Date : 00.00.00

Name of the Patient : Abc Xyzta Palmn / F / 52 yrs.
Referred by : Dr. Abc Xyzlwalkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 2 years.

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 partial sacralization of the L5 vertebra.

The L5 vertebra is as marked on the film.

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

There is retroplacement of the L3 over the L4 vertebra.

Posterior disc herniations with peridiscal osteophytes are seen to indent the thecal sac and narrow both neural foramina at the L3-L4 and L4-L5 levels. Bilateral far lateral (extraforaminal) disc bulges are seen at these levels.

A postero-central disc protrusion is seen to indent the thecal sac at the L2-L3 level.



Type II degenerative changes are noted within the L3, L4 and L5 vertebral bodies adjacent to the L2-L3, L3-L4 and L4-L5 intervertebral discs. A focal hyperintensity on all the pulse sequences is seen within the D11 and D12 vertebral bodies ? hemangioma with high fat content.

An anterior disc herniation is noted at the L3-L4 level.

The rest of 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 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 :

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

IMPRESSION :

1. Partial sacralization of the L5 vertebra.

2. Posterior disc herniations with peridiscal osteophytes at the L3-L4 and L4-L5 levels with bilateral neural foraminal narrowing.

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyza Khanlmn / F / 40 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O irritability and loss of memory for half an hour, 25 days back.
Similar history next day but for 2-3 minutes.

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 no shift of the midline structures.

Incidental note is made of pansinusitis and a deviated nasal septum to the right side.

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.

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyzh Valmn / M / 55 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE.
Alleged H/O fall.

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 large postero-central disc herniation indenting the thecal sac at the L3-L4 level. A small right postero-lateral (foraminal) disc herniation is seen to indent the exiting right L3 nerve root and cause mild right neural foraminal narrowing at this level.

Postero-central disc herniations are seen to indent the thecal sac at the L4-L5 and L5-S1 levels.

A mild posterior disc bulge is noted at the L2-L3 level.

Far lateral (extraforaminal) disc bulges are noted bilaterally at the L3-L4, L4-L5 and L5-S1 levels. Also seen is mild facetal hypertrophy at these levels. The intervertebral discs at these levels show loss of water content.





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 :

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

IMPRESSION :

1. A large postero-central disc herniation at the L3-L4 level.

2. Postero-central disc herniations at the L4-L5 and L5-S1 levels.

As compared to the previous MRI dated 00.00.00, there is no significant change noted.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzana lmn / F / 72 yrs.
Referred by : Dr. Abc Xyzhah / Dr. Abc Xyzagwati /
Dr. Abc Xyzmani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever, disorientation, inability to move the RLE and retention of urine.
H/O fall 1 month back with compression fracture of the D7 and D12 vertebrae.

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.

IMAGES SHOW PATIENT MOTION.

OBSERVATION :

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

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

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 within the right maxillary sinus and posterior ethmoidal air cells on the right side.

IMPRESSION :

The MRI features are suggestive of mild cerebral and cerebellar atrophy.

hs/ke
Date : 00.00.00

Name of the Patient : Abc XyzR. Motalmn / M / 77 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

H/O fall +.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There appears to be partial fusion of the C3, C4 and C5 vertebral bodies. The cervical intervertebral discs show loss of water content. The cervical vertebral bodies show areas of fatty replacement of normal marrow.

Posterior disc herniations with peridiscal osteophytes are seen to indent the cord over the C2-C3 to C6-C7 levels. Ligamentum flavum hypertrophy is noted at the C2-C3, C5-C6 and C6-C7 levels with resultant indentation upon the dorsal aspect of the cord at these levels.

The spinal cord at the C2-C3 and C6-C7 levels shows a hyperintense signal on the T2 Weighted images and this may suggest cord edema/ischemia.







The facet joints on the right side at the C3-C4, C4-C5 and C5-C6 levels show hypertrophic degenerative changes. The joints of Luschka on the left side show degenerative changes with left neural foraminal narrowing at the C5-C6 and C6-C7 levels.

Anterior disc herniations with peridiscal osteophytes are noted over the C3-C4 to the C6-C7 level.

The rest of the joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

Intermediate signal intensity is seen around the odontoid process with slight irregularity of the lens on the T1 Weighted images. This is seen to turn heterogenously hyperintense on the T2 Weighted and Fast Scan (T2 *) images and may be due to ? pannus ? degenerative changes.

The cervico-medullary junction are unremarkable.

IMPRESSION :

The MRI features are suggestive of :

1. Partial fusion of the C3, C4 and C5 vertebral bodies.

2. Posterior disc herniations with peridiscal osteophytes over the C2-C3 to C6-C7 levels.

3. Ligamentum flavum hypertrophy at the C2-C3, C5-C6 and C6-C7 levels with severe canal stenosis.

4. Cord signal alteration at the C2-C3 and C6-C7 levels may suggest cord edema/ischemia.

5. Hypertrophic facetal arthropathy on the right side at the C3-C4, C4-C5 and C5-C6 levels.

hs/ke
Date : 00.00.00

Name of the Patient : Abc XyzR. Motalmn / M / 72 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall +.

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 Fast Scan (T2 *) coronal images.

OBSERVATION :

Susceptibility artifacts are noted.

There are multiple small bright foci on the proton and T2 Weighted images within the corona radiata and centrum semiovale bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

Areas of similar signal intensity are seen in the periventricular white matter bilaterally.

Prominent Virchow Robin spaces are noted in the lentiform nuclei bilaterally.

There is fullness of the third and both the lateral ventricles. There is prominence of the basal cisternal spaces, cerebral cortical sulci and cerebellar folia bilaterally.







Note is made of hypointensities on the proton and T2 Weihgted images within the left globe and this may represent air, the result of trauma.

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

IMPRESSION :

1. Areas of altered signal within the corona radiata and centrum semiovale bilaterally and in the periventricular white matter bilaterally are most likely ischemic in etiology

2. Air within the left globe and this may be the result of trauma.

Date : 00.00.00

Name of the Patient : Abc Xyziben Khandelmn / F / 79 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the LUE and LLE with closure of the left eye and difficulty in speech and increased BP on admission.

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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is evidence of a fairly well-defined space-occupying lesion measuring approximately 3.5 x 3.8 x 3.5 cms and having its epicentre in the thalamus on the right side. This lesion is isointense to brain parenchyma on the T1 Weighted images and turns hypointense on the proton, T2 Weighted and Fast Scan (T2 *) images (predominantly hyperintense on the FLAIR images). This lesion would represent an acute bleed. Also seen is perilesional edema with extension into the right cerebral peduncles and slight clot retraction.

There is mild compression upon the right lateral and third ventricles with slight shift of the midline to the left side. Also seen are fluid-fluid levels within the occipital horns of both the lateral ventricles and this would suggest a dissection of the bleed into the ventricular system. Periventricular hyperintensities on the proton, T2 Weighted and FLAIR images are made note of.



Well-defined areas which are iso to hyperintense to CSF are noted within the lentiform nulcei bilaterally and these most likely represent lacunar infarcts.

No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of an acute bleed measuring approximately 3.5 x 3.8 x 3.5 cms and having its epicentre in the thalamus on the right side with mass effect and dissection into the ventricular system.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyztiben Jalmn / F / 59 yrs.
Referred by : Dr. Abc Xyzh Shah.
Examination : M.R.I. of the Brain and Orbits.

CLINICAL PROFILE :

C/O headaches with vomiting and periorbital edema since 15 days.
MRI to exclude venous sinus thrombosis, meningitis, ?? SOL.

EXAMINATION :

M.R.I of the brain and orbits 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.
3 mm thick STIR coronal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and coronal images with magnetization transfer.
3 mm thick T1 Weighted coronal images with fat saturation.
3 mm thick STIR coronal images.

OBSERVATION :

There are irregularly defined areas of hypointensity on the T1 Weighted images in the retro-orbital fat, medially, in the left orbit. These areas turn heterogeneously hyperintense on the STIR images and show patchy enhancement after contrast administration. However the optic nerves bilaterally show normal signal intensity. The intraocular lens is not well-identified bilaterally and these may be the result of previous cataract surgery.
..2/.







Few small bright foci on the FLAIR images are noted within the white matter in the frontal lobes bilaterally and these are most likely ischemic in etiology. There is mild fullness of the third and both the lateral ventricles. Also seen is mild prominence of the basal cisternal spaces, cerebral cortical sulci, cerebellar folia and Sylvian fissures bilaterally. Note is made of an empty sella.

Inflammatory changes are noted within the ethmoidal air cells, left maxillary sinus, and the sphenoid and frontal sinuses.

Soft tissue edema (hyperintense on the STIR images) is seen within the subcutaneous soft tissues in the temporal regions bilaterally and in the soft tissues around the right orbit.

The fourth ventricle is normal. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study. There is no obvious thrombosis of the dural venous sinuses on this scan.

IMPRESSION :

The MRI features are suggestive of :

1. An irregularly defined lesion within the medial aspect of the left orbit as described is most likely inflammatory in etiology.

2. Inflammatory changes within the ethmoidal air cells, left maxillary sinus, and the sphenoid and frontal sinuses.

Date : 00.00.00

Name of the Patient : Abc Xyza Suratlmn / M / 27 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 7 years with radiation of pain to BLE.
Alleged H/O fall 2 weeks back, since then increase in pain.

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 appears to be sacralization of the L5 vertebra and the L3 and L5 vertebrae are as marked on the film.

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

A small postero-central disc herniation more to the right of the midline is seen to indent the thecal sac at the L4-L5 level. This intervertebral disc shows loss of water content.

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 :

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

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. A small postero-central disc herniation more to the right of the midline, at the L4-L5 level.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzdali I. Shlmn / M / 28 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain radiating to the RUE and RLE followed with numbness/weakness of the LUE and LLE with difficulty in walking due to tremors and tingling in the RLE since 15 days.

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 appears to be congenital fusion of the C2 and C3 vertebrae.

A large postero-central disc extrusion with peridiscal osteophytes is seen to compress upon the spinal cord at the C3-C4 level. Slight inferior migration of the disc is visualized. The cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images suggesting cord edema/ischemia.

The facet joints at the C3-C4 and C4-C5 levels show mild degenerative changes.







The cervical intervertebral discs show loss of water content.

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

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

IMPRESSION :

1. Congenital fusion of the C2 and C3 vertebrae.

2. A large postero-central disc extrusion with peridiscal osteophytes compressing the spinal cord at the C3-C4 level with cord signal alteration suggesting cord edema/ischemia and canal stenosis.