the lesser trochanter till the mid shaft level (approximately 11.0 cms in length) by hypointense areas on the T1 Weighted images. This is seen to turn hyperintense on the T2 Weighted and STIR images. There is a break in the cortex along the medial aspect (se/im 104/10) with extension of the pathologic process just below the periosteum with resultant elevation of the same. Subtle hyperintense signal seen in the adjacent soft tissue on the T2 Weighted images may represent edema. The rest of the right femur and the left femur is unremarkable.








IMPRESSION :

The MRI features are suggestive of altered signal in the upper shaft of the right femur from the level of the lesser trochanter till the mid shaft level (approximately 11.0 cms) with break in the cortex and smooth periosteal reaction as described.

This most likely represents sclerosing osteomyelitis of Garre.

The possibility of a neoplastic process appears less likely.