Date : 00.00.00

Name of the Patient : Abc Xyzai Chlmn / F / 65 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches, giddiness and twitching of face since 2 days.
Known hypertensive. On Rx.

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 bilateral corona radiata and centrum semiovale, periventricular deep white matter, pons on the right side and right frontal deep white matter. These are iso to hypointense to white matter on the T1 Weighted images and would represent ischemic areas.

Lacunar infarcts are seen in the right cerebellar hemisphere, bilateral lentiform nuclei and right corona radiata.

There is mild dilatation of both the lateral ventricles with fullness of the fourth and third ventricles.

There is slight prominence of the cortical sulcal spaces in the fronto-parietal regions and cerebellar folia. The basal cisternal spaces are prominent. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Incidental note is made of left maxillary sinusitis and an empty sella.
...2/..











- 2 -

IMPRESSION :

1. Ischemic areas in bilateral corona radiata and centrum semiovale, periventricular deep white matter, pons on the right and right frontal deep white matter.

2. Lacunar infarcts in the right cerebellar hemisphere, bilateral lentiform nuclei and right corona radiata.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyz. lmn / M / 30 yrs.
Referred by : Dr. Abc Xyzpe.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

Alleged H/O trauma (fall of heavy weight) on 00.00.00.
C/O progressive weakness of BLE (L>R) since then.

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.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is anterior wedging of the D12 vertebral body and is retroplaced as compared to the L1 vertebra. There is suggestion of a fracture of the lamina and the spinous process of the D12 vertebral body. There is disruption of the D11-D12 facets.

There are hypointense areas in the superior portion of the D12 vertebral body which are seen to turn heterogeneously hyperintense on the T2 Weighted images and would represent bone edema/contusion in the given clinical setting. The superior cortical endplate of the D12 vertebra appears broken (fractured). The postero-superior portion of the D12 vertebral body is seen to compress upon spinal cord. The spinal cord at the D11 and D12 levels shows a hyperintense signal on the T2 Weighted images and is isointense to the cord on the T1 Weighted images
suggestive of cord edema/contusion.

There is an intermediate signal intensity lesion in the anterior epidural region at the D11 level on the T1 Weighted images which is seen to turn hyperintense on the T2 Weighted images and may represent haemorrhage (scans 106.7, 106.8, 107.7, 107.8, 104.3, 104.4, 105.3, 105.4).

The anterior longitudinal ligament appears stripped away from the D12 vertebra.

The paraspinal soft tissues at the D12 level shows altered signal intensity suggestive of edema/contusion. The paraspinous soft tissues at this level also shows altered signal intensity suggestive of edema/contusion.
...2/..





- 2 -



A small pseudo-posterior disc bulge is noted at the D12-L1 level.

The rest of the visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity.

The conus medullaris terminates at the L1-L2 level.

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images which shows a small posterior disc herniation at the L5-S1 level.

IMPRESSION :

In a known C/O trauma the MRI features are suggestive of anterior wedging of the D12 vertebra with fracture of the lamina and spinous process with bone edema/contusion at this level as described. Altered signal of the cord at the D11 and D12 levels suggests cord edema/contusion with probable haemorrhage in the anterior epidural region at the D11 level.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzr R. Kalmn / F / 40 yrs.
Referred by : Dr. Abc Xyzaj.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE since October 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 slight loss of water content of the L5-S1 intervertebral disc.

There are Tarlovs cysts on both sides at the S1 level and in the midline at the S2 level.

Small posterior disc bulges are noted at the L4-L5 and L5-S1 levels.

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 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 :

22.0 mm at L1-L2

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









- 2 -


20.0 mm at L3-L4

13.0 mm at L4-L5

14.0 mm at L5-S1.

IMPRESSION :

1. Tarlovs cysts on both sides at the S1 level and in the midline at the S2 level.

2. Small posterior disc bulges at the L4-L5 and L5-S1 levels.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzrilmn / F / 34 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 1 year.

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 axial images.
5 mm thick Proton density sagittal images.

OBSERVATION :

There is a well-marginated, hyperintense lesion on the T1 Weighted images in the antero- superior quadrant of the left femoral head. This lesion is supressed on the T2 Weighted and STIR images. A peripheral rim on all the pulse sequences is noted around this lesion. There is a small left hip joint effusion. The left femoral head shows normal contour. The left acetabulum is
unremarkable.

A similar, but smaller lesion is noted in the right femoral head, antero-superiorly. The right femoral head shows normal contour.

The double line sign is well identified in both the hip joints.

A focal hypointense signal on all the pulse sequences in the right iliac bone adjacent to the right S.I. Joint is a bone island. The S.I. Joint on either side are otherwise unremarkable.

Scar of the previous surgery is noted in the anterior abdominal wall. The muscles around the left hip joint are atrophic.

IMPRESSION :

The MRI features suggest Class A avascular necrosis of the femoral heads bilaterally. A small left hip joint effusion is noted.

As compared to the previous MRI (study no:0000) dated 00.00.00, there is no significant change noted.

Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 28 yrs.
Referred by : Dr. Abc Xyzvade.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 3 years which has increased since 10 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 sacralization of the L5 vertebra and the L3 vertebral body is as marked on the film.

There is mild retroplacement of the L4 over the L5 vertebra.

A large left paracentral disc extrusion is seen at the L4-L5 level with left antero-lateral compression of the thecal sac and resultant tight canal. An extruded disc portion is seen to migrate inferiorly in the left lateral recess of the L5 vertebra with impingement of the traversing left L5 nerve root. This disc is dessicated. Mild ligamentum flavum hypertrophy is also seen at the L4-L5 level.

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 D12-L1 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

17.0 mm at L3-L4

9.0 mm at L4-L5

13.0 mm at L5-S1.

The sacro-iliac joints were screened with 6 mm thick T1 Weighted coronal images and these show no feature of note.

IMPRESSION :

Degenerated L4-L5 intervertebral disc with a large left paracentral disc extrusion at this level with an extruded disc portion seen to migrate inferiorly in the left lateral recess of the L5 vertebra with impingement of the traversing left L5 nerve root
and resultant tight canal at this level.

kebv
Date : 00.00.00

Name of the Patient : Abc Xyzer B. Plmn / M / 27 days.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O myelomeningocele.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
3 mm thick T1 Weighted coronal images.

OBSERVATION :

There is an open sacral canal from the L5 level downwards .

There is outpouching of the thecal sac at the L5 level extending upto the surface of the skin and would represent a meningocele. There is tethering of the spinal cord at the L4-L5 level which appears to be tethered to a neural placode at the L4 level. There is a suspicious hypointense area within the spinal cord at the L3 and L4 vertebral levels suggestive of a syrinx.

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

The brain was screened with 5 mm thick T1 Weighted sagittal images and T2 Weighted axial images which shows severe dilatation of both the lateral and third ventricles. The fourth ventricle appears normal. There is resultant thinning of the corpus callosum. There is beaking of the tectal plate.

IMPRESSION :

The MRI features are suggestive of spinal dysraphism with meningomyelocele and tethering of the spinal cord with hydrocephalus and beaking of the tectal plate.

The diagnosis of a Chiari malformation should be considered.

ke/bv
Date : 00.00.00

Name of the Patient : Abc XyzK. lmn / F / 70 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to BUE with paresthesias and weakness of BLE since 4-5 years.

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 :

The cervical intervertebral discs show loss of water content.

The joints of Luschka on the left side at the C6-C7 level shows mild degenerative
changes with narrowing of the left neural foramen. Degenerative changes are also seen in the joints of Luschka at the C3-C4, C4-C5 and C5-C6 levels on the left side.

Focal fatty changes are noted in the upper cervical vertebral bodies.

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

The cervical spinal cord reveals normal signal intensity.

The clivus is more horizontally placed as compared to normal.

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

Subcentimeter and approximately 1.0 cms lymphnodes are visualizsed in the anterior and posterior triangles of the neck deep to the sternomastoid muscle.

IMPRESSION :

Mild degenerative changes of the joints of Luschka on the left side at the C3-C4, C4-C5, C5-C6 and C6-C7 levels.

ke/bv
Date : 00.00.00

Name of the Patient : Abc XyzK. Bholmn / M / 32 yrs.
Referred by : Dr. Abc Xyzatil.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O bilateral ptosis with difficulty in speech, giddiness and headaches since 11-12 days.

EXAMINATION :

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

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

OBSERVATION :

There are hyperintense areas on the T2 Weighted and FLAIR images in the occipital lobes and the cerebellar hemispheres bilaterally. Similar areas are also noted in the left thalamus and in the midbrain. These would represent areas of ischemia/infarction.

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 narrowing of the posterior cerebral artery on the left side. This could be due to ? vasculitis. (Film II, marked on new data).

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 right 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.
...2/..








- 2 -


IMPRESSION :

1. Altered signal in the occipital lobes, the cerebellar hemispheres bilaterally, in the left thalamus and in the midbrain would represent areas of ischemia/infarction.

2. Narrowing of the posterior cerebral artery on the left side with irregular outline may be due to ? vasculitis.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyz Jamalulmn / F / 64 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

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

OBSERVATION :

There is sacralization of the L5 vertebra and the L2 vertebral body is as marked on the film. Correlation with plain radiographs would be worthwhile.

The D12-L1, L1-L2 and L2-L3 intervertebral discs show loss of water content.

A small, right paracentral disc herniation is seen at the L1-L2 level with mild antero-lateral indentation of the thecal sac.

The left L5 nerve root appears to be of larger calibre A ? baggy nerve root sleeve ?? inflammation.

A small posterior disc bulge is identified at the L4-L5 level.

The remaining intervertebral discs show normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable. The lumbar vertebral bodies show spotty fatty changes suggestive of osteoporosis.

The conus medullaris terminates at the D12-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 :

19.0 mm at L1-L2
19.0 mm at L2-L3
...2/..







- 2 -

18.0 mm at L3-L4

15.0 mm at L4-L5

11.0 mm at L5-S1.

IMPRESSION :

1. Probable sacralization of the L5 vertebra. Correlation with plain radiographs would be worthwhile.

2. A small, right paracentral disc herniation at the L1-L2 level.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzi K. Vanlmn / F / 38 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

C/O pain in abdomen with black motions (on & off) since 2 1/2 months.

EXAMINATION :

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

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

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

5 mm thick T1 Weighted coronal images.

OBSERVATION :

A small, intermediate well-circumscribed area is seen at the region of the external os in the
cervix on the T1 Weighted images which is seen to turn hyperintense on the T2 Weighted images and would represent a Nabothian cyst.

The urinary bladder appears normal. There is no mass lesion identified on this study.

The ischio-rectal fossae on either side appear normal.

There are no abnormally enlarged pelvic lymph nodes identified. No obvious vascular anomaly is noted. There is no free fluid in th pelvis.

IMPRESSION :

The MRI features are suggestive of a small Nabothian cyst at the region of the external os in the cervix.