sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Huslmn / M / 28 yrs.
Referred by : Dr. Abc Xyznde.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain and backache radiating to the RUE and RLE since 3 years.

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 slight loss of water content of the cervical intervertebral discs.

Minimal posterior disc bulge is noted at the C3-C4 level.

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 :

No significant abnormality is detected within the cervical spine on this study.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzvi Ylmn / F / 15 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Hippocampal Region.

CLINICAL PROFILE :

C/O seizures since 5 years and pain on the left side of the neck. On anti-epileptics.

EXAMINATION :

M.R.I of the hippocampal region was performed, as requested using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick T2 Weighted axial images through the brain.

OBSERVATION :

There is no area of focal altered signal intensity on the T2 Weighted axial images of the brain.

The hippocampal complex is unremarkable on either side.

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 Hippocampal Region.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzji A. Slmn / M / 50 yrs.
Referred by : Dr. Abc Xyz. Gala.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O slurred speech with mild left sided hemiparesis since 3 days.

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 are ill-defined, hyperintense areas on the T2 Weighted images in the cerebellar hemispheres bilaterally, more so, posteriorly and superiorly. These lesions appear hypointense to normal white matter on the T1 Weighted images.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

INTRACRANIAL MRA :

The left vertebral artery appears slightly hypoplastic.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, right vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
Scan-00007




NECK MRA :

The left vertebral artery in the neck also appears hypoplastic. The right vertebral artery, the common carotid arteries and their bifurcations are unremarkable.

There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Altered signal in the cerebellar hemispheres bilaterally, more so, posteriorly and superiorly, represents ischemic changes, recent, in the given clinical setting.

2. No significant abnormality is detected on the intracranial and neck MRA on this study.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Blmn / F / 74 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches and vomiting since 00.00.00.
Known diabetic (recently detected) and ? 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 coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

Hyperintense areas are seen along the sulci in the temporo- parietal regions and in the region of the Sylvian fissure on the proton, T2 Weighted and FLAIR images, (better appreciated on the FLAIR images). These are isointense to the gray matter on the T1 Weighted images.

Hyperintense areas are seen in the periatrial deep white matter on the proton, T2 Weighted and FLAIR images and are isointense to white matter on the T1 Weighted images suggests ischemic changes.

There is 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.

Incidental note is made of left maxillary sinusitis.
00006
- 2 -

Both eyes are aphakic.

IMPRESSION :

The MRI features are suggestive of :

1. Altered signal along the sulci in the temporo-parietal regions and in the region of the Sylvian fissure would represent subarachnoid haemorrhage.

2. Altered signal in the periatrial deep white matter suggests ischemic changes.

A DSA would be worthwhile.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzin Adi Dumlmn / M / 17 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O single episode of seizure on 00.00.00.

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 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 maxillary sinuses and ethmoidal air cells bilaterally and note is made of enlarged adenoids.

IMPRESSION :

Normal study of the Brain.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyz V. Kanlmn / F / 30 yrs.
Referred by : Dr. Abc Xyzani.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache.

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 L3-L4 intervertebral disc.

A small posterior disc bulge is identified at the L4-L5 level with ventral indentation of the thecal sac.

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 S1 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
15.0 mm at L2-L3
16.0 mm at L3-L4
13.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

No significant abnormality is detected on this study.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Dlmn / F / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tinnutus in the right ear since 9 months with occasional headaches. Also C/O ocular pain and diplopia since 5 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.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is no focal area of altered signal intensity within the brain parenchyma.

The seventh and eighth cranial nerve complex on either side is unremarkable.

The optic nerves on either side are 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.

Incidental note is made of thickening of the mucosa in the maxillary sinuses bilaterally and a right maxillary polyp.

IMPRESSION :

No significant abnormality is detected on this study.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Mlmn / F / 25 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain and pain in the dorsal region radiating to both shoulder since 2 years.

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 C5/C6 block vertebra which is probably congenital in origin.

The odontoid process is seen to be in close proximity of the cervico-medullary junction with obliteration of the CSF space in neutral and flexion positions. However there is no basilar invagination.

A small posterior disc bulge is seen at the C6-C7 level with anterior indentation of the thecal sac. This disc shows slight loss of water content.

The cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.





The cervical spinal cord reveals normal signal intensity.

Flexion images of the cervical spine do not reveal any diagnostic feature of note.

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images which are unremarkable.

IMPRESSION :

1. Congenital block C5/C6 vertebra.

2. Indentation upon the cervico-medullary junction by the odontoid process.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyz Ylmn / F / 13 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O brain-stem glioma detected in December 0000. On AKT since September 0000. Received 30 sittings of radiotherapy.
For follow up.
C/O headaches, diplopia and imbalance while walking since 1 1/2 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.
4 mm thick FLAIR coronal images.
3 mm thick T1 Weighted coronal images.
5 mm thick T1 Weighted sagittal images.
MR cisternogram was obtained in the sagittal plane.

OBSERVATION :

There is a large ill-defined, hypointense area in the posterior aspect of the pons on the T1 Weighted images which is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. Few hypointense areas which are slightly hyperintense to CSF are seen within the lesion on the T1 Weighted images and are hyperintense on the T2 Weighted images in the posterior aspect of the lesion and would represent cystic/necrotic changes. Inferiorly this lesion is seen to extend upto the ponto-medullary junction and superiorly upto the junction of the upper pons and lower midbrain. There is mass effect with compression of the anterior aspect of the fourth ventricle. There is effacement of the peripontine cistern.

There is mild fullness of both the lateral ventricles. The third ventricle is normal. No obvious vascular anomaly is identified on this study.
..2/.








IMPRESSION :

In a known C/O brain-stem glioma, the MRI features are suggestive of a large ill-defined mass lesion in the pons with extensions as described.

As compared to the previous MRI (scan no.0000) dated 00.00.00,
there is slight increase in the size of the lesion. The cystic/necrotic component appears to be reduced.

The atria of the ventricles also appear slightly full.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzK. lmn / F / 20 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O admitted with headaches, vomiting and fever with altered sensorium 10 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.
5 mm thick FLAIR coronal images.

OBSERVATION :

The pons and midbrain appear swollen.

There is an ill-defined, hyperintense signal on the proton,
T2 Weighted and FLAIR images in the pons, midbrain, subthalamic region bilaterally, middle cerebellar peduncles bilaterally and in the right inferior frontal and bilateral medial temporal cortex. This lesion appears hypointense on the T1 Weighted images. Resultant effacement of the fourth ventricle, peripontine and ambient cisterns is noted.

There is mild dilatation of both the lateral and third ventricles. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Altered signal in the pons, midbrain, subthalamic region bilaterally, middle cerebellar peduncles bilaterally and in the right inferior frontal and bilateral medial temporal cortex is not specific for a single etiology. Encephalitis is a likely possibility. The possibility of vasculitis (? tuberculous vasculitis, in view of the CSF picture) is less likely.