ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzsh lmn / M / 33 yrs.
Referred by : Dr. Abc Xyzgrawal.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O vertigo with gait imbalance and diplopia on the left side on seeing to the left and 3-4 episodes of vomiting since 1 day.
C/O similar history 1 year ago.

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 STIR coronal images.
5 mm thick FLAIR coronal images.

OBSERVATION :

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

A hyperintense focus seen in the right thalamus on all the pulse sequences represents slow flow in a vessel.

The optic nerves show normal signal intensity on the STIR 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. No obvious vascular anomaly is identified on this study.

The cavernous sinuses are unremarkable.

Note is made of inflammation of the mastoid air cells on the left side.

IMPRESSION :

Normal study of the Brain.

Inflammation of the mastoid air cells on the left side.

Date : 00.00.00

Name of the Patient : Abc XyzD. Plmn / M / 20 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the LLE since 15 days.

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 (with fat saturation) images.
5 mm thick Proton density sagittal images.

OBSERVATION :

There is slight expansion of the neck of the left femur. A large mass lesion is seen in the neck and the upper shaft of the left femur in the region of the lesser trachantor which measures approximately 6.1 x 3.5 x 3.0 cms. This lesion is hypointense to the normal marrow on the T1 Weighted images and turns heterogeneously hyperintense on the T2 Weighted and STIR images. There is a suspicious break in the medial cortex of the neck of left femur. A sclerotic rim, which is hypointense on all the pulse sequences is noted around the lesion.

The right hip joint is unremarkable.

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

IMPRESSION :

The MRI features are suggestive of a slightly expansile mass lesion in the neck and the upper shaft of the left femur measuring approximately 6.1 x 3.5 x 3.0 cms as described. The differential diagnosis would include,

1. Mono-ostotic fibrous dysplasia.
2. Giant cell tumor.
3. Chondroblastoma.
4. Chondromyxoid fibroma.

Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 28 yrs.
Referred by : Dr. Abc Xyzl - Orthopaedic Department.
Examination : M.R.I. of the S. I. Joints.

CLINICAL PROFILE :

C/O radicular pain to the RLE (below knee) since 10 days.
H/O backache radiating to the LLE for 1 1/2 months 1 year back from which patient recovered with traction.

EXAMINATION :

M.R.I of the S. I. joints was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

5 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There are hypointense areas within the iliac bones bilaterally, the sacral ala (right more than the left), right ischium as well as the pubic bone and the head, neck and upper shaft of the left femur on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted and STIR images. There is involvement of the right sacro-iliac joint posteriorly. There is extension into the anterior soft tissues at the lower sacral region with involvement of the pyriformis muscle on the right side which is slightly hyperintense to the normal muscle on the T1 Weighted images and turns hyperintense on the T2 Weighted images. There is also extension of this pathology into the spinal canal at the S1/S2 levels on the right side with encasement of the sacral nerve roots (scans 104.9-16)

The left sacro-iliac joint appear normal.

Hyperintense signal is seen in the right gluteus muscle on the T2 Weighted images which could be due to intramuscular injection.
...2/..











- 2 -


The cervico-dorsal spine was screened with 5 mm thick T1 Weighted sagittal images and the lumbo-sacral spine was screened with 5 mm thick T2 Weighted sagittal images and 6 mm thick T1 Weighted coronal images which shows hypointense areas in the visualized dorso-lumbar vertebrae. Probable hemangiomas/areas of fatty replacement are noted in the D10 and D5 vertebral bodies.

IMPRESSION :

Altered signal within the iliac bones, the sacral ala (right more than the left), right
ischium as well as the pubic bone and the head, neck and upper shaft of the left femur with involvement the right sacro-iliac joint posteriorly and extending into the anterior soft tissues at the lower sacral region with involvement of the pyriformis muscle and also epidural involvement in the sacral canal with encasement of the
nerve roots on the right side is not specific for a single diagnosis.

The possibilities to be considered are :

1. Multiple metastases.

2. Multifocal tuberculosis.

3. Small cell tumor like multiple myeloma/lymphoma.

A biopsy from the affected bone would be worthwhile.

Date : 00.00.00

Name of the Patient : Abc Xyz Glmn / M / 21 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right focal 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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is prominence of the cortical sulcal spaces in the left high fronto-parietal region with underlying tissue loss. Hyperintense areas surrounding this area on the proton and T2 Weighted images would represent areas of gliosis (scans 103.18, 103.19, 102.18, 102.19). This lesion in toto would represent an area of cystic encephalomalacia, the result of a previous vascular insult.

There is mild dilatation of the left lateral and the fourth ventricles. The right lateral and the 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.

A mega cisterna magna is noted.

Incidental note is made of enlarged adenoids and inflammatory changes in the maxillary sinuses, ethmoidal air cells and frontal sinus.

IMPRESSION :

The MRI features are suggestive of an area of cystic encephalomalacia in the left fronto-parietal region, the result of previous vascular insult.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Mohammedlmn / M / 44 yrs.
Referred by : Dr. Abc Xyzaubal / Dr. Abc Xyzeshmukh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 15 days.

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 posterior disc herniation at the L2-L3 level with anterior indentation of the thecal sac. This disc shows loss of water content and is reduced in height. A large posterior peridiscal osteophyte is also noted at this level. An anterior disc herniation is also seen at this level. An anterior disc herniation is also seen at this level.

Schmorls nodes are seen in the L2 vertebra inferiorly and L3 vertebra superiorly.

Small posterior disc bulges are noted at the L4-L5 and L5-S1 levels. A left far lateral (extraforaminal) disc herniation is seen at the L1-L2 level.

Type II degenerative changes are noted in the L2 vertebral body adjacent to the L2-L3 intervertebral disc. Areas of focal fatty deposition are identified in the L1 and L3 vertebral bodies.

The rest of the lumbar vertebral bodies and the remaining intervertebral discs show 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 S2 level.
...2/..








- 2 -


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

14.0 mm at L1-L2

11.0 mm at L2-L3

15.0 mm at L3-L4

13.0 mm at L4-L5

11.0 mm at L5-S1.

IMPRESSION :

A posterior disc herniation with large posterior peridiscal osteophyte at the L2-L3 level.

Date : 00.00.00

Name of the Patient : Abc Xyzxmi Mlmn / F / 75 yrs.
Referred by : Dr. Abc Xyzhah / Dr. Abc Xyzehta.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE 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 slight forward translation of the L5 over the S1 vertebra.

A postero-central and a left far lateral disc protrusion is seen at the L5-S1 level with anterior indentation of the thecal sac. The L5-S1 facet joints bilaterally show degenerative changes with hypertrophic changes on the left side. There is resultant indentation upon the foraminal portion of the left L5 nerve root. Mild ligamentum flavum hypertrophy is also noted at this level.

There is slight retroplacement of the L1 over the L2 vertebra. A pseudoposterior disc herniation is seen at the L1-L2 level with anterior indentation of the thecal sac. Posterior peridiscal osteophytes are also noted at this level.

Small posterior disc bulges are seen at the L2-L3, L3-L4 and L4-L5 levels. The facet joints at these levels show mild degenerative changes. Ligamentum flavum hypertrophy is noted at the L4-L5 level.

The lumbar intervertebral discs show loss of water content.

Diffuse fatty changes are seen in the dorso-lumbar vertebrae, suggestive of osteoporosis. Slight wedging of the D9, D10, D11 and D12 vertebral bodies is noted.
...2/..







- 2 -


The remaining 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 :

13.0 mm at L1-L2

15.0 mm at L2-L3

15.0 mm at L3-L4

15.0 mm at L4-L5

13.0 mm at L5-S1.

IMPRESSION :

1. Slight forward translation of the L5 over the S1 vertebra.

2. A postero-central and a left far lateral disc protrusion at the L5-S1 level with degenerative changes of the L5-S1 facet joints bilaterally and hypertrophic changes on the left side with resultant indentation upon the foraminal portion of the left L5 nerve root.

3. Slight retroplacement of the L1 over the L2 vertebra with a pseudoposterior disc herniation and posterior peridiscal osteophytes at the L1-L2 level.

4. Small posterior disc bulges at the L2-L3, L3-L4 and L4-L5 levels with mild degenerative changes of the facet joints at these levels.

5. Osteoporotic changes in the dorso-lumbar spine with slight wedging of the D9 and D12 vertebrae.

Date : 00.00.00

Name of the Patient : Abc XyzAlmn / F / 53 yrs.
Referred by : Dr. Abc Xyz Gandhi.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE 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 slight retroplacement of the L3 over the L4 vertebra.

A pseudoposterior disc herniation is seen at the L3-L4 level with anterior indentation of the thecal sac. A left far lateral (extraforaminal) disc herniation is also seen at this level.

Small posterior disc bulge is seen at the L5-S1 level. The lumbar intervertebral discs show loss of water content.

The facet joints show mild degenerative changes at the L4-L5 level.

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 D12 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 :

19.0 mm at L1-L2

18.0 mm at L2-L3

17.0 mm at L3-L4

16.0 mm at L4-L5

12.0 mm at L5-S1.

The S. I. joints were screened with 5 mm thick T1 Weighted and STIR coronal images which shows hypointense areas in the sacral and iliac bones bilaterally adjacent to the sacro-iliac joints bilaterally with narrowing of the joint space bilaterally. Subtle hyperintense signal on the STIR images may represent edema.

IMPRESSION :

1. Slight retroplacement of the L3 over the L4 vertebra.

2. A pseudoposterior and a left far lateral disc herniation at the L3-L4 level.

3. Bilateral sacro-ilitis ? etiology.

Date : 00.00.00

Name of the Patient : Abc Xyza Gulmn / F / 28 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Hippocampal Region.

CLINICAL PROFILE :

C/O seizures since 2-3 months with MR +. On anti-epileptics.

EXAMINATION :

M.R.I of the hippocampal region was performed, as requested, using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick T2 Weighted axial images through the brain.

OBSERVATION :

There is no area of focal altered signal intensity on the T2 Weighted axial images of the brain.

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.

Incidental note is made of right maxillary sinusitis and inflammatory changes in the ethmoidal air cells.

IMPRESSION :

Normal study of the Brain.

Date : 00.00.00

Name of the Patient : Abc Xyza Halmn / F / 62 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias and burning sensation since 4-5 months.
H/O fall 7-8 months 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 slight forward translation of the L4 over the L5 and L5 over the S1 vertebra.

There is a posterior and left postero-lateral disc herniation with peridiscal osteophytes
at the L5-S1 level with anterior indentation of the thecal sac and left neural foraminal narrowing. There is resultant indentation upon the foraminal and the extraforaminal portion of the left L5 nerve root. The L5-S1 facet joints on the left side show degenerative changes.

A diffuse posterior disc herniation with peridiscal osteophyte is seen at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. The L4-L5 facet joints show mild degenerative changes.

A small postero-central disc herniation is noted at the L3-L4 level and posterior disc bulge at the L2-L3 level.

The lumbar intervertebral discs show loss of water content.

The lower lumbar vertebrae show Type II degenerative changes.

Hemangiomas with fatty content is seen in the D12 and L2 vertebral bodies.

The rest of the lumbar vertebral bodies show normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
...2/..








- 2 -

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 :

16.0 mm at L1-L2

16.0 mm at L2-L3

15.0 mm at L3-L4

13.0 mm at L4-L5

12.0 mm at L5-S1.

Slight atrophy of the paraspinal muscles is noted in the lower lumbar region.

IMPRESSION :

1. Slight forward translation of the L4 over the L5 and L5 over the S1 vertebra.

2. A posterior and left postero-lateral disc herniation with peridiscal
osteophytes at the L5-S1 level with resultant indentation upon the foraminal and the extraforaminal portion of the left L5 nerve root and facetal arthropathy on the left side at this level.

3. A diffuse posterior disc herniation with peridiscal osteophyte at the L4-L5 level with mild facetal arthropathy at this level.

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

Date : 00.00.00

Name of the Patient : Abc Xyzn D. Masulmn / M / 19 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O head injury with loss of consciousness for 15 minutes 1 year back.
C/O seizures since 1 year with occasional headaches and blackouts since 2 months. 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 area of focal altered signal intensity in the brain parenchyma.

The hippocampal complex is unremarkable on either side.

Both the lateral, third and the fourth ventricles are normal. The CSF space along the right cerebellar hemisphere appears prominent ? due to slight hypoplasia of the right cerebellar hemisphere. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

Slight hypoplasia of the right cerebellar hemisphere with slightly prominent right
cerebellar cistern.

No other significant abnormality is detected on this study.