sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzChirlmn / M / 21 yrs.
Referred by : Dr. Abc Xyzoshi.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O low back pain radiating to the RLE since 6-8 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 water content of the L5-S1 disc.

There is a fairly large, right paracentral disc herniation with peridiscal osteophyte at the L5-S1 level, with indentation on the traversing right S1 nerve root. Slight inferior migration of the disc fragment is noted and is seen to lie posterior to the S1 vertebral body.

A small, posterior disc bulge is noted at the L4-L5 level.

Slight hypertrophy of the facet joints 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.

The conus medullaris terminates at the D12-L1 level and the thecal sac terminates at the S2 level.




- 2 -



The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

16.0 mm at L1-L2

14.0 mm at L2-L3

13.0 mm at L3-L4

13.0 mm at L4-L5

6.0 mm at L5-S1.

IMPRESSION :

1. Degenerated L5-S1 disc with a fairly large, right paracentral disc herniation with peridiscal osteophyte at the L5-S1 level, indenting the traversing right S1 nerve root.

2. A small, posterior disc bulge at the L4-L5 level.

3. Slight facetal hypertrophy in the lumbar region.

Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 38 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tremors on the right side of body.
C/O Parkinsonism disease.
H/O head injury 3 years 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 and 4 mm thick Fast Scan (T2 *) coronal images.

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. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Normal study of the Brain.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzv R. Talmn / M / 47 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to BUE (left more than right) with paresthesias.
Alleged H/O fall on 00.00.00.

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 loss of normal cervical lordosis and loss of water content of the cervical intervertebral discs.

There are posterior disc herniations with peridiscal osteophytes indenting the cord and narrowing both neural foramina at the C3-C4, C4-C5 and C6-C7 levels.

A postero-central disc herniation with peridiscal osteophytes is seen to indent the cord at the C5-C6 level.

The cervical spinal cord at the C3-C4 and C4-C5 levels shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images (iso to hypointense to normal cord on the T1 Weighted images) which would be suggestive of cord edema/ischemia.

A posterior disc bulge is noted at the C2-C3 level. Anterior disc herniations with peridiscal osteophytes are noted in the cervical region.




- 2 -



The cervical vertebral bodies show normal signal intensity. The joints of Luschka at the C3-C4, C5-C6 and C6-C7 levels show degenerative changes bilaterally. The visualized pre and paravertebral soft tissues are unremarkable.

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

IMPRESSION :

1. Posterior disc herniations with peridiscal osteophytes indenting the spinal cord at the C3-C4, C4-C5 and C6-C7 levels.

2. A postero-central disc herniation at the C5-C6 level.

3. Cord signal alteration at the C3-C4 and C4-C5 levels suggest cord edema/ischemia.

4. Degenerative changes of the joints of Luschka at the C3-C4, C5-C6 and C6-C7 levels bilaterally.

As compared to the previous MRI (study no:0000) dated 00.00.00, there is decrease in the cord edema over the C3 to C5 vertebral levels with focal cord signal alteration at the C3-C4 and C4-C5 levels on this study. There is no significant change in the degree of disc herniations on the present study.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 25 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O low back pain since 1 month.
H/O fall prior to this.

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 water content of the lower lumbar intervertebral discs.

Small, postero-central disc herniations with posterior peridiscal osteophytes are noted at the L3-L4, L4-L5 and L5-S1 levels, indenting the dural theca anteriorly.

Small, postero-central protruded disc is noted at the D11-D12 level.

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 L2 level and the thecal sac terminates at the S2 level.
...2/..













- 2 -


The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

20.0 mm at L1-L2

19.0 mm at L2-L3

15.0 mm at L3-L4

15.0 mm at L4-L5

12.0 mm at L5-S1.

IMPRESSION :

Degenerated lower lumbar discs, with small postero-central disc herniations with posterior peridiscal osteophytes at the L3-L4, L4-L5 and L5-S1 level.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 18 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O progressive weakness in all four limbs with bladder/bowel involvement since 15 days.
H/O fever with neck swellling on the right side since October 0000 which has increased in size.

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 :

Areas of hypointensity on the T1 Weighted images are seen to involve the C5, C6 and C7 vertebral bodies . The C5 and C7 vertebral bodies turn hyperintense on the T2 Weighted images whereas the C6 vertebral body remains hypointense.

There is extension of this pathologic process into the anterior and right lateral epidural space over the C4 to C7 vertebral levels with resultant compression upon the spinal cord. The cord over these levels shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia/myelitis. Also seen is encroachment into the neural foramina bilaterally into the C5-C6 and C6-C7 and on the right side at the C4-C5 and C7-D1 levels with encasement of the exiting corresponding nerve roots. The right pedicles of the C5, C6 and C7 vertebrae appear to be involved.

The pathologic process is also seen to extend into the prevertebral, right paravertebral and right paraspinal soft tissues over the C3 to D1/D2 levels. This soft tissue lesion is hypointense with a hyperintense rim on the T1 Weighted images and turns hyperintense with a hypointense rim on the Fast Scan (T2 *) images and this may represent an abscess (which appears to be loculated).
...2/..







- 2 -


The C2-C3 to C5-C6 intervertebral discs show loss of water content. The C6-C7 intervertebral disc is hyperintense on the T2 Weighted images (? involved by the pathologic process).

The rest of cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.

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

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the C5, C6 and C7 vertebrae with soft tissue extensions and cord compression with cord edema/ischemia/myelitis over the C4 to C7 vertebral levels as described.

The differential diagnosis may include infective processes like tuberculosis (more likely) or neoplastic processes like small cell tumors (less likely).

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyzaben N. Patralmn / F / 65 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Dorso-lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache.
Alleged H/O fall on 00.00.00.

EXAMINATION :

M.R.I of the dorso-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 visualized dorso-lumbar intervertebral discs show loss of water content.

There appears to be sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.

Postero-central disc herniations with peridiscal osteophytes are seen to indent the thecal sac at the D10-D11 and D11-D12 levels.

A small postero-central disc herniation is seen to indent the thecal sac at the L4-L5 level. Note is made of a posterior disc bulge at the L3-L4 level.

The L3-L4 and L4-L5 facet joints show hypertrophic degenerative changes.

A Schmorls node is noted at the inferior aspect of the D11 vertebral body.

The rest of the visualized dorso-lumbo-sacral vertebral bodies reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The visualized dorso-lumbar spinal cord reveals normal signal intensity.
...2/..








- 2 -


The conus medullaris terminates at the D12-L1 level and thecal sac terminates at S1 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

11.0 mm at D10-D11
13.0 mm at D11-D12
18.0 mm at D12-L1
16.0 mm at L1-L2
15.0 mm at L2-L3
13.0 mm at L3-L4
12.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Sacralization of the L5 vertebra.

2. Postero-central disc herniations with peridiscal osteophytes at the D10-D11 and D11-D12 levels.

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

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

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzali Dlmn / F / 6 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain and Intracranial M.R.A.

CLINICAL PROFILE :

C/O headaches and vomiting.
Operated for right parietal SOL in October 0000.
Recurrent symptoms in January 0000.
H/P s/o ? choroid plexus Ca, ? hemangiopericytoma with focal papillary areas.

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.

Intracranial MRA was performed with 3D TOF sequence.

OBSERVATION :

BRAIN :

There is evidence of an ill-defined, variegated mass lesion in the right parieto-occipital region. There is resultant bulging of this lesion into the craniotomy flap in the right posterior parietal region.

This mass lesion is predominantly hypointense on the T1 Weighted images and turns heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images. Areas which are iso to hyperintense to CSF are seen within this lesion and these would represent cystic/necrotic changes. Note is made of perilesional edema in the right parieto-temporo-occipital lobes with compression upon the occipital horn and atrium of the right lateral ventricle and the splenium and posterior body of the corpus callosum.

The rest of the ventricular system and basal cisternal spaces are unremarkable. There is no shift of the midline structures.
...2/..






- 2 -



INTRACRANIAL MRA :

The posterior Sylvian branches of the right middle cerebral artery are displaced slightly anteriorly.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, left middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified. No obvious abnormal vascularity is noted around the lesion.

The superior sagittal sinus shows normal flow-void signal on the spin-echo and FSE sequences, though it is in close relation of the tumor.

IMPRESSION :

The MRI features are suggestive of a mass lesion in the right parieto-occipital region with mass effect as described. Such features may be seen with astrocytoma, PNETs, supratentorial ependymoma or hemangiopericytoma or choroid plexus carcinoma. This may be a residual or a recurrent lesion (The patient is status post-operative). The right posterior Sylvian branches are displaced slightly anteriorly. No abnormal vascularity is noted around the lesion.

No previous scans were available for comparison.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzr Dlmn / M / 49 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O surgery in 0000 for skull base schwannoma (? Xth nerve schwannoma).
Recent H/O purulent discharge from the left ear.

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 coronal images.

5 mm thick FLAIR coronal images.

An MR Cisternogram was also obtained in the coronal plane.

OBSERVATION :

There is seen an approximately 2.0 x 1.2 x 2.0 cms sized intermediate signal intensity mass lesion on the T1 Weighted images in the region of the skull base on the left, eroding the clivus on the
left and partially eroding the left petrous tip. This lesion appears significantly hyperintense on the proton, T2 Weighted and FLAIR images. Intermediate signal is noted in the left internal jugular vein at the site of the tumor which may suggest ? thrombosis/? tumor extension.

There is evidence of operative intervention in the left temporo-occipital region.

Volume loss in the left cerebellar hemisphere is noted with an ill-defined, CSF intensity lesion on all the pulse sequences in the left cerebellar hemisphere which may represent gliotic/encephalomalacic changes, the sequelae of previous surgery. Resultant mild dilatation
and pull of the fourth ventricle to the left is noted. The nerve root sleeve in the left internal auditory canal appears slightly baggy.

Both the lateral and third 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.

Altered signal in the left mastoid air cells may suggests an inflammatory changes. ...2/..









- 2 -


IMPRESSION :

1. Post-operative status.

2. An approximately 2.0 x 1.2 x 2.0 cms sized mass lesion in the region of the skull base on the left, eroding the clivus on the left and partially eroding the left petrous tip as described may represent residual/recurrent skull base schwannoma.

3. Volume loss with altered signal in the left cerebellar hemisphere represents
encephalomalacic changes, the sequelae of previous surgery. Resultant mild
dilatation of fourth ventricle is noted.

No previous scans were available for comparison.

A repeat scan, if necessary with contrast would be useful.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Ghlmn / M / 24 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache since 2 months with sudden onset of weakness of BLE since 4 days.

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.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The D8, D9, D10 and D11 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The D9-D10 intervertebral disc is also involved and appears hyperintense on the T2 Weighted images. There is breach in the superior cortical enplate of D10 and inferior cortical endplate of the D9 vertebral bodies.

There is seen a prevertebral and paravertebral intermediate signal intensity mass lesion on the T1 Weighted images extending over D7 to D12 vertebral levels which also appears hyperintense on the T2 Weighted images. Also epidural extension of the disease process is noted with resultant compression of the dorsal spinal cord at the D9 and D10 vertebral levels. The dorsal spinal cord at these levels shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia. The soft tissue lesion is seen to extend into the corresponding neural foramen at the D9-D10 and D10-D11 levels.

The aorta and the inferior vena cava are displaced anteriorly by the pre and paravertebral soft tissue lesion.

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

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








- 2 -


Cortical cysts are seen in the left kidney.

Note is made of a distended bladder.

IMPRESSION :

Altered signal of the D8 to D11 vertebral bodies and the D9-D10 intervertebral disc most likely represents osteitis with discitis, probably tuberculous in etiology. Prevertebral and paravertebral lesion over D6 to D12 vertebral levels and
anterior epidural soft tissue lesion at the D9 and D10 vertebral levels most likely represents an abscess/granulation tissue. Cord compression is noted at the D9 and D10 levels with cord signal alteration suggesting cord edema/ischemia.

The possibility of a neoplasm seems less likely.

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyz M. Klmn / M / 14 yrs.
Referred by : Dr. Abc XyzVaishnav.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O swelling on the left side of the upper back since 1 month with evening rise of temperature.
Past H/O tuberculous abscess of the chest wall, which was drained. Has received 6 months of AKT.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

8 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images are seen to involve the D6 and D9 vertebral bodies and the left side of the D5 vertebral body and the right side of the D8 vertebral body. The right pedicles of the D8 and D9 vertebrae and the left pedicles of the D5 and D6 vertebral bodies are also involved.

There is a large left paracentral soft tissue component over the D5 to D7 vertebral levels. It is hypointense with a hyperintense rim on the T1 Weighted images and turns hyperintense with a hypointense rim on the T2 Weighted images and would represent a loculated abscess. Another near similar lesions are seen in the left posterior paraspinal soft tissues over the C6 to D6 vertebral levels and in the right posterior paraspinal soft tissues over the D1 to D9 vertebral levels. There is extension of the pathologic process into the posterior epidural space over the D5 to D7 vertebral levels with cord compression. The cord over these levels show a subtle hyperintense signal on the T2 Weighted images suggestive of cord edema/ischemia/myelitis.
....2/.












- 2 -


A small right paravertebral soft tissue component is noted at the D8 and D9 vertebral levels.

The rest of the visualized dorsal vertebral bodies and intervertebral discs are unremarkable.

Probable involvement of the posterior segments of the left D4 and D5 ribs and the manubro-sternum is noted.

IMPRESSION :

The MRI features are suggestive of a pathologic porcess most likely an infective lesion like tuberculosis involving the D5, D6, D8 and D9 vertebrae with multiple soft tissue lesions and cord compression over the D5 to D7 vertebral levels as described.

The possibility of this being a neoplastic process is less likely.