sb/ke
/11 Date : 00.00.00

Name of the Patient : Abc Xyzal J. Jobanplmn / M / 73 yrs.
Referred by : Dr. Abc Xyzna.
Examination : M.R.I. of the Chest and Chest Wall.

CLINICAL PROFILE :

C/O swelling/nodule along the lateral margin of the left breast/pectoral region.

EXAMINATION :

M.R.I of the chest and chestwall was performed using the following parameters :

8 mm thick T1 Weighted and T2 Weighted axial images.

4 mm thick T1 Weighted and T2 Weighted sagittal and coronal images.

4 mm thick STIR axial images.

OBSERVATION :

There is seen an approximately 1.7 x 1.0 x 2.0 cms sized well-defined, intermediate signal intensity mass lesion on the T1 Weighted images in the supero-lateral quadrant of the left breast just postero-lateral to the left nipple. This lesion appears hyperintense on the T2 Weighted and STIR images. The subareolar tissue also shows similar signal intensity characteristics. There is no obvious involvement of the left pectoral muscles. The subcutaneous fat does not show evidence of streaking. No obvious abnormally enlarged left axillary lymph nodes are noted.

The visualized right breast region is unremarkable.

No obvious mediastinal mass lesion or mediastinal lymph nodal enlargement is identified.

IMPRESSION :

Mass lesion in the supero-lateral quadrant of the left breast with thickening of the subareolar tissue as described is not specific a single etiology. A malignant lesion should be ruled out.

There is no chest wall involvement or axillary lymph nodal enlargement identified.

Date : 00.00.00

Name of the Patient : Abc Xyzray Tatlmn / M / 65 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O paresthesias in BUE on 00.00.00 from which patient has recovered.
Now C/O slight weakness in BLE.

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 multiple, lacunar infarcts in the right periatrial region, thalami, lentiform nuclei, corona radiata and centrum semiovale bilaterally. Hyperintense signal on the T2 Weighted and FLAIR images around the lacunar infarcts would represent gliotic changes.

Hyperintense signal on the T2 Weighted and FLAIR images is also noted in the right posterior parietal subcortical white matter, corona radiata and in the posterior parietal periventricular white matter bilaterally which also represents ischemic changes.

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

The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Incidentally noted is a hypoplastic inferior cerebellar vermis.

A polyp is noted in the left maxillary antrum.
...2/..









00009
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IMPRESSION :

1 Lacunar infarcts in the right periatrial region, thalami, lentiform nuclei, corona radiata and centrum semiovale bilaterally with perilesional gliotic changes.

2. Altered signal in the right posterior parietal subcortical white matter, corona
radiata and in the posterior parietal periventricular white matter bilaterally represents ischemic changes.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 24 yrs.
Referred by : Dr. Abc Xyz Chauhan.
Examination : Intracranial M.R.A. and M.R.V.

CLINICAL PROFILE :

C/O headaches with inability to bend neck downwards.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images.
5 mm thick T1Weighted and T2 Weighted sagittal images.
Intracranial MRA and MRV was performed using 3D TOF and 2D TOF sequences respectively.

OBSERVATION :

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

The ventricular system and basal cisternal spaces are unremarkable. There is no midline shift.

Incidentally noted is a convex superior margin of the pituitary gland which may be normal for the patients age.

Linear intermediate signal is seen in the spinal canal at the C2 and C3 levels on the T1
Weighted images and is seen to turn hyperintense on the T2 Weighted images. This may represents blood. Further evaluation would be worthwhile to look for the cause of haemorrhage within the spinal canal.

INTRACRANIAL MRA :

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. The posterior cerebral artery is seen to be prominent and continuous as the posterior communicating artery on the left side.

No obvious aneurysm or vascular malformation is identified.
...2/..








00008
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INTRACRANIAL MRV :

The left transverse and sigmoid sinuses appear hypoplastic. The rest of the dural venous sinuses are well visualized. The deep venous structures are also well identified. There is no evidence of venous sinus thrombosis on this study.

IMPRESSION :

Probable haemorrhage in the spinal canal at the C2 and C3 levels and need further evaluation.

Date : 00.00.00

Name of the Patient : Abc XyzS. Paralmn / F / 7 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O momentary paresthesias in the RUE and RLE since 2 years.

EXAMINATION :

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

5 mm thick T2 Weighted and FLAIR axial images.

After administration of contrast, the following parameters were used :

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

OBSERVATION :

There is still seen volume loss in the left frontal region with a hyperintense signal on the T2 Weighted images along the left inferior and frontal cortex.

After administration of contrast, vascular structures in the sulcal spaces are prominent predominantly in the left fronto-temporo-parietal region as compared to the right. These may be due to slow flow/stagnation of contrast.

No other focal or diffuse area of abnormal enhancement is noted in the brain parenchyma or the meninges.

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

Inflammatory changes are noted in the paranasal sinuses.

IMPRESSION :

Prominent vascular structures in the sulcal spaces predominantly in the left fronto-temporo- parietal region may be due to slow flow/stagnation of contrast.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz W. Salmn / F / 6 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with seizures since 00.00.00. 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 abnormal area of altered signal intensity within the brain parenchyma. Hyperintense areas on the T2 Weighted images in the posterior parietal region (scans 103.14, 103.15) represent terminal areas of myelination.

The posterior head and body of the right hippocampus shows decreased volume with a prominent
temporal horn as compared to the opposite side. There is however no change in signal intensity
(scans 106.9-11, 107.9-11).

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 inflammatory changes in the left maxillary sinus, left mastoid air cells and enlarged adenoids.

IMPRESSION :

Decrease in volume of the right hippocampus without appreciable change in signal
intensity.

Right hippocampal sclerosis should be excluded.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz D. lmn / M / 38 yrs.
Referred by : Dr. Abc Xyzpital.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in both hip joints (left more than right).

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 Proton density sagittal images.

OBSERVATION :

There is loss of normal contour of the femoral heads on either side.

There is an ill-defined, hypointense signal on the T1 Weighted images in the head of the left femur. This lesion remains hypointense on the T2 Weighted and STIR images and represents sclerosis. This lesion is well demarcated from the neck of the left femur and represents Class D avascular necrosis of the femoral head. The left femoral neck shows an ill-defined hyperintense signal on the T2 Weighted and STIR images suggesting bone edema. The articular cartilage overlying the left femoral head is not well-defined. Marginal osteophytes are noted around the left acetabulum which is otherwise unremarkable. There is a small left hip joint effusion with probable synovial thickening around the left hip joint. Slight decrease in bulk of the muscles around the left hip joint is noted, when compared to the right.

There is an ill-defined, heterogeneous signal in the right femoral head which is hypointense and hyperintense to normal marrow on the T1 Weighted and T2 Weighted images. This suggests Class
B/Class C avascular necrosis of the right femoral head. The right femoral neck shows an ill-defined hyperintense signal on the T2 Weighted and STIR images suggesting bone edema. The articular cartilage overlying the right femoral head is not well-defined. Marginal osteophytes are noted around the right acetabulum which is otherwise unremarkable. There is a small right hip joint effusion with probable synovial thickening around the right hip joint.
00005
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IMPRESSION :

1. Class D avascular necrosis of the left femoral head.

2. Class B/Class C avascular necrosis of the right femoral head.

sb/bv Date : 00.00.00

Name of the Patient : Abc Xyzo V. Tlmn / M / 46 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the left hip joint.
H/O steroids intake for 10 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 images.

5 mm thick Proton density sagittal images.

OBSERVATION :

There is loss of normal contour of the left femoral head.

There is an ill-defined, predominantly hypointense intermediate signal intensity lesion on the T1 Weighted images in the anterior and superior quadrants of the head of the left femur. This lesion appears predominantly hyperintense on the T2 Weighted and STIR images. This lesion is well demarcated from the neck of the left femur and represents Class B/C avascular necrosis of the femoral head. The double line sign is well-identified in the left femoral head. The left femoral neck shows an ill-defined hyperintense signal on the T2 Weighted and STIR images suggesting bone edema. The articular cartilage overlying the left femoral head is not well-defined. The left acetabulum is unremarkable. There is a small left hip joint effusion. Slight decrease in bulk of the muscles around the left hip joint is noted, when compared to the right.

The visualized right hip joint is unremarkable except for minimal fluid in the right hip joint.
.
IMPRESSION :

The MRI featrures are suggestive of Class B/C avascular necrosis of the left femoral head.

Date : 00.00.00

Name of the Patient : Abc XyzBalmn / F / 29 yrs.
Referred by : Dr. Abc Xyzo / Dr. Abc Xyzhah.
Examination : M.R.I. of the Sella and Perisellar Region.

CLINICAL PROFILE :

Known C/O pituitary microadenoma.
For follow up.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.

3 mm thick T1 Weighted sagittal images.

After administration of contrast, 3 mm thick T1 Weighted sagittal and coronal images were obtained. 3 mm thick T1 Weighted delayed sagittal images were also obtained.

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted axial images (after contrast administration).

OBSERVATION :

There is seen a very small, subcentimeter non-enhancing lesion in the anterior pituitary gland along the floor of the sella, in the midline (scans 106.3, 106.4, 109.3, 109.4, 107.6). This lesion is not well-appreciated on the unenhanced T1 Weighted and T2 Weighted images of the pituitary gland.

The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. The pituitary stalk is in the midline. The hypothalamus is unremarkable.





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The suprasellar cistern and the cavernous sinuses are unremarkable on either side.

There is no significant abnormality detected in the brain parenchyma. The ventricular system is unremarkable.

There is no other area of abnormal enhancement in the brain parenchyma or the meninges.

Polyps/mucus retention cysts are noted in the maxillary sinuses bilaterally.

IMPRESSION :

A very small, subcentimeter non-enhancing lesion in the anterior pituitary gland along the floor of the sella, in the midline as described most likely represents a residual pituitary microadenoma.

As compared to the previous MRI dated 00.00.00, there is slight reduction in the size of the lesion.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzg lmn / M / 52 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O increased blood pressure with tremors on the left side of body on the morning of 00.00.00.
No complains at present.

EXAMINATION :

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

OBSERVATION :

INTRACRANIAL MRA :

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 posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

There is flattening of the left carotid bulb. A filling defect is noted along the posterior wall of the proximal segment of the left internal carotid artery, just distal to the left common carotid bifurcation, for a distance of about 1.0 cm. This most likely represents an atheromatous plaque. There is however, no significant stenosis of the vessel noted.

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

IMPRESSION :

1. No significant abnormality is detected within intracranial MRA on this study.

2. An atheromatous plaque along the posterior wall of the proximal left internal carotid artery just distal to its bifurcation without stenosis.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzi Rlmn / M / 63 yrs.
Referred by : Dr. Abc Xyzdhia.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O left hemiparesis on 00.00.00 which has recovered partially.
Now C/O mild weakness of the LUE since then.
Known DM/HT (recently diagnosed).

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 a small bright focus on the proton, T2 Weighted and FLAIR images in the right thalamus laterally. This lesion appears iso to hypointense to normal gray matter on the T1 Weighted images and most likely represents an ischemic focus (scans 102.11, 102.12, 104.11, 104.12, 105.10, 105.9).

Smaller ischemic foci are also noted in the left frontal region and right frontal region (scans 105.11, 105.16).

A lacunar infarct is also noted in the right thalamus.

Prominent perivascular spaces are noted in the centrum semiovale bilaterally.

There is mild dilatation of both the lateral and the third ventricles. The fourth ventricle is 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 sphenoid sinus on the left and in the maxillary sinuses and ethmoidal air cells bilaterally.

IMPRESSION :

1. Altered signal in the right thalamus laterally most likely represents an ischemic focus.
2. A lacunar infarct in the right thalamus.