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Sunday, 27 December 2015 16:48

14746

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzMlmn / M / 12 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

H/O fall of weight on the back on 00.00.00 with paraplegia and bladder involvement since then.

EXAMINATION :

M.R.I of the dorso-lumbar 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.

OBSERVATION :

There is slight anterior wedging of the D12 vertebral body with slight retropulsion of the same. The D12 vertebra shows a hypointense signal on the T1 Weighted images which appears hyperintense on the T2 Weighted images. The D11-D12 and D12-L1 intervertebral discs appear unremarkable. Fracture of the pedicles, transverse process, the laminae and probably the spinous process of the D12 vertebra is noted. There is rupture of the posterior longitudinal ligament. The anterior longitudinal ligament appears intact but is probably stripped away from the D12 vertebra. The D11-D12 facet joints show diastasis. Intermediate signal on the T1 Weighted images in the anterior epidural space at the D12 vertebral level, which appears relatively hypointense to CSF on the T2 Weighted images may represent epidural haemorrhage. There is resultant mild cord compression at the D12 vertebral level. The lower dorsal spinal cord over about D6 upto the conus medullaris shows a hyperintense signal on the T2 Weighted images (iso to hypointense to normal cord on the T1 Weighted images) which suggest cord contusion/edema in the given clinical setting.



Ill-defined, hyperintense signal on the T2 Weighted images is noted in the prevertebral, paravertebral and posterior paraspinal soft tissues over the D11 to L1 vertebral levels, which may represent soft tissue injury.

Mild central wedging of the L1 vertebral body is noted with subtle altered signal along its superior cortical endplate.

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

The conus medullaris terminates at the L1-L2 level.

IMPRESSION :

Anterior wedging of the D12 vertebral body with slight retropulsion and fracture of the posterior elements of D12 as described is the sequelae of previous trauma. Cord signal alteration over about D6 upto the conus medullaris would represent cord contusion/edema. There is mild cord compression at the D12 vertebral level.



Sunday, 27 December 2015 16:48

14744

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Bholmn / F / 31 yrs.
Referred by : Dr. Abc Xyzgpal.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O primary amenorrhea.
Detected to have a pituitary microadenoma 1 1/2 years back.
C/O CSF rhinorrhea since 2 months.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted sagittal and coronal images.

3 mm thick Fast Scan (T2 *) coronal images.

MR cisternogram was obtained in the coronal (supine and prone)and sagittal planes.

The brain was screened with 5 mm thick T2 Weighted axial images.

OBSERVATION :

There is still seen an approximately 8.0 x 10.0 x 15.0 mms sized intermediate signal intensity mass lesion on the T1 Weighted images in the right cavernous sinus inclose relation to the postero-inferior margin of the anterior pituitary gland on the right. This lesion appears relatively hypointense on the T2 Weighted images. Probable extension of the lesion into the sphenoid sinus along its right lateral margin is noted.

The rest of the pituitary gland appears normal in height and shows a concave superior margin.

The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. The pituitary stalk is in the
midline. The hypothalamus is unremarkable.
..2/.





The suprasellar cistern and the left cavernous sinus are unremarkable.

Minimal mucosal thickening is noted in the maxillary antra bilaterally. Minimal fluid is noted along the posterior wall of the sphenoid sinus. A small amount of fluid is also noted in the left lateral recess of the sphenoid sinus (scan 106.16).

There is no obvious outpouching of the meninges through a break in the floor of the anterior cranial fossa or the sphenoid sinus.
Review of the CT Scan dated 00.00.00, reveals thinning of the right lateral wall of the sphenoid sinus with probable erosion of the same and extension of the previously described lesion in the right cavernous sinus into the sphenoid sinus.

The T2 Weighted axial images of the brain do not reveal any significant feature of note, except for mild fullness of both the lateral ventricles.

IMPRESSION :

1. A residual pituitary adenoma in the right cavernous sinus inclose relation to the postero-inferior margin of the anterior pituitary gland on the right. Probable extension of the lesion into the sphenoid sinus along its right lateral margin is noted.

2. Minimal mucosal thickening in the maxillary antra bilaterally with minimal fluid along the posterior margin of the sphenoid sinus and in the left lateral recess of sphenoid sinus.

3. No definite meningeal outpouching is noted on this study, though extension of the lesion in the right cavernous sinus into the sphenoid sinus along its right lateral margin is noted.


















Sunday, 27 December 2015 16:48

14743

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzyans N. lmn / M / 7 1/2 yrs.
Referred by : Dr. Abc Xyzadkat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches since 15 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 no focal area of altered signal intensity in 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.

Incidental note is made of enlarged adenoids.

IMPRESSION :

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













Sunday, 27 December 2015 16:48

14742

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzVaslmn / F / 58 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness and loss of consciousness.
Known diabetic/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 on the proton, T2 Weighted and FLAIR images in the subcortical white matter in the fronto-parietal regions bilaterally and in the posterior parietal periventricular white matter bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and represents ischemic changes.

There is no evidence of haemorrhage on this study.

Focal hypointense signal, more pronounced on the Fast Scan (T2 *) images in the globus pallidus bilaterally most likely represents globus pallidus calcification.

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. No obvious vascular anomaly is identified on this study.



IMPRESSION :

Altered signal in the subcortical white matter in the fronto-parietal regions bilaterally and in the posterior parietal periventricular white matter bilaterally most likely represent ischemic changes.















Sunday, 27 December 2015 16:48

14741

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / F / 60 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness, slurred speech and ear discharge.
Known hypertensive/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 coronal images.

OBSERVATION :

There is a small bright focus on the proton, T2 Weighted and FLAIR images in the left frontal white matter which may represent ischemic focus (scan 105.18). There is no evidence of haemorrhage on this study.

Dilated perivascular spaces are seen in the centrum semiovale bilaterally and left cerebral peduncle.

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. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the mastoid air cells bilaterally.

IMPRESSION :

Altered signal in the left frontal white matter which may represent ischemic focus.













Sunday, 27 December 2015 16:48

14740

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzayan Ylmn / M / 35 yrs.
Referred by : Dr. Abc Xyzhiri.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O wasting of the LLE with difficulty in walking since 4 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 loss of normal lumbar lordosis and loss of water content of the L1-L2, L4-L5 and L5-S1 intervertebral discs.

There is a left postero-lateral disc herniation with small peridiscal osteophytes at the L5-S1 level with left neural foraminal narrowing and minimal indentation on the traversing left S1 nerve root.

A posterior and left postero-lateral disc herniation with peridiscal osteophytes is noted at the L4-L5 level with indentation on the traversing left L5 nerve root.

A minimal posterior disc bulge is noted at the L3-L4 level.

Facetal hypertrophy is noted in the lumbar region.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.
..2/.







The conus medullaris terminates at the L1-L2 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 :

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

The T2 Weighted sagittal images of the dorsal spine reveals facetal hypertrophy at the D1-D2 level.

IMPRESSION :

1. A left postero-lateral disc herniation with small peridiscal osteophytes at the L5-S1 level with left neural foraminal narrowing and minimal indentation on the traversing left S1 nerve root.

2. A posterior and left postero-lateral disc herniation with peridiscal osteophytes at the L4-L5 level with indentation on the traversing left L5 nerve root.

3. Facetal hypertrophy in the lumbar region and at the D1-D2 level.

Sunday, 27 December 2015 16:48

14739

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzra lmn / M / 14 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 2 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 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 are unremarkable.

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. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the paranasal sinuses bilaterally and also noted are enlarged adenoids.

IMPRESSION :

Slight prominence of the cerebellar folia bilaterally.

No other significant abnormality is detected on this study.













Sunday, 27 December 2015 16:48

14738

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzVilmn / M / 48 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the region of the left hip since 1 month.

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 Proton density sagittal images.

OBSERVATION :

There is seen a well marginated region in the anterior and superior quadrants of the left femoral head which follows fat signal characteristics on all the pulse sequences. This area is demarcated from the rest of the femoral head by a hypointense rim on all the pulse sequences (double line sign). Ill-defined hyperintense signal on the T1 Weighted and STIR images in the rest of the left femoral head and neck represents bone edema. There is a small left hip joint effusion. The left acetabulum is unremarkable.

The articular cartilages around the left femoral head is unremarkable. The soft tissues around the left hip joint are unremarkable.

The visualized right hip joint is unremarkable.

IMPRESSION :

The MRI features are suggestive of Class A avascular necrosis of the left femoral head with bone edema in the head and neck of left femur.

Sunday, 27 December 2015 16:48

14736

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlesh Shetlmn / M / 2 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O fall from a height with loss of consciousness for an hour 17 days back.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

4 mm thick FLAIR coronal images.

OBSERVATION :

There is seen a small, extra-axial, CSF signal intensity lesion on all the pulse sequences in the right temporal lobe, which most likely represents an arachnoid cyst. Resultant mild indentation on the right temporal lobe is noted. This lesion measures approximately 1.8 x 2.8 x 2.2 cms.

There is no focal area of abnormal altered signal intensity in the brain parenchyma per se. Hyperintense areas seen in both posterior parietal regions represent terminal areas of myelination (scan 103.12-13).

There is mild dilatation of the right temporal horn as compared to the left. Both the lateral, third and the fourth ventricles are otherwise unremarkable. 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.

IMPRESSION :

A CSF signal intensity lesion on all the pulse sequences in the right temporal lobe, most likely represents an arachnoid cyst.









Sunday, 27 December 2015 16:48

14735

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzati Ralmn / F / 40 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to 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 :

The lumbar intervertebral discs show loss of water content.

A postero-central disc herniation is seen to indent the thecal sac at the L4-L5 level. Also seen are right postero-lateral and right far lateral disc herniations with slight right neural foraminal narrowing at the L4-L5 level.

Left postero-lateral and left far lateral disc herniations are seen to narrow the left neural foramen at the L3-L4 level.

The L3-L4 and L4-L5 facet joints show hypertrophic degenerative changes. The L5-S1 facet joint shows mild degenerative changes.

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

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-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 :

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

IMPRESSION :

The MRI features are suggestive of :

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

2. Right postero-lateral and right far lateral disc herniations at the L4-L5 level.

3. Left postero-lateral and left far lateral disc herniations at the L3-L4 level.

4. Hypertrophic facetal arthropathy at the L3-L4 and L4-L5 levels.