Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 69 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 2 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 scoliosis of the lumbar spine with convexity to the left with clockwise rotation of the mid-lumbar vertebrae.

There is a decrease in the height of the D12 vertebral body. This vertebra appears hypointense on the T1 Weighted images and turns heterogeneously hyperintense on the T2 Weighted images. Linear hypointensities on all the pulse sequences within it would suggest compressed trabeculae. The D12 vertebral body is wedged anteriorly and is seen to bulge posteriorly with indentation upon the cord. There appears to be a break of the superior and inferior cortical endplates of the D12 vertebra.

A postero-central disc herniation with peridiscal osteophytes is seen to indent the thecal sac at the L5-S1 level. A left postero-lateral (foraminal) disc herniation is seen to narrow the left neural foramen and impinge the exiting left L5 nerve root at this level. The left L5-S1 facet joint shows hypertrophic degenerative changes. Also seen is a left far lateral (extraforaminal) disc herniation indenting the extraforaminal portion of the exiting left L5 nerve root at this level.

A posterior disc herniation with peridiscal osteophytes, more to the right of the midline is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level. A right far lateral (extraforaminal) disc herniation is seen to indent the extraforaminal portion of the exiting right L4 nerve root at the L4-L5 level. The L4-L5 facet joints, bilaterally, show hypertrophic degenerative changes. Also seen is ligamentum flavum hypertrophy at this level.
...2/..




- 2 -


A postero-central disc herniation with peridiscal osteophytes is seen to indent the thecal sac at the L3-L4 level. A right postero-lateral (foraminal) disc herniation is seen to narrow the right neural foramen at the L3-L4 level. The right facet joint at this level shows hypertrophic degenerative changes.

The lumbar intervertebral discs show loss of water content. Anterior disc herniations are seen at the L3-L4, L4-L5 and L5-S1 levels.

Schmorls node is seen in the L2 vertebra superiorly.

The lumbar vertebral bodies show areas of fatty replacement of normal marrow suggestive of osteoporotic changes. The cervico-dorsal spine was screened with 5 mm thick T1 Weighted sagittal images and the visualized cervico-dorsal vertebral bodies show similar signal changes.

Posteriorly bulging discs are noted at the D9-D10 and D10-D11 levels.

The visualized pre and paravertebral soft tissues are unremarkable. Incidental note is made of a large extrarenal pelvis on the left side.

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

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

15.0 mm at L1-L2

13.0 mm at L2-L3

13.0 mm at L3-L4

10.0 mm at L4-L5

12.0 mm at L5-S1.
...3/..











- 3 -


IMPRESSION :

The MRI features are suggestive of :

1. Compression fracture of the D12 vertebral body superimposed upon an osteoporotic spine. The possibility of a pathologic fracture seems less likely.

2. Postero-central disc herniations with peridiscal osteophytes at the L3-L4 and L5-S1 levels.

3. A left postero-lateral (foraminal) and left far lateral (extraforaminal) disc herniation at the L5-S1 level.

4. A right postero-lateral (foraminal) disc herniation at the L3-L4 level.

5. A posterior disc herniation with peridiscal osteophytes, more to the right of the midline with bilateral hypertrophic facetal arthropathy and ligamentum flavum hypertrophy with canal stenosis at the L4-L5 level.

6. A right far lateral (extraforaminal) disc herniation at the L4-L5 level.

7. Hypertrophic facetal arthropathy on the left side at the L5-S1 level and on the right side at the L3-L4 level.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyz Bholmn / F / 36 yrs.
Referred by : Dr. Abc Xyz Sampat.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O weakness and wasting of the left arm since 3 years and numbness of the LUE.

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 :

Focal fatty changes are noted in the upper cervical vertebrae with probable hemangioma in the D1 vertebra.

Few cervical intervertebral discs show slight loss of water content.

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

The cervical and the visualized upper dorsal spinal cord reveals normal signal intensity.

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

IMPRESSION :

No significant abnormality is detected on this study.

Date : 00.00.00

Name of the Patient : Abc XyzB. Slmn / F / 50 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden loss of consciousness.

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 Fast Scan (T2 *) coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a fairly large, approximately 5.0 x 6.5 x 4.2 cms sized intermediate signal intensity mass lesion on the T1Weighted images in the right deep temporo-parietal region. This lesion appears heterogeneously hyperintense on the proton, T2 Weighted and Fast Scan (T2 *) images. Focal small, hypointense areas are noted within this lesion on the Fast Scan (T2 *) images. This lesion represents a hyperacute to acute intracerebral hematoma. Fluid level in the occipital horn of the lateral ventricles bilaterally with non-visualization of the fourth ventricle suggests intraventricular extension of the lesion. Peripheral hyperintense signal on the T2 Weighted images represents serum due to clot retraction. There is effacement of the sulcal spaces in the cerebral hemispheres bilaterally with compression of the right lateral and the third ventricle and shift of the midline structures to the left. The cerebellar folia are also effaced with cerebellar tonsilar ectopia. The basal cisternal spaces are also effaced. The lesion is seen to extend into the corona radiata superiorly and into the midbrain on the right inferiorly.

Inflammatory changes are noted in the paranasal sinuses.

IMPRESSION :

An approximately 5.0 x 6.5 x 4.2 cms sized mass lesion in the right deep temporo-parietal region represents a hyperacute to acute intracerebral hematoma. There is resultant significant mass effect with intraventricular extension of the hematoma as described.

Date : 00.00.00

Name of the Patient : Abc Xyzootwlmn / M / 14 yrs.
Referred by : Dr. Abc Xyz. Kapadia.
Examination : M.R.I. of the Left Distal Femur.

CLINICAL PROFILE :

C/O pain above the left knee joint since 1 month.
H/O being hit by a season ball 1 year back.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and GRASS sagittal images.
5 mm thick T1 Weighted and STIR coronal images.
6 mm thick T1 Weighted axial images.

OBSERVATION :

There is a large well-defined mass lesion in the lower one third of the left femur which extends cranially for about 14.5 cms from the left knee joint. There is a clear zone of transition between the lesion and normal marrow. Mixed signal intensity areas are seen in this lesion on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the proton, GRASS and STIR images. There is break in the anterior and posterior cortex with periosteal elevation and spread of the pathology in the adjacent soft tissue. The lesion is predominantly metaphyseal. The epiphysis shows a mottled appearance in the medial and lateral condyle and is hypointense on the T1 Weighted images and turns hyperintense on the proton, STIR and GRASS images suggestive of its involvement.

The left knee joint however appears to be spared.

Effusion is noted within the left knee joint.

The femoral attachment of the anterior and posterior cruciate ligament of the femur is also involved.

IMPRESSION :

The MRI features are suggestive of a mass lesion in the distal metaphysis of the left femur
with its cranio-caudate extension measuring 14.5 cms with involvement of the epiphysis and periosteal extensions as described. This most probably represents an osteogenic sarcoma.

sb/ke
A Date : 00.00.00

Name of the Patient : Abc Xyzhand Dlmn / M / 46 yrs.
Referred by : Dr. Abc Xyzampat / Dr. Abc Xyzmpat.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O wasting of the RLE with loss of sensation over the left sole and foot.
Now C/O paresthesias in the left hand.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

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

OBSERVATION :

There is slight loss of water content of the L3-L4 and L4-L5 intervertebral discs.

The visualized dorso-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 lower dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

IMPRESSION :

No significant abnormality is detected on this study.

Date : 00.00.00

Name of the Patient : Abc Xyzhand Dlmn / M / 46 yrs.
Referred by : Dr. Abc Xyzampat / Dr. Abc Xyzmpat.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O wasting of the RLE with loss of sensation over the left sole and foot.
Now C/O paresthesias in the left hand.
EMG shows no evidence of a peripheral nerve or root lesion in the left upper and both lower limbs.

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 :

There is loss of water content of the cervical intervertebral discs.

There is a posteriorly herniated disc with peridiscal osteophyte at the C5-C6 level indenting the dural theca anteriorly.

Small posterior disc bulges with posterior peridiscal osteophytes are noted at the C2-C3, C3-C4 and C4-C5 levels.

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

The cervical spinal cord reveals normal signal intensity.

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

IMPRESSION :

1. A posteriorly herniated disc with peridiscal osteophyte at the C5-C6 level.

2. Small posterior disc bulges with posterior peridiscal osteophytes at the C2-C3, C3-C4 and C4-C5 levels.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzl D. Nalmn / F / 18 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever with chills, headaches, vomiting, dysarthria and gait imbalance since 15 days.
H/O LP done 8 days back followed by loss of vision bilaterally.

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.
3 mm thick STIR coronal images.

After administration of contrast, the following parameters were used :

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

OBSERVATION :

There is a small hypointense area in the medial aspect of the left temporal lobe on the T1 Weighted images which is seen to remain hypointense on the proton, T2 Weighted and FLAIR images. There is surrounding edema with slight effacement of the adjacent sulci in that region. After administration of contrast, there is rim enhancement of the lesion in the medial aspect of the left medial temporal lobe which measures approximately 2.2 x 1.1 cms.

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

There is mild fullness of both the lateral ventricles. The 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.

IMPRESSION :

The MRI features are suggestive of a granulomatous infective lesion in the medial aspect of the left temporal lobe following the signal characteristics of a tuberculoma.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzrprasad Sultlmn / M / 52 yrs.
Referred by : Dr. Abc Xyzatanpal.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to the RUE with paresthesias since October 0000.
Detected to have tuberculous spine in December in 0000. On AKT since then.

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 :

There is partial collapse of the C5 vertebral body with loss of normal curvature of the cervical spine.

There is replacement of the normal marrow of the C5 vertebral body by hypointense areas on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. There is pre and paravertebral soft tissue extension over the C4 and C5 levels. There is posterior bulging of the C5 vertebral body with an anterior epidural lesion which is of intermediate signal intensity on the T1 Weighted images and turns heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. There is compression upon the spinal cord at the C4-C5 level which shows a subtle hyperintense signal on the Fast Scan (T2 *) images (isointense to normal cord on the T1 Weighted images). There is breach in the superior cortex of the C5 vertebra with involvement of the C4 vertebral body in its inferior aspect as well as the C4-C5 intervertebral disc.

The cervical intervertebral discs show loss of water content.
..2/..










- 2 -


The C2 and C3 vertebral bodies show diffuse fatty changes. The rest of the cervical vertebral bodies show normal signal intensity. The joints of Luschka are unremarkable.

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

Altered signal is also noted in the D1, D2 and D3 vertebral bodies.

The rest of the dorsal spine was screened with 5 mm thick T1 Weighted sagittal images and does not reveal any diagnostic feature of note.

IMPRESSION :

The MRI features are suggestive of partial collapse of the C5 vertebral body with altered signal in the C4, C5, D1, D2 and D3 vertebrae with involvement of the pre and paravertebral soft tissues and cord signal alteration at the C4-C5 level as described. This is most probably due to granulomatous infective process like tuberculosis.

The possibility of this being a neoplastic process or metastasis cannot be entirely ruled out.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzp Halmn / M / 31 yrs.
Referred by : Dr. Abc Xyz Khatri / Dr. Abc Xyzhashur.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 21 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.

3 mm thick T1 Weighted axial images through the L5-S1 level.

OBSERVATION :

There is slight retrolisthesis of the L5 over the S1 vertebra.

There is a postero-central disc herniation with peridiscal osteophyte at the L5-S1 level with anterior indentation of the thecal sac and mild left neural foraminal narrowing. The L5-S1 disc is dessicated. There is mild ligamentum flavum hypertrophy at the L5-S1 level.

The L3-L4 intervertebral disc shows mild loss of water content.

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 S3 level.
...2/..












- 2 -


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

18.0 mm at L1-L2

17.0 mm at L2-L3

15.0 mm at L3-L4

15.0 mm at L4-L5

14.0 mm at L5-S1.

The S. I. joints were screened with 4 mm thick T1 Weighted coronal images and do not reveal any diagnostic feature of note.

IMPRESSION :

1. Slight retrolisthesis of the L5 over the S1 vertebra.

2. A postero-central disc herniation with peridiscal osteophyte at the L5-S1 level.

ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzKhlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of breathlessness on 00.00.00 with speech difficulty since then.
C/O bladder involvement with weakness of the RUE and RLE.
Known hypertensive.

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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is thickening of the gyri in the left temporo-parietal region. There are hypointense areas in the left temporo-parietal cortex and subcortical white matter on the T1 Weighted images which are seen to turn hyperintense on the proton, T2 Weighted, FLAIR and Fast Scan (T2 *) coronal images. Involvement of the insular cortex, external capsule and the left lentiform nucleus is also noted. Few hyperintense areas are seen along the cortex and a well-defined hyperintense area is seen within the left lentiform nucleus on the T1 Weighted images which remain so on the proton, T2 Weighted and FLAIR images but show a subtle hypointense signal on the Fast Scan (T2 *) images, these would represent altered blood and the lesion would represent a haemorrhagic infarct. There is mild mass effect with effacement of the adjacent sulci and indentation upon the body of the left lateral ventricle.

A lacunar infarct (hyperintense to CSF on all the pulse sequences) is noted in the body of the caudate nucleus on the right side.

Ischemic foci are also noted in the right high parietal cortex and in the posterior parietal white matter bilaterally.

Intermediate signal intensity is seen in the cavernous as well as the petrous portion of the internal carotid artery on the right side on the T1 Weighted images which is seen to turn hyperintense on the proton and T2 Weighted images and would represent thrombus.
..2/..






- 2 -


The right lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci in the fronto-parietal regions and in the cerebellar folia bilaterally.

Inflammatory changes are noted in the sphenoid sinus on the left side.

IMPRESSION :

1. A haemorrhagic infarct in the left temporo-parietal region.

2. A lacunar infarct in the body of the caudate nucleus on the right side.

3. Thrombus in the cavernous as well as the petrous portion of the internal carotid artery on the right side.

4. Ischemic foci in the right high parietal cortex and in the posterior parietal white matter bilaterally.