sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyza lmn / M / 70 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O dysarthria and deviation of right angle of mouth with high blood pressure 1 year back.
C/O slowed down all activities with gait imbalance 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.

OBSERVATION :

Lacunar infarcts are noted in the pons, lentiform nuclei, thalami, external capsular regions bilaterally and in the right corona radiata and left centrum semiovale.

There is a diffuse, hyperintense signal on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally . This signal is iso to hypointense to the normal white matter on the T1 Weighted images.

There is mild to moderate dilatation of both the lateral and the third ventricles. The fourth ventricle is normal. There is 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.

Inflammatory changes are noted in the left maxillary antrum.

IMPRESSION :

1. Lacunar infarcts in the pons, lentiform nuclei, thalami, external capsular regions bilaterally and in the right corona radiata and left centrum semiovale.
2. Diffuse, altered signal in the periventricular white matter bilaterally most likely represents ischemic changes. In view of h/o hypertension Binswangers disease should be ruled out.
3. Mild to moderate dilatation of both the lateral and the third ventricles.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzni Slmn / F / 71 yrs.
Referred by : Dr. Abc Xyzrvekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O radicular pain in the LLE on walking since 6 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 lumbar intervertebral discs.

Small posterior and right far lateral disc bulges with peridiscal osteophytes are noted at the L4-L5 and L5-S1 levels. Minimal indentation on the extraforaminal segment of the right L5 nerve root at the L5-S1 level is noted.

Slight facetal and ligamentum flavum hypertrophy is noted at the L4-L5 level and slight facetal hypertrophy is noted at the L3-L4 level.

Anterior disc herniations with anterior peridiscal osteophytes are seen in the dorso-lumbar region.

The lumbar vertebral bodies 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-L2 level and the thecal sac terminates at the S1 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

18.0 mm at L3-L4

14.0 mm at L4-L5

13.0 mm at L5-S1.

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

IMPRESSION :

1. Small posterior and right far lateral disc bulges with peridiscal osteophytes at the L4-L5 and L5-S1 levels with minimal indentation on the extraforaminal segment of the right L5 nerve root at the L5-S1 level.

2. Slight facetal and ligamentum flavum hypertrophy at the L4-L5 level and slight facetal hypertrophy at the L3-L4 level.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzSlmn / M / 57 yrs.
Referred by : Dr. Abc Xyzawkar / Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O radicular pain in the RLE with weakness since 1 year.
Known C/O mild anterior poliomyelitis of the RLE sinch childhood.

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 slight loss of water content of the lumbar intervertebral discs.

A minimal posterior disc bulge is noted at the L5-S1 level.

A small posterior and right postero-lateral disc bulge is noted at the L4-L5 level with minimal indentation on the extraforaminal segment of the right L4 nerve root.

The right ilio-psoas muscle is reduced in bulk when compared to the left most likely due to previous poliomyelitis.

The lumbar vertebral bodies 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.
...2/..












- 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

15.0 mm at L2-L3

15.0 mm at L3-L4

14.0 mm at L4-L5

9.0 mm at L5-S1.

IMPRESSION :

1. A minimal posterior disc bulge at the L5-S1 level.

2. A small posterior and right postero-lateral disc bulge at the L4-L5 level with minimal indentation on the extraforaminal segment of the right L4 nerve root.

3. The right ilio-psoas muscle is reduced in bulk when compared to the left most likely due to previous poliomyelitis.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzar lmn / M / 37 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Post-Contrast Study of the Brain.

CLINICAL PROFILE :

C/O seizures since 20 years. On anti-epileptics.

EXAMINATION :

The brain was screened with 3 mm thick T2 Weighted axial images through the region of interest.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images with magnetization transfer.

3 mm thick T1 Weighted coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is still seen an ill-defined, hyperintense signal on the T2 Weighted images in the left medial temporal lobe. The left medial temporal cortex appears slightly bulky.

The cerebellar folia are prominent.

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

The ventricular system is unremarkable. There is no midline shift.

IMPRESSION :

There is no significant change noted in the left medial temporal lesion on comparison with the previous MRI (scan no:00000) dated 00.00.00. No focal area of abnormal enhancement is noted in the brain parenchyma or the meninges.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzp Salmn / M / 44 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since childhood. 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 no focal area of altered signal intensity within 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 slight prominence of the cerebellar folia bilaterally. 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 :

Slight prominence of the cerebellar folia bilaterally.

No other significant abnormality is detected on this study.

Date : 00.00.00

Name of the Patient : Abc XyzYasin Nilmn / M / 35 yrs.
Referred by : Dr. Abc XyzAndar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O vehicular accident at 1.30 am on 00.00.00 with loss of consciousness.

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 T2 Weighted and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is an intermediate signal intensity mass lesion having its epicenter in the right lentiform nucleus in the right fronto-temporo-parietal region and measures approximately 5.1 x 9.3 x 6.5 cms. The centre of this lesion is slight hypointense to white matter on the T1 Weighted images and is seen to turn heterogeneously hypointense on the proton and T2 Weighted images. Few hypointense areas within this lesion are seen to bloom on the Fast Scan (T2 *) images. The periphery of this lesion is slightly hyperintense to CSF on the T1 Weighted images and turns more hyperintense on the proton, T2 Weighted and Fast Scan (T2 *) images. Fluid level is seen at the periphery and would represent clot retraction and the lesion would represent an acute hematoma. There is slight dissection into the fourth ventricle. There is mass effect with compression upon the body of the right lateral and third ventricles with shift of the midline structures to the left.

There is mild fullness of both the lateral ventricles.

No obvious vascular anomaly is identified on this study.
...2/..












- 2 -

Incidental note is made of a hyperintense signal in the soft tissues in the left fronto-temporal region on the proton and T2 Weighted images and would represent subgaleal contusion/edema.

Inflammatory changes are noted in the ethmoidal air cells and left maxillary antrum.

IMPRESSION :

The MRI features are suggestive of an acute hematoma measuring approximately 5.1 x
9.3 x 6.5 cms in the right fronto-temporo-parietal region with slight dissection into the fourth ventricle, compressing the body of the right lateral and third ventricles with shift of the midline structures to the left.

Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 55 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O difficulty in swallowing 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 are hyperintense areas on the proton, T2 Weighted and FLAIR images in the posterior parietal, periventricular deep white matter, bilateral centrum semiovale, in the left corona radiata and the frontal deep white matter. These are isointense to hypointense to normal white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.

Lacunar infarct (hyperintense on all the pulse sequences) is noted in the right lentiform nucleus.

There is mild dilatation of both the lateral ventricles. There is slight prominence of the cerebral cortical sulcal spaces in the fronto-parietal regions bilaterally.

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.

Inflammatory changes are noted in the left maxillary antrum. A subgaleal lipoma is noted in the high frontal region in the midline.

IMPRESSION :

1. Altered signal in the posterior parietal, periventricular deep white matter, bilateral centrum semiovale, in the left corona radiata and the frontal deep white matter are suggestive of areas of ischemia/infarction.

2. Lacunar infarct in the right lentiform nucleus.

Date : 00.00.00

Name of the Patient : Abc Xyzani K. Kablmn / F / 60 yrs.
Referred by : Dr. Abc Xyzdhwa.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 4 months.
H/O fall 2 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 anterior wedging of the D12, L1 and L3 vertebral bodies with angular kyphus at the D12-L1 level. Herniation of the adjacent intervertebral discs into the bodies of these vertebrae is noted.

There is replacement of the normal marrow of the D12 and L1 vertebral bodies
by hypointense areas on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted images.

Posterior disc bulges are seen at the L3-L4 and L4-L5 levels with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. The facet joints at these levels also show degenerative changes. A small, postero-central protruded disc is noted at the L5-S1 level.

The D11-D12 facet joints show gross hypertrophic degenerative changes with resultant
canal stenosis. The dorsal spinal cord at thsi level shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia.

The lumbar intervertebral discs show loss of water content.

The visualized dorso-lumbar vertebral bodies show diffuse fatty changes suggestive of osteoporosis.

The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
...2/..



- 2 -

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 :

17.0 mm at L1-L2

14.0 mm at L2-L3

13.0 mm at L3-L4

13.0 mm at L4-L5

10.0 mm at L5-S1.

The upper dorsal spine was screened with 5 mm thick T1 Weighted sagittal images and which does not reveal any significant feature of note.

IMPRESSION :

The MRI features are suggestive of :

1. Anterior wedging of the D12, L1 and L3 vertebral bodies with angular kyphus at the D12-L1 level, may be the sequelae of previous trauma.

2. Altered signal in the D12 and L1 vertebral bodies would represent bone edema.

3. Posterior disc bulges at the L3-L4 and L4-L5 levels with facetal arthropathy
at these levels.

4. Hypertrophic facetal arthropathy at the D11-D12 level with resultant canal stenosis and cord compression. Altered cord signal at the D11-D12 level, suggests cord edema/ischemia.

Date : 00.00.00

Name of the Patient : Abc Xyzatesh M. Shelmn / M / 1 1/2 yrs.
Referred by : Dr. Abc XyzMehta / Dr. Abc Xyzthalani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O fever with irritability (restlessness) since 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 coronal images.

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.

OBSERVATION :

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

Mild fullness of both the lateral ventricles is noted. The third and 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.

There is no area of abnormal enhancement within the brain parenchyma or along the meninges after administration of contrast.

Note is made of an enlarged adenoids.

IMPRESSION :

No significant abnormality detected on this study.

bv/ke
Date : 00.00.00

Name of the Patient : Abc Xyzhlmn / M / 42 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

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

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 loss of water content of the L5-S1 and D12-L1 intervertebral discs.

There is a fairly large postero-central disc extrusion with peridiscal osteophytes at the L5-S1 level with ventral indentation of the thecal sac and canal stenosis. Mild hypertrophic changes of the facet joints and mild ligamentum flavum hypertrophy is also seen at the L5-S1 level.

The lumbar vertebral bodies and the remaining intervertebral discs 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 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

14.0 mm at L3-L4

13.0 mm at L4-L5

10.0 mm at L5-S1.

IMPRESSION :

A fairly large postero-central disc extrusion with peridiscal osteophytes at the L5-S1 level with hypertrophy of the facet joints and ligamentum flavum hypertrophy with resultant canal stenosis.