A Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 5 yrs.
Referred by : Dr. Abc Xyzhalani.
Examination : M.R.I. of the Brain & Sella.

CLINICAL PROFILE :

C/O precocius menarche. No axillary or genital hair growth.
USG s/o B/L bulky ovaries with follicles.
X-rays of Wrist s/o advanced bone age.
Clitoromegaly +.

EXAMINATION :

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

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

After administration of contrast, 3 mm thick T1 Weighted sagittal and coronal images through the sella and 4 mm thick T1 Weighted axial images through the brain were obtained. Delayed 3 mm thick T1 Weighted sagittal images through the sella were also obtained.

OBSERVATION :

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

Both the lateral and the third ventricles appear chinky. 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.

Hyperintense foci on T2 Weighted images in the right frontal white matter most likely represents prominent perivascular spaces.

There is no focal mass lesion identified in the pituitary gland. The posterior pituitary gland shows a normal hyperintense signal on the T1 Weighted images. The pituitary stalk is in midline. The perisellar region and the cavernous sinuses are unremarkable on either side.

00000A

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

Inflammatory changes are noted in the paranasal sinuses and the right mastoid air cells and enlarged adenoids.

IMPRESSION :

Normal study of the brain, sella and the perisellar region.

Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 5 yrs.
Referred by : Dr. Abc Xyzhalani.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

C/O precocius menarche. No axillary or genital hair growth.
USG shows B/L bulky ovaries with follicles.
X-rays of Wrist s/o advanced bone age.
Clitoromegaly +.

EXAMINATION :

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

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

OBSERVATION :

A small, subcentimeter, follicle is noted in the left ovary. Both the ovaries on either side are otherwise unremarkable.

The uterus is normal in size and signal characteristics for the patients age. No adnexal mass lesion is identified.

Urinary bladder shows normal wall thickness. The ischio-rectal fossae on either side appear normal.

There are no abnormally enlarged pelvic lymphnodes noted. There is no free fluid in the pelvis.

Hyperintense signal in the left gluteal region on the T2 Weighted images is probably due to intramuscular injection.

IMPRESSION :

A small, subcentimeter follicle in the left ovary.

No other significant abnormality is detected on this study.

Date : 00.00.00

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

CLINICAL PROFILE :

C/O backache radiating to the RLE since 2 months.
H/O fall.

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 marked loss of water content of the L4-L5 and L5-S1 intervertebral discs and slight loss of water content of all the lumbar intervertebral discs.

There is a posteriorly bulging disc with posterior peridiscal osteophytes at the L5-S1 level with slight bilateral neural foraminal narrowing more so on the right side. The right facet joint at the L5-S1 level appears slightly hypertrophied.

A posterior disc bulge with peridiscal osteophytes is noted at the L4-L5 level with slight left neural foraminal narrowing.

Type I degenerative marrow changes (hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images) are noted in the L5 vertebral body adjacent to the L5-S1 intervertebral disc. Schmorls node is noted along the inferior margin of the L4 vertebral body.

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.

The conus medullaris terminates at the L2 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

18.0 mm at L3-L4

13.0 mm at L4-L5

12.0 mm at L5-S1.

IMPRESSION :

1. A posteriorly bulging disc with posterior peridiscal osteophytes at the L5-S1 level with slight bilateral neural foraminal narrowing more so on the right side. The right facet joint at the L5-S1 level appears slightly hypertrophied.

2. A posterior disc bulge with peridiscal osteophytes at the L4-L5 level.

Date : 00.00.00

Name of the Patient : Abc Xyz H. lmn / M / 38 yrs.
Referred by : Dr. Abc Xyz Kothari / Dr. Abc Xyzhah.
Examination : M.R.I. of the Left Tibia.

CLINICAL PROFILE :

C/O pain in the left leg below knee since 4-5 years which has increased since 15 days.

EXAMINATION :

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

4 mm thick T1 Weighted and GRASS sagittal images.

4 mm thick T1 Weighted and STIR coronal images.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There appears to be a horizontal fracture line through the upper one third of the left tibia involving the tibial condyles. There are ill-defined hypointense areas around the fracture line on the T1 Weighted images. These are seen to turn hyperintense on the T2 Weighted, STIR and GRASS images. Subtle hyperintense signal is also noted in the adjacent soft tissue.

A hypointense area is seen in the medial condyle of the left femur adjacent to the articular surface, on the T1 Weighted images which is seen to turn hyperintense on the GRASS and STIR images and may represent osteochondritis dessicans/subchondral cyst.

A curvilinear hyperintense signal is seen in the posterior horn of the medial meniscus
of the left knee joint, reaching upto the inferior articular surface on all the pulse sequences and would represent Grade III meniscal signal (meniscal tear). A minimal effusion is seen in the left knee joint.

The left leg was screened with 5 mm thick T1 Weighted coronal images which shows curvilinear hypointense signal at the midshaft level which would represent a vessel.

00008
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IMPRESSION :

1. A horizontal fracture line through the upper one third of the left tibia involving the tibial condyles with altered signal which may represent bone bruise/edema. A pathological fracture should be ruled out.

2. Altered signal in the medial condyle adjacent to the articular surface of the left femur may represent osteochondritis dessicans/subchondral cyst.

3. Altered signal in the posterior horn of the meidal meniscus of the left knee joint reaching upto the inferior articular surface would represent Grade III meniscal signal (meniscal tear) (horizontal flap tear).

Date : 00.00.00

Name of the Patient : Abc Xyzieve Dclmn / F / 74 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O low back pain with radiation to the RLE and paresthesias since 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 scoliosis of the dorso-lumbar spine with convexity to the right.

There is reduction in height of the L5-S1 intervertebral disc and loss of water content of the lumbar intervertebral discs.

A posterior disc bulge with posterior peridiscal osteophyte is noted at the L5-S1 level with bilateral neural foraminal narrowing, more on the right.

A diffuse posterior disc bulge is noted at the L4-L5 level with right neural foraminal narrowing and indentation on the extraforaminal segment of the right L4 nerve root.

A posterior and left far lateral disc bulge is noted at the L3-L4 level.

A posterior disc herniation with peridiscal osteophyte is noted at the L2-L3 level. A left far lateral disc herniation is also noted at this level.

A right far lateral disc bulge with peridiscal osteophyte is noted at the L1-L2 level with slight right neural foraminal narrowing.


00007
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The right facet joints at the L4-L5 and L5-S1 levels appear slightly hypertrophied.

The rest of the lumbar vertebral bodies show spotty fatty marrow changes. 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 :

16.0 mm at L1-L2

15.0 mm at L2-L3

14.0 mm at L3-L4

12.0 mm at L4-L5

7.0 mm at L5-S1.

IMPRESSION :

1. A posterior disc bulge with posterior peridiscal osteophyte at the L5-S1 level with bilateral neural foraminal narrowing.

2. A diffuse posterior disc bulge at the L4-L5 level with indentation on the extraforaminal segment of the right L4 nerve root.

3. A posterior and left far lateral disc bulge at the L3-L4 level.

4. A posterior disc herniation with peridiscal osteophyte at the L2-L3 level with a left far lateral disc herniation at this level.

5. A right far lateral disc bulge with peridiscal osteophyte at the L1-L2 level with
6. Spotty fatty marrow changes in the lumbar vertebrae suggests osteoporotic changes.

Date : 00.00.00

Name of the Patient : Abc Xyzsh Bhulmn / M / 28 yrs.
Referred by : Dr. Abc Xyzatt.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 00.00.00. Last episode on 00.00.00. Treated for cysticercus.

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, T2 Weighted and FLAIR coronal images.

OBSERVATION :

There is seen an approximately 1.4 x 1.6 cms sized, well-marginated intermediate signal intensity mass lesion on the T1 Weighted images in the right fronto-parietal cortex. This lesion turns appreciably hypointense on the T2 Weighted and FLAIR images with a peripheral hyperintense rim. There is perilesional edema with effacement of the sucal spaces and minimal indentation on the right lateral ventricle.

The left lateral , third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midlinse structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

An approximately 1.4 x 1.6 cms sized, lesion in the right fronto-parietal cortex follows the signal characteristics of a tuberculoma.

As compared to the previous MRI (study no. 0000) dated 00.00.00, there is an increase in the size of the lesion and the perilesional edema.

Date : 18.02..99

Name of the Patient : Abc Xyza S. Mlmn / F / 68 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backche radiaitng to BLE with paresthesias (right more than left).
H/O spine surgery 16 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 are post-operative changes in the posterior soft tissues over the L2 to the S1 levels with laminectomy of the L3, L4, L5 and S1 vertebrae and partial laminectomy of the L2 vertebra.

There is forward subluxation of the L3 over the L4 and of the L4 over the L5 verterbrae and slight retroplacement of the L1 over the L2 vertebrae.

There are diffuse posterior disc herniations at the L3-L4 and L4-L5 levels with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. Also seen is impingement of the exiting L3 and L4 nerve roots at the L3-L4 and L4-L5 levels, respectively.

The L3-L4 and L4-L5 facet joints show hypertrophic degenerative changes with resultant central and lateral canal stenosis.

Far lateral (extraforaminal) disc herniations are seen at the L3-L4, L4-L5 and L5-S1 levels.

Posterior disc bulges are seen at the L1-L2, L2-L3 and L5-S1 levels with anterior indentation of the thecal sac and mild bilateral neural foraminal narrowing. The L2-L3 facet joints show hypertrophic degenerative changes. Mild facetal arthropathy is noted at the L1-L2 level.
..2/.




00005

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There appears to be inflammation of the traversing right L5 nerve root and the traversing left S1 nerve root.

The lumbar intervertebral discs show loss of water content. Hypointense areas are seen within the L3-L4 and L4-L5 intervertebral discs on all the pulse sequencs suggestive of calcium/vacuum phenomena.

The pedicles of the lumbar vertebrae appear to be congenitally short in their antero-posterior dimensions.

Fatty changes are noted in the lumbar vertebrae.

Mild central wedging of the D9 vertebral body is seen with a probable hemangioma in the D10 vertebral body. Posterior disc bulges with peridiscal osteophytes are seen at the D9-D10 and D10-D11 levels.

The visualized pre and paravertebral soft tissues are unremarkable.

The intrathecal nerve roots over the L2 to L5 levels appear thick and appear to be centrally placed and would represent Group I/III arachnoids. The intrathecal nerve roots are peripherally plastered at the L5-S1 and S1 levels suggestive of Group II arachnoids.

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

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. Forward subluxation of the L3 over the L4 and of the L4 over the L5 verterbrae.

3. Diffuse posterior disc herniations at the L3-L4 and L4-L5 levels with impingement of the exiting L3 and L4 nerve roots respectively at these levels .
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00005
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4. Hypertrophic facetal arthropathy at the L3-L4 and L4-L5 levels with
resultant central and lateral canal stenosis.

5. Posterior disc bulges at the L1-L2, L2-L3 and L5-S1 levels with hypertrophic facetal arthropathy at the L2-L3 level.

6. Arachnoiditis over the L2 to S1 levels.

7. Probable inflammation of the traversing right L5 nerve root and the traversing left S1 nerve root.

Date : 00.00.00

Name of the Patient : Abc Xyzv Hundlmn / M / 28 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left retromastoid craniotomy with excision of cerebello-pontine angle tumor (VIIIth nerve schwannoma) on 00.00.00.
C/O tinnitus in the left ear with decreased hearing.
For follow-up.

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 coronal images.

5 mm thick T1 Weighted sagittal images.

MR Cisternogram was obtained in the coronal plane.

OBSERVATION :

There are post-operative changes in the occipital and mastoid region on the left side.

There is widening of the CSF space in the region of the left internal auditory meatus/canal. The seventh and eighth cranial nerve complex is not well-visualized in this region.

Areas which are iso to hyperintense to CSF on all the pulse sequences are noted within the left cerebellar hemisphere. These would represent encephalomalacic changes, probably the result of previous surgery.

Both the lateral and third ventricles show fullness. The fourth ventricle is normal.
There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.


00004

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IMPRESSION :

The MRI features are suggestive of widening of the CSF space in the region of left internal auditory meatus/canal as described.

No obvious residual mass lesion is identified on this non-enhanced study of the internal auditory meatus.

If clinically indicated a contrast enhanced study may be worthwhile.

hs./sb

Name of the Patient : Abc XyzS. lmn / M / 20 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O head injury in October 0000 with weakness of the LUE and LLE. Bifrontal burr holes with evacuation of subdural hygromas was done on 4.11.97 and 00.00.00 with 5 sittings of HBOT.

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 :

Areas of hyperintensity on the proton and FLAIR images are seen along the cortical gray matter in the right temporal and left parieto-occipital lobes. These are most likely the result of previous contusions.

Areas which are near isointense to CSF are seen in the inferior right frontal lobe and left high parietal region. These are surrounded by hyperintense areas on the FLAIR images and which would represent gliotic changes. These would represent areas of cystic encephalomalacia, the result of previous trauma.

There is mild fullness of the third and both the lateral ventricles. There is mild prominence of the basal cisternal spaces and cerebellar folia bilaterally. Mild atrophy of the brainstem is noted.

The fourth ventricle is normal. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are seen within the maxillary sinuses bilaterally.


00003

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IMPRESSION :

The MRI features are suggestive of :

1. Areas of altered signal along the cortical gray matter in the right temporal and left parieto-occipital lobes are most likely the result of cortical contusions.

2. Areas of cystic encephalomalacia in the inferior right frontal lobe and left high parietal region are probably the result of previous trauma.

3. Mild fullness of the third and both the lateral ventricles with prominent cerebellar folia, basal cisternal spaces and mild brainstem atrophy.

Date : 00.00.00

Name of the Patient : Abc XyzThlmn / F / 70 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O radicular pain to the LLE with occasional numbness 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 appears to be sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.

There is mild retroplacement of the L1 over the L2, L2 over the L3 and L3 over the L4 vertebrae.

The lumbar intervertebral discs show loss of water content and the L1-L2, L2-L3, L3-L4 and L4-L5 intervertebral discs are reduced in height.

A postero-central disc herniation is seen to indent the thecal sac at the L4-L5 level.

There are small posterior disc herniations with peridiscal osteophytes indenting the thecal sac and causing mild neural foraminal narrowing bilaterally at the L1-L2, L2-L3 and L3-L4 levels. The foraminal portion of the L2 and L3 nerve roots bilaterally appear impinged.

The pedicles of the lumbar vertebrae are congenitally short in their antero-posterior dimensions. Facetal hypertrophy is noted over the L1-L2 to L4-L5 levels.

The lumbar vertebral bodies show areas of fatty replacement of normal marrow suggestive of osteoporotic changes.
...2/..








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The rest of 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.

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

13.0 mm at L1-L2

11.0 mm at L2-L3

10.0 mm at L3-L4

9.0 mm at L4-L5

10.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra. Please correlate with plain radiographs.

2. A postero-central disc herniation with a tight canal at the L4-L5 level.

3. Small posterior disc herniations with peridiscal osteophytes and a tight canal at the L1-L2, L2-L3 and L3-L4 levels.

4. Facetal hypertrophy over the L1-L2 to L4-L5 levels.

5. Impingement of the foraminal portion of the L2 and L3 nerve roots bilaterally.

6. Congenitally short pedicles of the lumbar vertebrae in their antero-posterior dimensions.