ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzo Khatlmn / M / 40 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O paraplegia with bladder/bowel involvement since 2 months.
H/O D4 laminectomy for Pott's spine 14 years back.
H/O decompressive dorsal laminectomy at D2-D3 on 00.00.00 for ossification of the ligamentum flavum causing spinal cord compression. Post-operatively patient has total paraplegia.
H/O spinal surgery on 00.00.00 (details not available).

EXAMINATION :

M.R.I. of the 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.

6 mm thick T1 Weighted coronal images.

OBSERVATION :

There appears to be fusion of the D1 and D2 vertebral bodies with obliteration of the D1-D2 disc.

There are post-operative changes in the posterior soft tissues over the C6 to the D6 levels with laminectomy of the D1, D2, D3, D4 and D5 vertebral bodies.

The cervico-dorsal spinal cord over the C7 to atleast the D6 level is not well-defined. The cord appears smaller in diameter at the D3 and the C6 vertebral levels. Ill-defined hyperintense signal is visualized within the cervico-dorsal spinal cord suggestive of cord edema/ischemia/myelomalacia.

The rest of the visualized cervico-dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
...2/..










- 2 -


IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. Fusion of the D1 and D2 vertebral bodies with obliteration of the D1-D2 disc is probably the sequelae of previous infection.

3. Cord edema/ischemia/myelomalacia in the cervico-dorsal spinal cord over the C7 to atleast the D6 levels.

As compared to the previous MRI (scan no.00007) dated 00.00.00 the large collection
in the subcutaneous tissues posteriorly, is no longer identified on this study.

Date : 00.00.00

Name of the Patient : Abc Xyzna Vijay Mahlmn / M / 39 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 10 years. On anti-epileptics.

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 slight reduction in the volume of the right hippocampus, which shows a hyperintense signal on the T2 Weighted images, suggesting hippocampal sclerosis.

The hippocampal complex on the left 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 :

The MRI features suggest right hippocampal sclerosis.

Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 51 yrs.
Referred by : Dr. Abc Xyzrikh.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O closure of the right eye with right sided headaches.
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.
5 mm thick FLAIR coronal images.
3 mm thick T1 Weighted coronal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and 4 mm thick T1 Weighted coronal images with magnetization transfer.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

There is an intermediate signal intensity lesion on the T1 Weighted images in the
interhemispheric fissure in the high frontal region, which appears relatively hypointense on the T2 Weighted images.

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal.
The cerebellar hemisphers are slightly hypoplastic with a mega cisterna magna. The rest of the
basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

There is still seen an intermediate signal intensity lesion on the T1 Weighted images in the right cavernous sinus. This lesion appears relatively hypointense on the T2 Weighted images. The cavernous segment of the right internal carotid artery is partially encased by the lesion but shows normal flow-void signal. The left cavernous sinus, sella and suprasellar cistern are unremarkable.
...2/..




- 2 -


The visualized orbtis and orbital apices are unremarkable. The visualized optic nerves show normal signal intensity.

Mucosal thickening is noted in the maxillary sinus and ethmoidal air cells on the right side.

Inflammatory changs are noted in the mastoid air cells bilaterally.

Marrow of the clivus is slightly inhomogeneous.

After contrast administration, there is patchy enhancement of the lesion in the right cavernous sinus. Intense enhancement of the lesion in the interhemispheric fissure in the high frontal region is also noted.

IMPRESSION :

1. No abnormality is detected in the brain parenchyma per se.

2. Patchy enhancing lesion in the right cavernous sinus as described.

3. Enhancing lesion in the interhemispheric fissure in the high frontal region may also represent an inflammatory meningeal lesion.

As compared to the previous MRI (scan nos. 00006/45) dated 29/00.00.00, there appears to be slight reduction in the bulk of the lesion in the right cavernous sinus and interhemispheric
fissure.

ke/hs
Date : 00.00.00

Name of the Patient : Abc Xyzui A. Ralmn / M / 27 yrs.
Referred by : Dr. Abc Xyzin.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE since 1 week.
Alleged H/O fall 7 years back.

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 small posterior disc herniation at the L5-S1 level. This disc shows loss of water content.

A small posterior and left far lateral (extraforaminal) disc bulge is seen at the L4-L5 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 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

18.0 mm at L2-L3
...2/..








- 2 -


18.0 mm at L3-L4

15.0 mm at L4-L5

16.0 mm at L5-S1.

IMPRESSION :

1. A small posterior disc herniation at the L5-S1 level.

2. A small posterior and left far lateral (extraforaminal) disc bulge at the L4-L5 level.

ke/hs
Date : 00.00.00

Name of the Patient : Abc Xyzn G. Glmn / F / 42 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to BUE and BLE with paresthesias in the LUE and BLE since 2 months.

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 a small posterior disc bulge with peridiscal osteophytes at the C5-C6 level with anterior indentation of the thecal sac.

Small posterior peridiscal osteophytes are also noted at the C4-C5 and C6-C7 levels.

The C4-C5, C5-C6, C6-C7 and C7-D1 intervertebral discs show loss of water content.

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

The cervical spinal cord reveals normal signal intensity.

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

Incidental note is made of a hyperintense lesion in the isthmus and the left lobe of the thyroid on the T1 Weighted and T2 Weighted images and would represent a cyst/nodule which would require further evaluation.

IMPRESSION :

1. A small posterior disc bulge with peridiscal osteophytes at the C5-C6 level.
2. Small posterior peridiscal osteophytes at the C4-C5 and C6-C7 levels.

ke/hs
Date : 00.00.00

Name of the Patient : Abc Xyzbi M.Y. Shlmn / F / 48 yrs.
Referred by : Dr. Abc Xyztcheswalla.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (left more than right) with paresthesias.

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 D11 vertebra appears to be as marked on the film.

There is collapse of the D10 vertebral body with slight anterior wedging.

There is replacement of the normal marrow of the D9 and D10 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The pedicles of these vertebrae are also involved by the pathology. The superior and inferior cortical endplates of the D10 vertebral body and the inferior cortical endplate of the D9 vertebra are breached with involvement of the D9-D10 intervertebral disc. There is pre and paravertebral soft tissue extension at the D9 and D10 levels. Anterior epidural extension is also noted at this level with encroachment into the D9-D10 neural foramina bilaterally and encasement of the exiting nerve roots. The spinal cord at these levels shows a subtle hyperintense signal on the T2 Weighted images (is isointense to normal cord on the T1 Weighted images) suggestive of cord edema/ischemia/myelitis.

The rest of the visualized dorso-lumbar vertebral bodies and the remaining visualized intervertebral discs are unremarkable.

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








- 2 -


IMPRESSION :

The MRI features are suggestive of altered signal of the D9 and D10 vertebrae and D9-D10 intervertebral disc with soft tissue extensions as described and cord signal alteration at these levels represent cord edema/ischemia/myelitis. These features are not specific for a single etiology. This may represent an infective process like tuberculosis. The possibility of this being a neoplastic process like a small cell tumor or metastasis is less likely.

ke/hs
Date : 00.00.00

Name of the Patient : Abc XyzK. Blmn / F / 37 yrs.
Referred by : Dr. Abc Xyzrla.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE with paresthesias since 4-5 years which have increased since 2-3 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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is a right paracentral disc extrusion at the L5-S1 level with right antero-lateral indentation of the thecal sac and right neural foraminal narrowing. There is indentation upon the traversing right S1 nerve root. A small extruded disc portion is seen to migrate inferiorly and lie posterior to the S1 vertebral body.

A large postero-central disc extrusion is seen at the L4-L5 level with anterior compression of the thecal sac and canal stenosis. An extruded disc portion is seen to migrate inferiorly into the right lateral recess of the L5 vertebra with indentation upon the traversing right L5 nerve root. Small posterior peridiscal osteophytes are also noted at this level. The L4-L5 facet joints show mild degenerative changes.

A small postero-central disc herniation is seen at the L3-L4 level with anterior indentation of the thecal sac.

The L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.
...2/..









- 2 -


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 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

11.0 mm at L3-L4

6.0 mm at L4-L5

11.0 mm at L5-S1.

IMPRESSION :

1. A right paracentral disc extrusion at the L5-S1 level with indentation upon the traversing right S1 nerve root. A small extruded disc portion is seen posterior to the S1 vertebral body.

2. A large postero-central disc extrusion at the L4-L5 level with canal stenosis. An extruded disc portion is seen in the right lateral recess of the L5 vertebra with indentation upon the traversing right L5 nerve root.

3. A small postero-central disc herniation at the L3-L4 level.

4. Mild facetal arthropathy at the L4-L5 level.

Date : 00.00.00

Name of the Patient : Abc XyzR. Nlmn / F / 42 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

H/O HT and thyroid on treatment.
C/O pain and swelling over the right knee joint since 4 months.
H/O fall 2-3 times within 4 months.

EXAMINATION :

M.R.I of the right knee joint was performed using the following parameters :

4 mm thick T1 Weighted, proton and GRASS sagittal images.

4 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick GRASS axial images.

OBSERVATION :

Menisci

A hyperintense signal is seen within the anterior and posterior horns of the medial meniscus not reaching upto the inferior articular surface and would represent Grade II meniscal signal (meniscal degeneration).

The anterior horn and the posterior horn of the lateral meniscus reveal normal configuration and signal characteristics.

Cruciate Ligaments :

The anterior and posterior cruciate ligaments show normal contour and signal characteristics.

Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.
...2/..








- 2 -


Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

The articular cartilage overlying the patella on its medial facet appears slightly thin suggesting chondromalacia patellae.

The articular cartilage overlying the tibia and femur appears normal.

There is an ill-defined hypointense area along the medial aspect of the tibial plateau on the T1 Weighted images and is seen to turn hyperintense on the T2 Weighted and GRASS images and would represent bone contusion in the given clinical setting.

Ill-defined hypointense area is seen in the metaphyseal region and in the upper shaft of the tibia and the lower shaft of the femur on the T1 Weighted images which is seen to turn hyperintense on the T2 Weighted and GRASS images would represent marrow inhomogenity. Fatty changes are also noted in all the bones.

Mild effusion is noted in the right knee joint and in the suprapatellar bursa.

Osteophytic lippings are also noted along the medial and lateral aspects of the femur and tibia.

IMPRESSION :

1. Bone contusions along the medial aspect of the tibial plateau.

2. Mild effusion in the right knee joint.

3. Grade II meniscal signal (meniscal degeneration) within the posterior horn of the medial meniscus.

4. Inhomogenity of the marrow of the tibia and femur with fatty chagnes suggestive of osteoporosis.

5. Chondromalacia patellae.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzPawalmn / M / 70 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 2 years.
H/O fall many years ago.

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 lumbar intervertebral discs except the L5-S1 disc. The L4-L5 disc shows evidence of calcium/vacuum phenomena.

There is Grade I spondylolisthesis of the L4 over the L5 vertebra without obvious spondylolysis.

Slight retroplacement of the L3 over the L4 and L2 over L3 vertebrae is noted.

A left far lateral protruded disc is noted at the L5-S1 level.

A generalized posteriorly herniated disc is noted at the L4-L5 level with bilateral neural foraminal narrowing. There is also facetal and ligamentum flavum hypertrophy with resultant canal stenosis.

Posterior and bilateral far lateral disc bulges with peridiscal osteophytes are noted at the L3-L4 level with bilateral neural foraminal narrowing. Facetal and ligamentum flavum hypertrophy with canal stenosis is also noted.

A small posterior disc bulge with small peridiscal osteophytes is noted at the L2-L3 level.
....2/.







- 2 -


Small postero-central protruded disc is noted at the L1-L2 level.

A postero-central disc herniation is noted at the D12-L1 level indenting the dural theca anteriorly. Slight superior migration of the disc fragment is seen.

Schmorls node is noted in the L3 vertebral body.

Type II degenerative marrow changes are noted adjacent to the lower lumbar intervertebral discs, anteriorly.

The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L2 level and the thecal sac terminates at the S1-S2 level.

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

6.0 mm at D12-L1

10.0 mm at L1-L2

10.0 mm at L2-L3

12.0 mm at L3-L4

8.0 mm at L4-L5

7.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L4 over the L5 vertebra without obvious spondylolysis.
...3/..










- 3 -


2. Slight retroplacement of the L3 over the L4 and L2 over L3 vertebrae.

3. A generalized posteriorly herniated disc at the L4-L5 level with facetal and ligamentum flavum hypertrophy with resultant canal stenosis.

4. Posterior and bilateral far lateral disc bulges with peridiscal osteophytes at the L3-L4 level with facetal and ligamentum flavum hypertrophy with canal stenosis.

5. A small posterior disc bulge with small peridiscal osteophytes at the L2-L3 level.

6. A postero-central disc herniation at the D12-L1 level with slight superior migration of the disc fragment.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzdin H. Deesalmn / M / 27 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 4-5 years which has increased since 1 1/2 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 loss of water content of the L5-S1 intervertebral disc.

There is a small, left paracentral disc herniation at the L5-S1 level with minimal indentation on the traversing left S1 nerve root.

A minimal posterior disc bulge is noted at the L4-L5 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 L1-L2 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
...2/.









- 2 -


15.0 mm at L2-L3

13.0 mm at L3-L4

14.0 mm at L4-L5

10.0 mm at L5-S1.

Screening, T2 Weighted sagittal images of the cervico-dorsal region do not reveal any significant feature of note.

IMPRESSION :

Degenerated L5-S1 disc with a small left paracentral disc herniation indenting the traversing left S1 nerve root at that level.