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Sunday, 27 December 2015 16:48

14723

sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzandra lmn / M / 56 yrs.
Referred by : Dr. Abc Xyzheja / Dr. Abc Xyzauhan.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided hemiparesis with slurred speech, drooping of the left eyelid and diplopia since 00.00.00
Known diabetic.

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 and STIR coronal images through the cavernous sinus and the orbits.

OBSERVATION :

There is an ill-defined hyperintense signal on the proton, T2 Weighted and FLAIR images in the left cerebral peduncle and in the midbrain, in the midline anteriorly. This lesion appears hypointense to normal white matter on the T1 Weighted images and most likely represents ischemic lesions, probably recent in the given clinical setting.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter on the left and in the subcortical white matter in the fronto-parietal regions bilaterally. These lesions appear iso to hypointense to white matter on the T1 Weighted images and these also most likely represent ischemic lesions.

There is mild 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. R>
Hyperintense signal is seen within the left sigmoid and transverse sinuses (? slow flow).

The cavernous sinuses, sella and the suprasellar cistern
s are unremarkable on either side. The optic nerves on either side appear normal in course and signal characteristics.

Inflammatory changes are noted in the left mastoid air cells.

IMPRESSION :

The MRI features are suggestive of :

1. Altered signal in the left cerebral peduncle and in the midbrain, in the midline anteriorly most likely represents ischemic lesions, probably recent in the given clinical setting.

2. Altered signal in the posterior parietal periventricular white matter on the left and in the subcortical white matter in the fronto-parietal regions bilaterally are
also most likely ischemic in etiology.

3. No abnormality is detected in the region of the cavernous sinuses, sella or suprasellar cisterns on this study.










Sunday, 27 December 2015 16:48

14722

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzranjan Almlmn / M / 76 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of weakness of the RUE 1 month 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.

5 mm thick T1 Weighted sagittal images.

MR cisternogram was obtained in the coronal plane.

OBSERVATION :

There are small hyperintense areas on the proton, T2 Weighted and FLAIR images in the left corona radiata and centrum semiovale, left lentiform nucleus and in the periventricular deep white matter. These are isointense to normal white matter on the T1 Weighted images and are probably ischemic in etiology.

Prominent perivascular spaces are seen in the periventricular white matter bilaterally.

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

There is slight fullness of both the lateral and third ventricles. The fourth ventricle is normal. There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.




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 mild inflammatory changes in the maxillary sinuses and right mastoid air cells.

IMPRESSION :

1. Altered signal in the left corona radiata and centrum semiovale, left lentiform nucleus and in the periventricular deep white matter are probably ischemic in etiology.

2. Cerebral atrophy.













Sunday, 27 December 2015 16:48

14721

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz B. lmn / M / 82 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of left hemiparesis and subsequent fall and altered sensorium at 9.30 pm on 00.00.00.
Known 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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is an ill-defined, hypointense area on the T1 Weighted images in the right inferior frontal region. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images with a focal hypointense signal within, laterally.

Ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images are noted at the right occipital pole, posterior parietal periventricular white matter bilaterally and in the right posterior parietal white matter. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images.

The petrous and cavernous segments of the right internal carotid artery and probably also the right middle cerebral artery show an intraluminal signal on all the pulse sequences. Very subtle, effacement of the sulcal spaces is noted in the right cerebral hemisphere.






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

IMPRESSION :

1. Altered signal in the right inferior frontal region most likely represents a haemorrhagic contusion, (with the given h/o fall).

2. Altered signal in the right occipital pole, posterior parietal periventricular white matter bilaterally and in the right posterior parietal white matter most likely represent ischemic changes.

3. Intraluminal signal in the petrous and cavernous segments of the right internal carotid artery and probably also the right middle cerebral artery most likely represents a thrombus (less likely to represent slow flow).

















Sunday, 27 December 2015 16:48

14720

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzana lmn / F / 73 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

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

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.

OBSERVATION :

Lacunar infarcts 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 proton, T2 Weighted and FLAIR 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. These areas appear hypointense to normal white matter on the T1 Weighted images.

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. No obvious vascular anomaly is identified on this study.






Incidentally noted is hyperostosis frontalis interna.

IMPRESSION :

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

2. 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.














Sunday, 27 December 2015 16:48

14718

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzar Relmn / M / 68 yrs.
Referred by : Dr. Abc Xyzala.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O 3 episodes of deviation of the angle of the mouth with slurred speech since last one month.
Known 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 a hyperintense signal on the T2 Weighted images in the left corona radiata extending into the left centrum semiovale and may represent an area of ischemia.

There is an ill-defined, hyperintense signal on the T1 Weighted images in the left lentiform nucleus, which appears isointense to normal grey matter on the T2 Weighted images. This may represent paramagnetic substance deposition/calcification.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidental note is made of left mastoiditis.

INTRACRANIAL MRA :

The right vertebral artery is hypoplastic.
..2/.








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 :

There is slight narrowing of the internal carotid artery on the left side just distal to the common carotid bifurcation with a plaque along its postero-lateral wall.

The right vertebral artery in the neck is also hypoplastic.

The common carotid arteries and their extracranial branches appear normal bilaterally.

IMPRESSION :

1. Altered signal in the left corona radiata extending into the left centrum semiovale may represent an area of ischemia.

2. Mild cerebral and cerebellar atrophy.

3. Slight narrowing of the internal carotid artery on the left side just distal to the left common carotid bifurcation with a plaque along its postero-lateral wall.

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


Sunday, 27 December 2015 16:48

14717

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzli Anlmn / M / 35 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever with chills 15-20 days back.
C/O giddiness with fall and loss of consciousness for 2 days 9 days back.
C/O altered behaviour and 2 episodes of seizures 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.

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 is unremarkable on either side.

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. 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 right maxillary sinus.

IMPRESSION :

No significant abnormality is detected on this study.













Sunday, 27 December 2015 16:48

14716

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Slmn / F / 23 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O 3 episodes of paresthesias in the RUE and RLE since 1 month.
H/O seizures 3-4 years ago.

EXAMINATION :

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

3 mm thick STIR coronal images were obtained through optic nerves.

OBSERVATION :

After contrast administration, there is no focal area of abnormal enhancement in the brain parenchyma or along the meninges.

Lesions in the frontal region and the left occipital region do not show any evidence of enhancement after contrast administration.




Sunday, 27 December 2015 16:48

14715

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Andlmn / M / 52 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O giddiness with gait ataxia since 3 months.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick FLAIR coronal images.

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

OBSERVATION :

There is slight prominence of the right cerebellar folia, posteriorly, with a hyperintense signal on the T2 Weighted and FLAIR images in the cerebellar hemisphere in that region, which most likely is the sequelae of a previous vascular insult.

There is mild fullness of both the lateral and third ventricles. The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

INTRACRANIAL MRA :

The A1 segment of the right anterior cerebral artery and the right vertebral artery appears hypoplastic. The right posterior cerebral artery appears as a continuation of the right posterior communicating artery.











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

NECK MRA :

The right vertebral artery in the neck also appears hypoplastic.

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Altered signal in the right cerebellar hemisphere most likely represents an old infarct.

2. Hypoplastic A1 segment of the right anterior cerebral artery and the right vertebral artery.

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


Sunday, 27 December 2015 16:48

14713

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzka Nlmn / F / 4 1/2 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O fall with unresponsiveness for half an hour and deviation of left eyelid towards inner side on 00.00.00 which is recovered now.

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 a small, approximately 4.0 mms diameter sized hypointense lesion on the T1 Weighted images in the right para-atrial region. This lesion appears hyperintense on the T2 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.

Inflammatory changes are noted in the sphenoid sinus.

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 :

A small, approximately 4.0 mms diameter sized lesion in the right para-atrial region is a ? prominent perivascular space, ?? lacune.

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

Sunday, 27 December 2015 16:48

14712

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzajlmn / M / 11 yrs.
Referred by : Dr. Abc Xyzwadekar
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O weakness of BLE with bladder involvement since 7 days.
H/O fever.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.
9 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is slight increase in the diameter of the dorsal spinal cord which shows hyperintense signal on the T2 Weighted images, centrally extending over D1 to the tip of the conus medullaris (isointense to the normal cord on the T1 Weighted images).

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.

There is no cord compression.

The conus medullaris terminates at the L1-L2 level.

T2 Weighted sagittal images of the cervico-dorsal region, reveals the signal change extending into the cervical region upto the C1-C2 level.

IMPRESSION :

Altered signal in the cervical and dorsal spinal cord extending over the C2 upto the conus medullaris as described most likely represents myelitis in the given clinical setting.