sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Wadlmn / F / 5 yrs.
Referred by : Dr. Abc Xyzehta.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

H/O fever with cough since 7 days.
H/O spinal deformity.

EXAMINATION :

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

3 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

4 mm thick T1 Weighted coronal images.

OBSERVATION :

There is scoliosis of the dorsal spine in the middorsal region with convexity to the right. Slight left lateral wedging of the D5, D6 and D7 vertebrae is noted with crowding of the left sided ribs in this region. The height of the D6 and D7 vertebra appear more as compared to their antero-posterior dimensions suggestive of waisting. Probable fusion of the posterior elements of these vertebrae is also noted. The D5, D6 and D7 vertebrae appear as a congenital block vertebra.

The visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The visualized dorsal spinal cord reveals normal signal intensity. There is no cord compression. A hyperintense signal seen in the centre of the spinal cord on the T2 Weighted axial images appears artifactual and is not seen on the sagittal and coronal images (Gibbs phenomena).

The conus medullaris terminates at the L1-L2 level.
..2/.






IMPRESSION :

Congenital block D5/D6/D7 vertebrae with slight scoliosis of the middorsal spine in this region. No abnormality of the spinal cord is noted in this region.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzkant P. Rellmn / M / 35 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O fall of a shutter on the head 1 month back with difficulty to eat or sign, blurred vision in both eyes and visual defect on the left side since 25 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 FLAIR and 5 mm thick Fast Scan (T2 *) coronal images.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the white matter in the right cerebellar hemisphere, left middle cerebellar peduncle, right temporo-parietal region and in the right posterior parietal region. These lesions appear hypointense to normal white matter on the T1 Weighted images.

There is another similar lesion in the right inferior temporal region which is seen to involve the gray and white matter.

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 :

1. Altered signal intensity lesions in the white matter in the right cerebellar hemisphere, left middle cerebellar peduncle, right temporo-parietal region and in the right posterior parietal region is not specific for a single etiology. These most likely represent demyelinating lesions. The possibility of these lesions representing contusions as a sequelae of previous head trauma seems less likely.

2. Area of altered signal in the right temporal region involving the gray and white matter may represent a contusion in the given clinical setting.

However a contrast enhanced scan would be worthwhile.

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Dlmn / F / 35 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to the RLE with paresthesias.

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 mild retroplacement of the L4 vertebra over the L5 vertebra.

Small postero-central and left postero-lateral disc herniations are seen to indent the thecal sac and left neural foramina respectively at the L4-L5 and L5-S1 levels.

There is a mild posterior disc bulge at the D11-D12 level.

The L4-L5 and L5-S1 intervertebral discs show 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 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 :

17.0 mm at L1-L2
16.0 mm at L2-L3
16.0 mm at L3-L4
13.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Mild retroplacement of the L4 vertebra over the L5 vertebra.

2. Small postero-central and left postero-lateral disc herniations at the L4-L5 and L5-S1 levels.

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzsh Poolmn / M / 6 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since the age of 6 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.

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 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.

IMPRESSION :

Normal study of the Brain.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzai L. Plmn / F / 30 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O backache.

EXAMINATION :

M.R.I of the cervico-dorsal 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.

The lumbo-sacral spine was screened with 4 mm thick T1 Weighted sagittal images.

OBSERVATION :

A mild posterior disc bulge is noted at the C5-C6 level.

The cervical intervertebral discs show loss of water content.

The visualized cervico-dorsal vertebral bodies reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The visualized cervico-dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

Small, postero-central protruded discs are noted at the L2-L3 and L4-L5 levels, on the screening images of the lumbo-sacral spine.

IMPRESSION :

The MRI features are suggestive of a mild posterior disc bulge at the C5-C6 level.

hs/sb/rg/nl
/29 Date : 00.00.00

Name of the Patient : Abc Xyzh Klmn / M / 50 yrs.
Referred by : Dr. Abc Xyzla.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O sudden onset of giddiness with fall and loss of consciousness on 00.00.00 with injury to head and hand.
C/O generalized weakness with body pain since then.

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.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

BRAIN :

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

There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

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



- 2 - Scan-00008/29



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 :

Mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

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

hs/sb/rg/nl
Date: 00.00.00

Name of the Patient : Abc Xyzrao Pandlmn / M / 63 yrs.
Referred by : Dr. Abc Xyzandel.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O high blood pressure with fall on 00.00.00.
H/O loss of consciousness for 3 days, 8 days later with Shunt surgery done on 00.00.00.
Known hypertensive. On Rx.

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 evidence of a shunt tube coursing through the right parietal lobe with its tip lying within the right occipital horn. Hyperintense areas on the T2 Weighted images are seen along the course of the shunt tube and may represent seepage of CSF (? shunt failure).

There is mild to moderate dilatation of the ventricular system.

Hyperintense areas on the T2 Weighted images are seen within the fronto-parietal and periatrial white matter bilaterally and these are most likely ischemic in etiology.

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

There is no shift of the midline structures.
Scan-00007


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 visualized carotid and vertebral arteries are unremarkable.

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

IMPRESSION :

1. Post-shunt status as described.

2. Mild to moderate communicating hydrocephalus.

3. Areas of altered signal within the fronto-parietal and periatrial white matter bilaterally are most likely ischemic in etiology.

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

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzree Ashlmn / F / 37 yrs.
Referred by : Dr. Abc Xyzikhalikar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O giddiness with loss of consciousness for an hour on 00.00.00.
C/O gait imbalance, headaches with heaviness of head since then.

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.

The cervical spine was screened with 5 mm thick T2 Weighted sagittal images.

OBSERVATION :

There is an ill-defined hyperintense signal on the proton and T2 Weighted images in the posterior parietal periventricular white matter on the left. This lesion appears iso to hypointense to normal white matter on the T1 Weighted images and most likely represents an ischemic lesion (scans 102.13, 105.5).

The hippocampal complex is unremarkable on either side.

Mild fullness of both the lateral ventricles is noted. 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.



R>
Inflammatory changes are noted in the sphenoid sinus and in the left mastoid air cells.

Screening images of the cervical spine do not reveal any significant feature of note.

IMPRESSION :

Altered signal in the posterior parietal periventricular white matter on the left most likely represents ischemic changes.

sb/hs/rg.
Date: 00.00.00

Name of the Patient : Abc Xyzana lmn / F / 73 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches, vomiting and altered sensorium at 6.00 pm on 00.00.00.
Known hypertensive/diabetic.

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 an ill-defined hyperintense signal on the T2 Weighted images in the left cerebellar hemisphere, inferiorly and along the right temporal cortex. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic lesions, probably recent, in the given clinical setting.

Lacunar infarcts (iso to hyperintense to CSF) are noted in the right cerebellar hemisphere, bilateral thalami, lentiform nuclei, head of the left caudate nucleus and in the corona radiata bilaterally.

Ill-defined, hyperintense signal on the T2 Weighted images is seen in the periventricular white matter bilaterally and in the subcortical white matter in the left fronto-temporal region and in the right frontal region.

There is mild fullness of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures.

Incidentally noted is hyperostosis frontalis interna.
..2/.



>

INTRACRANIAL MRA :

There is slight narrowing of the cavernous segment of both the internal carotid arteries.

The left vertebral artery is not well-identified.

The petrous 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.

NECK MRA :

The left vertebral artery is faintly visualized in the neck. The external carotid arteries also show attenuated flow signal, distal to the common carotid arteries bilaterally.

The common carotid arteries and their bifurcations are unremarkable. The proximal internal carotid arteries are also unremarkable.

IMPRESSION :

1. Altered signal in the left cerebellar hemisphere, inferiorly and along the right temporal cortex most likely represent ischemic lesions, probably recent, in the given clinical setting.

2. Lacunar infarcts in the right cerebellar hemisphere, bilateral thalami, lentiform nuclei, head of left caudate nucleus and in the corona radiata bilaterally.

3. Altered signal in the periventricular white matter bilaterally and in the subcortical white matter in the left fronto-temporal region and in the right frontal region represent ischemic changes.

4. Attenuated flow signal of the external carotid arteries bilaterally.
..3/.


- 3 - Scan-00005


5. The left vertebral artery is not well-visualized.

6. Slight narrowing of the cavernous segment of both the internal carotid arteries.

As compared to the previous MRI (study no.00000) dated 00.00.00, the lesions in the left cerebellar hemisphere, inferiorly and in the right temporal cortex were not identified on the previous study.

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzl Dlmn / M / 9 yrs.
Referred by : Dr. Abc Xyzlani / Dr. Abc Xyztrak.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O cerebral tuberculomas. Received AKT for 18 months.
For follow-up.
C/O headaches since 4 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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There are still seen small hypointense specks in the right high parietal region (se/im: 102/15, 103/15, 106/9) and in the left inferior frontal region (se/im:103/10, 102/10, 106/15, 106/16) on all the pulse sequences which may represent calcific foci. Very minimal perilesional hyperintensity is noted on the T2 Weighted images, around the lesions which may represent residual gliosis.There is no other area of focal 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. No obvious vascular anomaly is identified on this study.


IMPRESSION :Areas of altered signal intensity in the cerebral hemispheres as described may represent residual calcifying granulomas. As compared to the previous MRI (study no:0000) dated 00.00.00, there is no significant change noted.