Date : 00.00.00

Name of the Patient : Abc Xyzdra Thalmn / M / 41 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

C/O lower abdominal pain since 1 year.

EXAMINATION :

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

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

6 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

Bilateral small hydrocoeles of the tunica vaginalis are noted.

The urinary bladder appears normal. There is no prostatic enlargement noted. 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.

The L5-S1 disc shows loss of water content. A small posterior disc herniation is seen at this level.

IMPRESSION :

Bilateral small hydrocoeles of the tunica vaginalis.

No other significant abnormality detected on this study.

Date : 00.00.00

Name of the Patient : Abc Xyzbhai R. Plmn / M / 75 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Lumbo-sacral Spine & Sacro-iliac Joints.

CLINICAL PROFILE :

C/O backache radiating to BLE since 1 month which has increased since 1 week.

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.

The sacro-iliac joint was scanned with 5 mm thick T1 Weighted axial images and 5 mm thick STIR coronal images.

OBSERVATION :

There is collapse of the L1 vertebral body. There is replacement of the normal marrow of L1 by the hypointense areas on the T1 Weighted images which is seen to turn heterogenously hyperintense on the T2 Weighted images. There is slight bulge of the vertebral body with pre and paravertebral soft tissues with breach in the posterior and superior cortex.. A small anterior epidural extension is also noted.

Hypointense areas are also noted within the L3, L4, L5, S1, S2 and the S4 vertebral bodies on the T1 Weighted images. Similar areas are seen in the right pedicle and the transverse process of the D5 vertebra, both the sacral ala and the iliac bones. Subtle hyperintense signal is noted on the STIR images in the left gluteal muscle with break in the cortex of the left iliac bone.

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

The prostate appears to be enlarged.

A cystic area is seen within the left kidney ? cortical cyst.
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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 :

18.0 mm at L1-L2

19.0 mm at L2-L3

16.0 mm at L3-L4

13.0 mm at L4-L5

13.0 mm at L5-S1.

The cervico-dorsal spine was screened with 5 mm thick T1 Weighted sagittal images
which shows slight degenerative changes in the cervical region and Schmorls nodes at the D6-D7 and D7-D8 levels. A hemangioma is seen in the D7 vertebral body.

IMPRESSION :

The MRI features are suggestive of altered signal of the L1, L3, L4, L5, S1, S2 and S4 vertebral bodies with extensions as described. There is also involvement of the
right pedicle and the transverse process of the D5 vertebra, both the sacral ala and the iliac bones and left gluteal muscle by the pathology. These most likely represent metastasis.

In view of the enlarged prostate, a prostatic carcinoma with metastasis may be considered as a likely possibility.

Date : 00.00.00

Name of the Patient : Abc Xyz Salmn / M / 26 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O pontine astrocytoma. Received 30 cycles of Radiotherapy.
Headaches, diplopia and ataxia still persist.

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.

5 mm thick T1 Weighted and T2 Weighted sagittal images.

OBSERVATION :

There is an ill-defined, hypointense area in the pons on the T1 Weighted images which is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. Superiorly this lesion is seen to extend upto the tectum and the lower mid-brain, more on the left side. Inferiorly, the medulla is also involved. There is extension into the middle cerebellar peduncles, bilaterally, left more than right. Slight involvement of the left cerebellar hemisphere is also seen. There is mass effect with compression of the fourth ventricle as well as the foramen of Luschka and Magendie.

There is resultant mild dilatation of both the lateral and the third ventricles with periventricular CSF ooze.

There is beaking of the cerebellar tonsils with herniation and the tip is seen to lie below the foramen magnum level.

The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.
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IMPRESSION :

The MRI features are suggestive of an ill-defined mass lesion in the pons extending superiorly into the tectum and the lower mid-brain on the left side and inferiorly, into the medulla with mass effect as described. This most likely represent a neoplastic process like an astrocytoma. There is mild obstructive hydrocephalus.

Previous investigations were not available for comparison.

Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 52 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 4 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 a diffuse posterior disc herniation at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. There is mild indentation on the foraminal portion of the exiting L4 nerve roots. Bilateral far lateral (extraforaminal) disc herniations are also noted at this level, left more than right with mild indentation on the extraforaminal portion of the left exiting L4 nerve root. The L4-L5 facet joints show mild degenerative changes.

There is a left postero-lateral and left far lateral (extraforaminal) disc herniation at the L3-L4 level with left neural foraminal narrowing and indentation on the foraminal and extraforaminal portion of the exiting left L3 nerve root. A right far lateral (extraforaminal) disc herniation is seen to indent the extraforaminal portion of the exiting right L3 nerve root at this level.

There appears to be a lesion which is isointense to fat in the posterior epidural space at the L4 and L5 vertebral levels with slight remodelling of the posterior appendages of the L4 and L5 vertebrae. This may represent an epidural lipoma/epidural lipomatosis.

Schmorls node is seen in the superior aspect of the L1 vertebral body. The L3-L4 and L4-L5 intervertebral discs show loss of water content.

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.
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00007
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The conus medullaris terminates at the L1-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 :

17.0 mm at L1-L2

15.0 mm at L2-L3

15.0 mm at L3-L4

16.0 mm at L4-L5

12.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A diffuse posterior disc herniation at the L4-L5 level with mild indentation on the foraminal portion of the exiting L4 nerve roots.

2. Bilateral far lateral (extraforaminal) disc herniations at the L4-L5 level, left more than right with mild indentation on the extraforaminal portion of the exiting left L4 nerve root and mild facetal arthropathy at this level.

3. A left postero-lateral and left far lateral (extraforaminal) disc herniation at the L3-L4 level indenting the foraminal and extraforaminal portion of the exiting left L3 nerve root.

4. A right far lateral (extraforaminal) disc herniation indenting the extraforaminal portion of the exiting right L3 nerve root at L3-L4 level.

5. A lesion within the posterior epidural space at the L4 and L5 vertebral levels
which may represent an epidural lipoma/epidural lipomatosis.

Date : 00.00.00

Name of the Patient : Abc XyzK. lmn / F / 2 yrs.
Referred by : Dr. Abc Xyzmath.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tremors of the whole body with gait ataxia since 15 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There are hyperintense areas on the proton and T2 Weighted images in the periatrial deep white matter bilaterally and would represent terminal areas of myelination.

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

Incidental note is made of enlarged adenoids and a Thornwaldts cyst.

IMPRESSION :

No significant abnormality is detected within the brian on this study,

Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 35 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 20-22 days with ? bladder incontinence since 2 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 loss of water content of the L4-L5 and L5-S1 intervertebral discs.

There is a postero-central disc herniation with peridiscal osteophytes at the L5-S1 level, indenting the dural theca anteriorly.

There is a postero-central and left paracentral disc herniation with peridiscal osteophytes at the L4-L5 level with indentation on the traversing left L5 nerve root.

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 uterus is retroverted and shows a fibroid in the visualized myometrium. Further evaluation (e.g. with sonograpy).

The conus medullaris terminates at the D12-L1 level and the thecal sac terminates at the S2 level.


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

18.0 mm at L1-L2

18.0 mm at L2-L3

16.0 mm at L3-L4

10.0 mm at L4-L5

9.0 mm at L5-S1.

IMPRESSION :

Degenerated L4-L5 and L5-S1 discs with :

1. A postero-central disc herniation with peridiscal osteophytes at the L5-S1 level.

2. A postero-central and left paracentral disc herniation with peridiscal osteophytes at the L4-L5 level.

Date : 00.00.00

Name of the Patient : Abc Xyzo D. Kaslmn / M / 70 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O radicular pain in the LUE and LLE with paresthesias since 1 month. Also C/O loss of weight and appetite.
H/O pulmonary kochs (detected 2 days back).

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.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is replacement of normal marrow of the D1 vertebral body by hypointense areas on the T1 Weighted images. The left pedicle also appears to be involved by the pathology. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. There is slight anterior and left lateral epidural extension with encroachment into the D1-D2 neural foramen on the left side. Mild left paravertebral soft tissue lesion is noted.

Bilateral pleural effusions are seen, left more than right .

There is slight forward subluxation of the D2 over the D3 vertebrae. Posterior disc bulges are seen at the D2-D3 and D3-D4 levels.

The cervico-dorsal intervertebral discs show loss of water content.

Diffuse fatty changes are noted in the rest of the visualized dorsal vertebral bodies.

A hemangioma with fatty content is seen in the D5 vertebral body.
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The visualized cervico-dorsal spinal cord reveals normal signal intensity.

IMPRESSION :

The MRI features are suggestive of altered signal of the D1 vertebral body with involvement of the left pedicle and extensions as described is most probably due to a granulomatous infective process like tuberculosis.

The possibility of a neoplastic process like a small cell tumor or metastasis cannot be ruled out.

.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzyam lmn / M / 32 yrs.
Referred by : Dr. Abc Xyzarwal.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

Operated for right sided body tumor on 00.00.00.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images and 3 mm thick FLAIR coronal 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 and FLAIR images along the gyri in the right temporo-parietal region, along the distribution of the right middle cerebral artery. This lesion appears hypointense on the T1 Weighted images. There is resultant effacement of the sulcal spaces in the right temporo-parietal region with indentation on the right lateral and third ventricle and mild shift of the midline structures to the left. Distortion of the upper brainstem axis is also noted.

The left lateral and the fourth ventricles are normal.

Inflammatory changes are noted in the left maxillary sinus.

INTRACRANIAL MRA :

There is non-visualization of the petrous, cavernous and supraclinoid segment of the right internal carotid artery. Faint visualization of the right middle cerebral artery and some of its Sylvian branches are noted.

The petrous, cavernous and supraclinoid segments of the left internal carotid artery show normal signal and calibre. The visualized anterior cerebral, left middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
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00003
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NECK MRA :

There is non-visualization of the entire right common carotid artery and the right external and internal carotid arteries. The right vertebral artery is unremarkable. The left common carotid artery and its bifurcation and the left vertebral artery are also unremarkable. There is no vessel wall irregularity of the visualized vessels.

IMPRESSION :

1. Altered signal in the right temporo-parietal cortex represents a recent cortical infarct .

2. Non-visualization of the right common carotid artery and the right internal and external carotid arteries with faint visualization of the right middle cerebral artery and some of its Sylvian branches.

Date : 00.00.00

Name of the Patient : Abc Xyzsh Blmn / M / 31 yrs.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches since 3-4 years which has increased since 1 week.

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.

5 mm thick T1 Weighted sagittal images.

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.

A polyp/mucus retention cyst is noted in the left maxillary antrum.

IMPRESSION :

Normal study of the Brain.

Date : 00.00.00

Name of the Patient : Abc Xyz Dhlmn / F / 62 yrs.
Referred by : Dr. Abc Xyz. Desai.
Examination : M.R.I. of the Right Shoulder.

CLINICAL PROFILE :

H/O fall on 00.00.00.
C/O pain and limitation of joint movement.

EXAMINATION :

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

4 mm thick T1 Weighted axial images and 5 mm thick GRASS axial images.

4 mm thick T1 Weighted sagittal images.

4 mm thick T1 Weighted, Proton and T2 Weighted coronal images.

OBSERVATION :

There are mottled hypointense areas in the acromion process on the T1 Weighted images which are seen to turn hyperintense on the T2 Weighted and GRASS images. However there is no obvious fracture noted.

The head of the right humerus shows normal contour and the head and upper shaft of the right humerus show normal signal intensity. The visualized scapula appears normal. The glenoid labrum is unremarkable. The biceps tendon in the biciptical groove shows normal signal intensity.

The articular cartilage of the head of the right humerus appears normal. There is no joint effusion.

The tendinous insertion of the supraspinatous muscle shows normal signal intensity. There is no evidence of fluid in the subdeltoid bursa. There is no evidence of a tear of the supraspinatous muscle.

The soft tissues around the right shoulder joint, posteriorly, show a hyperintense signal on the T2 Weighted images suggesting soft tissue injury..
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There is no bone erosion or destruction seen.

The visualized axilla is unremarkable.

An osteophyte is noted along the inferior margin of the acromio-clavicular joint.

IMPRESSION :

1. Bone edema/bruise in the acromion process of the right shoulder.

2. Soft tissue injury around the right shoulder , more so superiorly and posteriorly.

3. An osteophyte along the inferior margin of the acromio-clavicular joint.