hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyz Pandilmn / M / 41 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness and headaches since 1 month.
H/O right hemiparesis in 0000.
Known hypertensive.
Chronic tobacco chewer and alcoholic.

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 well-defined areas which are iso to hyperintense to CSF on all the pulse sequences within the corona radiata bilaterally and these would represent lacunar infarcts. These also show peripheral gliotic changes (hyperintense on the proton, T2 Weighted and FLAIR images).

Smaller areas with similar signal characteristics are noted within the lentiform nuclei (extending into the posterior limb of the internal capsule) bilaterally and pons.

There is fullness of the ventricular system and prominence of the cerebral cortical sulci, Sylvian fissures and cerebellar folia bilaterally.







Note is made of an empty sella.

The basal cisternal spaces are also prominent. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the ethmoidal air cells and both maxillary sinuses.

IMPRESSION :

The MRI features are suggestive of :

1. Lacunar infarcts within the corona radiata bilaterally,
lentiform nuclei (extending into the posterior limb of the internal capsule) bilaterally and pons.

2. Cerebral and cerebellar atrophy.

hs/bv
Date : 00.00.00

Name of the Patient : Abc XyzShlmn / F / 45 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache 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.

3 mm thick T1 Weighted axial images at the L4-L5 level.

OBSERVATION :

There appears to be sacralization of the L5 vertebra and the L1 vertebra is as marked on the film.

There is mild retroplacement of the L4 vertebra over the L5 vertebra.

A postero-central disc herniation is seen to indent the thecal sac at the L4-L5 level. Inferior migration of the disc is identified posterior to the L5 vertebral body. A left postero-lateral (foraminal) disc herniation is seen to indent the exiting left L4 nerve root and narrow the left neural foramen at this level.

The L4-L5 intervertebral disc shows loss of water content.

Mild facetal hypertrophy is noted at the L4-L5 level.





A mild posterior disc bulge is seen at the L3-L4 level.

Focal fat deposition is identified in the D12 and L2 vertebrae.

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 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 :

20.0 mm at L1-L2
17.0 mm at L2-L3
17.0 mm at L3-L4
14.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Sacralization of the L5 vertebra.

2. A postero-central disc herniation at the L4-L5 level with a left postero-lateral (foraminal) disc herniation indenting the exiting left L4 nerve root at this level.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzmmed Afzal Ylmn / M / 5 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O drop attacks 6-7 months back. On Valparin.

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.

There is slight fullness of the right temporal horn as compared to left and this may be a normal variant (scans 106.10, 105.10).

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.

IMPRESSION :

No significant abnormality is detected within the brain on this study.

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyzalmn / F / 19 yrs.
Referred by : Dr. Abc Xyzathod.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures 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.

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 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 Brain.

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyzben Trilmn / F / 56 yrs.
Referred by : Dr. Abc Xyzta / Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O acute onset of vertigo 3 months back with occasional paresthesias in BUE.

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.

FEW IMAGES SHOW PATIENT MOTION.

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 no shift of the midline structures.

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.

Date : 00.00.00

Name of the Patient : Abc Xyzal Ralmn / M / 68 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

H/O L4-L5 laminectomy 1 month back.
C/O pain and swelling over BLE with fever (on and off) since then with incontinence of urine since 3 days.
Known diabetic. On Rx.

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.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted sagittal and axial images with fat saturation.

6 mm thick T1 Weighted coronal images.

5 mm thick STIR coronal images.

The dorsal spine was screened with 5 mm thick T1 Weighted sagittal images with fat saturation.

FEW IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

There is evidence of a laminectomy of the L5 vertebra.

..2/.





00003
- 2 -

Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images are seen to involve the L4 and L5 vertebral bodies and pedicles. After contrast administration the areas within the L4 and L5 vertebrae are seen to enhance. The L4-L5 intervertebral disc is hyperintense on the T2 Weighted images suggestive of its involvement.

Irregularly defined areas of hypointensity on the T1 Weighted images which turn mildly hyperintense on the T2 Weighted images are seen within the epidural space with encasement of the thecal sac at the L4 and L5 vertebral levels. This is seen to extend into the paraspinal soft tissues via the laminectomy defect. This lesion is also seen to enhance and would represent granulation tissue. There is obliteration of the surrounding epidural fat over these levels. There is also extension into the neural foramina bilaterally at the L4-L5 level with encasement of the foraminal L4 nerve roots bilaterally.

Large, lobulated areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images are seen to involve the psoas muscles and in the pre-aortic region from the L3 vertebral level downwards. Inferiorly it is seen to extend into the pelvis and involve the ilio-psoas. The periphery of this lesion shows thick and irregular enhancement and this would suggest an abscess.

Hyperintense signal is identified in the erector spinae group of muscles bilaterally which are seen to enhance after contrast administration.

The intrathecal nerve roots in the lumbar region are ill-defined. Enhancement is noted within the thecal sac and along the periphery of the dorsal cord and this would suggest arachnoiditis.
..3/.










00003
- 3 -

The L2-L3, L3-L4 and L5-S1 intervertebral discs show loss of water content.

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

The L2-L3, L3-L4 and L5-S1 facet joints show degenerative changes.

A small effusion is seen within the left hip joint.

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. Osteitis with discitis of the L4 and L5 vertebrae and L4-L5 intervertebral disc respectively.

3. Abscess within the psoas muscles and pre-aortic region as described.

4. Granulation tisssue within the epidural space at the L4 and L5 vertebral levels.

5. Arachnoiditis in the dorsal and lumbar region.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O giddiness with fall on the right side 2 weeks 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 :

There is a small bright focus in the right postero-parietal deep white matter on the FLAIR images which would represent an ischemic focus.

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 left maxillary polyp and mild inflammatory changes in the ethmoidal air cells.

IMPRESSION :

The MRI features are suggestive of altered signal in the right postero-parietal deep white matter which would represent an ischemic focus.

ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzRiyaz Shlmn / M / 24 yrs.
Referred by : Dr. Abc Xyzhah / Dr. Abc Xyz Shah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain since 1 year.

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 are small posterior disc bulges at the C5-C6 and C6-C7 levels with anterior indentation of the thecal sac. The C5-C6 intervertebral disc shows slight loss of water content.

The cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The tissues are unremarkable.

The cjoints of Luschka and the visualized pre and paravertebral soft ervical spinal cord reveals normal signal intensity.

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

IMPRESSION :

The MRI features are suggestive of small posterior disc bulges at the C5-C6 and C6-C7 levels.

sb/ke
/32 Date : 00.00.00

Name of the Patient : Abc Xyz N. lmn / F / 55 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

H/O fall with loss of sensation waist downwards and bladder/bowel involvement since 15 days.

EXAMINATION :

M.R.I of the cervico-dorsal 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 near complete collapse of the D2 vertebral body. The D1, D2 and D3 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The D2-D3 intervertebral disc appears hyperintense on the T2 Weighted images. Involvement of the spinous processes of the D2 and D3 vertebrae is also noted.

There is a fairly large prevertebral and right paravertebral intermediate signal intensity soft tissue lesion on the T1 Weighted images extending over C6 to D4 vertebral levels. This lesion appears heterogenously hyperintense on the T2 Weighted images. Resultant anterior displacement of the trachea is noted. There is also extension of the soft tissue lesion into the anterior and right lateral epidural space over C6-C7 to D4 vertebral levels, with cord compression and posterior displacement of the cord. The upper dorsal spinal cord over D1 to D4 vertebral levels shows a hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia.
00009
- 2 -


The D4 vertebral body shows altered signal along its right lateral margin.

The rest of the visualized cervico-dorsal vertebral bodies show spotty fatty marrow changes. The D5, D6, D7 and D8 vertebral bodies appears slightly wedged, centrally.

The facet joints are unremarkable.

Screening T1 Weighted sagittal images of the dorso-lumbar spine reveal a hypointense signal involving the L3 vertebral body.

IMPRESSION :

Near complete collapse of D2 vertebral body with altered signal of the D1 to D3 vertebral bodies and the D2-D3 intervertebral disc suggests osteitis with discitis, most likely tuberculous in etiology. Prevertebral, right paravertebral and anterior epidural soft tissue lesion as described may represent granulation tissue/abscess. There is cord compression and cord signal alteration over D1 to D4 vertebral levels which suggests cord edema/ischemia.

The D4 and L3 vertebrae also show altered signal as described.

The possibility of the above described lesion representing a neoplasm seems less likely.

Slight central wedging of the D5 to D8 vertebral bodies as described may be due to osteoporosis.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Klmn / M / 46 yrs.
Referred by : Dr. Abc Xyzla.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness with diplopia since 1 month.
C/O 1 episode of seizure in June 0000.

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.
3 mm thick T2 Weighted coronal images.

OBSERVATION :

There are areas which are iso to hyperintense to CSF on all the pulse sequences within the head of the caudate nucleus and anterior aspect of the lentiform nucleus on the left side and the left posterior parietal lobe. These would most likely represent lacunar infarcts.

Hyperintense signal is identified in the left posterior parietal lobe on the FLAIR sequences which would represent gliotic changes (scans 106.1-3)

There is a decrease in the volume of the right hippocampus (head and body) and it shows a subtle hyperintense signal on the T2 Weighted images. The right temporal horn is dilated.

There is mild fullness of the fourth and both the lateral ventricles.

There is prominence of the cerebellar folia and cerebral cortical sulci bilaterally.
00008
- 2 -

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 :

1. Lacunar infarcts within the head of the caudate nucleus and anterior aspect of the lentiform nucleus on the left side and the left posterior parietal lobe.

2. Gliotic changes in the right posterior parietal lobe.

3. Hippocampal sclerosis on the right side.