sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzsham Palmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided hemiparesis with slurred speech since 3.00 pm on 00.00.00.

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 :

The gyri in the right temporo-parietal region appear slightly swollen and show an ill-defined hypointense signal on the T1 Weighted images which appears hyperintense on the proton, T2 Weighted and FLAIR images. There is resultant slight effacement of the cortical sulcal spaces and the right Sylvian cistern.

Similar signal intensity change is noted in the right lentiform nucleus.

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.

Inflammatory changes are noted in the right maxillary antrum, ethmoidal air cells and sphenoid sinus on the left.

IMPRESSION :

Altered signal along the right temporo-parietal cortex and the right lentiform nucleus suggest an acute vascular insult along the distribution of the right middle cerebral artery.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz C.lmn / F / 50 yrs.
Referred by : Dr. Abc Xyznamiya.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O slurred speech (2 episodes) since 2 days.
Known diabetic. On Rx.
H/O coronary angioplasty done.

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 occipital cortex which may represent an ischemic lesion (scans 102.9).

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

INTRACRANIAL MRA :

There is non-visualization of the petrous, cavernous and supraclinoid segments of the left internal carotid artery. Faint visualization with narrowing of the cavernous and supraclinoid segment of the right internal carotid artery is noted. Slight irregularity of the proximal segment of the left middle cerebral artery is noted.

The petrous segments of the right internal carotid artery shows normal signal and calibre. The visualized anterior cerebral, right middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
...2/..











- 2 -


NECK MRA :

The right common carotid artery and its bifurcation and the vertebral arteries on either side are unremarkable.

The left common carotid artery is unremarkable. The left internal carotid artery not visualized right from its origin. The left external carotid artery is unremarkable.


IMPRESSION :

1. Altered signal in the left occipital cortex may represent an ischemic lesion.

2. Non-visualization of the left internal carotid artery in its entirety, right from its origin in the neck.

3. Faint visualization and narrowing of the cavernous and supraclinoid segment of the right internal carotid artery.

4. Slight irregularity of the proximal segment of the left middle cerebral artery..

The above described vascular changes may be due to atherosclerosis.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Dlmn / M / 42 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O bilateral optic atrophy since 10 years.

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 and STIR coronal images through the optic nerves.

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.

The optic nerves on either side appear slightly smaller in diameter with prominent perioptic CSF space. There is however, no change in signal intensity. The optic nerves on either side are normal in their course.

Inflammatory changes are noted in the left maxillary antrum.

IMPRESSION :

No abnormality is detected within the brain parenchyma per se.

The optic nerves on either side appears slightly smaller in diameter without change in signal intensity.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzkumar Slmn / M / 45 yrs.
Referred by : Dr. Abc Xyznshah.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the right hip joint since 1 month.

EXAMINATION :

M.R.I of both hips was performed using the following parameters :

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick T1 Weighted sagittal images through the right hip joint.

OBSERVATION :

A small hypointense area is seen in the roof of the right acetabulum on all the pulse sequences and would represent a bone island.

The femoral head bilaterally and the left acetabulum reveal normal signal intensity bilaterally. There is no obvious bony destruction or erosions noted. The articular cartilages are unremarkable. There is no effusion within both the hip joints.

The musculature surrounding both the hip joints and the visualized pelvis is normal.

IMPRESSION :

A bone island in the roof of the right acetabulum.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzaxmi Nanalmn / F / 32 yrs.
Referred by : Dr. Abc Xyzikhalikar.
Examination : M.R.I. of the Cervico-Dorsal Spine.

CLINICAL PROFILE :

C/O paresthesias in BLE since 4 days.
C/O acute retention of urine.

EXAMINATION :

M.R.I of the cervico-dorsal 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 cervico-dorsal spinal cord over the C7 to D4 vertebral levels appear slightly swollen. There is an ill-defined, hyperintense signal on the T2 Weighted images in the cervico-dorsal spinal cord over these levels. This lesion appears isointense to normal cord on the T1 Weighted images. Resultant slight effacement of the subarachnoid space is noted.

Small postero-central protruded discs are noted at the C5-C6 and C6-C7 levels.

A bony spur is noted along the left lamina at the D2-D3 level and centrally at the D7 vertebral level with resultant slight effacement of the posterior subarachnoid space at these levels.

The visualized cervico-dorsal vertebral bodies reveal normal signal intensity. The visualized cervico-dorsal intervertebral discs show loss of water content. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

IMPRESSION :

1. Slight swelling of the cervico-dorsal spinal cord over the C7 to D4 vertebral levels with altered signal as described is not specific for a single etiology. These changes may suggest myelitis/demyelination.

2. Bony spur along the left lamina at the D2-D3 level and centrally at the D7 vertebral level with resultant slight effacement of the posterior subarachnoid space at these levels.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzD. Bholmn / F / 17 yrs.
Referred by : Dr. Abc Xyzndesha.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since March 0000 which has increased since 3 months.
H/O fall in March 0000.

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 normal lumbar lordosis. The L4 vertebral body appears hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. Erosion of the left lateral and posterior margins of the L4 body is noted. Break in the superior and inferior cortical endplate is also noted, to the left of the midline. The L3-L4 and L4-L5 intervertebral discs to the left of the midline appear more hyperintense on the T2 Weighted images.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the left paravertebral region extending over the L3 and L4 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Extension into the anterior epidural space at these levels is also noted, with thecal sac compression. Encasement of the L4 nerve roots in the neural foramen at the L4-L5 level, bilaterally is also noted. The left psoas muscle is involved by the lesion.

The rest of the visualized lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the L1-L2 level and the thecal sac terminates at the S1-S2 level.
...2/..












- 2 -


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

17.0 mm at L1-L2

15.0 mm at L2-L3

16.0 mm at L3-L4

14.0 mm at L4-L5

9.0 mm at L5-S1.

IMPRESSION :

Altered signal of the L4 vertebral body and the L3-L4 and L4-L5 intervertebral discs most likely represents osteitis with discitis, probably tuberculous in etiology. Left paravertebral and anterior epidural soft tissue lesion over the L3 and L4 vertebral levels represents an abscess/granulation tissue.

The possibility of a neoplasm is less likely.

sb/ke
/68 Date : 00.00.00

Name of the Patient : Abc Xyzben lmn / F / 52 yrs.
Referred by : Dr. Abc Xyzejpal / Dr. Abc Xyzstak.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O left partial 3rd and 4th nerve palsy with closure of the left eye.
Known diabetic.

EXAMINATION :

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

OBSERVATION :

INTRACRANIAL MRA :

The right vertebral artery appears hypoplastic as compared to the left.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar 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 as compared to the left.

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.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyza A. Qurlmn / F / 36 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with altered behaviour for 2-3 hours on 00.00.00.
C/O similar complaints 1 year ago.
H/O HIV with toxoplasmosis in brain since July 0000. On treatment.

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.

OBSERVATION :

There is seen a well marginated, subcentimeter, iso to slightly hyperintense lesion on the T1 Weighted images in the subcortical white matter in the left high parietal region. This lesion shows a hyperintense signal, centrally, with a peripheral hypointense rim on the proton, T2 Weighted and FLAIR images. There is perilesional edema with slight sulcal space effacement in that region.

A fairly large, approximately 2.8 x 2.0 cms sized lesion following similar signal characteristics is noted in the right inferior frontal and frontal region. There is significant perilesional edema with sulcal space effacement and mild indentation on the frontal horn of the right lateral ventricle.

Perilesional edema is also noted around the small lesions in the right high parietal region.

There is an ill-defined, mixed signal intensity lesion (hypointense and hyperintense signal on the T1 Weighted, proton and T2 Weighted images) on all the pulse sequences in the right posterior temporal cortex and subcortical white matter. Focal dilatation of the temporal horn of the right lateral ventricle is noted.
....2/..










- 2 -


There are focal, hypointense lesions on the T1 Weighted images in the right cerebellar hemisphere, cerebral peduncles bilaterally, bilateral thalami and lentiform nuclei and in the subcortical white matter in the fronto-parietal regions bilaterally. These lesions appear hyperintense on the proton and T2 Weighted images while some of them remain hypointense on the FLAIR images. There is no significant perilesional edema around these lesions.

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

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

IMPRESSION :

1. Subcentimeter lesion with perilesional edema in the high parietal regions bilaterally may represent recurrent/fresh granulomas.

2. An approximately 2.8 x 2.0 cms sized granuloma in the right inferior frontal and frontal region, with perilesional edema.

3. Altered signal intensity lesion in the right posterior temporal lobe represents an area of encephalomalacia with haemorrhagic/paramagnetic substance deposition, probably the sequelae of a previous vascular insult.

4. Multiple focal lesions in the right cerebellar hemisphere, cerebral peduncles bilaterally, bilateral thalami and lentiform nuclei and in the subcortical white matter in the fronto-parietal regions bilaterally as described may represent resolved granulomas/lacunes .

5. Mild cerebral cortical and cerebellar atrophy with ventricular fullness.

As compared to the previous MRI dated 00.00.00, there are recurrent/fresh lesions in the posterior parietal regions bilaterally and in the right inferior frontal and frontal region. The rest of the lesions are largely unchanged.

ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzJlmn / F / 58 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE (on & off) since 3 years which has increased since 1 year.
H/O fall in 0000.

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 :

The lumbar intervertebral discs show loss of water content. Hypointense areas are seen in the L5-S1 intervertebral disc on all the pulse sequences suggestive of calcification/ vacuum phenomena.

There is a posterior disc bulge with a posterior peridiscal osteophyte and a right far lateral disc herniation at the L5-S1 level with anterior indentation of the thecal sac and right neural foraminal narrowing. There is resultant indentation upon the extraforaminal portion of the right L5 nerve root.

There is slight forward subluxation of the L4 over the L5 vertebra. A pseudoposterior disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. There is mild indentation on the right L4 nerve root. The L4-L5 facet joints show hypertrophic degenerative changes.

There is a small, posterior disc bulge with peridiscal osteophytes at the L3-L4 level.

Schmorls node is seen in the superior aspect of the L5 vertebra.
...2/..








- 2 -


The lumbar intervertebral discs show loss of water content. Hypointense areas are seen in the L5-S1 intervertebral disc on all the pulse sequences suggestive of calcification/vacuum phenomena.

The lumbar vertebral bodies show 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 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

18.0 mm at L2-L3

15.0 mm at L3-L4

11.0 mm at L4-L5

12.0 mm at L5-S1.

IMPRESSION :

1. A posterior disc bulge with a posterior peridiscal osteophyte and a right far lateral disc herniation at the L5-S1 level with resultant indentation upon the extraforaminal portion of the right L5 nerve root.

2. Slight forward subluxation of the L4 over the L5 vertebra with a pseudoposterior disc herniation at the L4-L5 level and facetal arthropathy at this level.

3. A small, posterior disc bulge with posterior peridiscal osteophyte at the L3-L4 level.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Mehdihlmn / M / 80 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided weakness with dysarthria and high blood pressure since 8 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 coronal images.

OBSERVATION :

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the right corona radiata extending into the right centrum semiovale. This lesion appears hypointense on the T1 Weighted images and most likely represent ischemic lesion, probably recent in the given clinical setting.

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

Lacunar infarcts are noted in the lentiform nuclei and thalami bilaterally.

There is mild dilatation of both the lateral, third and the fourth ventricles. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebellar cortical sulci bilaterally.
There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

A CSF intensity lesion in the left anterior temporal region may either represent a prominent sulcal space or may represent a small arachnoid cyst.
...2/..










- 2 -


IMPRESSION :

1. Altered signal in the right corona radiata extending into the right centrum semiovale most likely represent ischemic lesion, probably recent, in the given clinical setting.

2. Altered signal in the pons, periventricular white matter bilaterally and in the subcortical white matter in the left fronto-temporal region most likely represent ischemic lesions.

3. Lacunar infarcts in the lentiform nuclei and thalami bilaterally.