Date : 00.00.00

Name of the Patient : Abc Xyzarayan Slmn / M / 42 yrs.
Referred by : Dr. Abc Xyzilotri.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O road accident on 00.00.00 with loss of consciousness since then.
H/O convulsion, discharge of blood from the right ear (2 episodes), vomiting and weakness of the LUE and LLE.

EXAMINATION :

M.R.I of the dorsal 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.

IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is partial collapse of the D6 and D7 vertebral bodies with mild angular kyphus at that level.

There is replacement of the normal marrow of the D6 and D7 vertebral bodies by hypointense areas on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted images. There is bulging of these vertebral bodies in the pre and paravertebral soft tissues. Posterior bulging is also noted upon the spinal cord at the D5-D6 and D6-D7 levels. The spinal cord at the D6 level shows a hyperintense signal on the T2 Weighted images and is isointense to normal cord on the T1 Weighted images suggestive of cord edema/ischemia.

Subtle hyperintense signal on the T2 Weighted images is also noted in the D8 vertebral body in its superior aspect.

Anterior wedging of the D9 vertebral body is noted.

Ligamentum flavum hypertrophy is noted at the D7-D8 level.

The rest of the dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The remaining facet joints are unremarkable.
...2/..






- 2 -


The conus medullaris terminates at the L1 level.

The cervico-dorsal spine was screened with 5 mm thick T2 Weighted sagittal images and is unremarkable. 5 mm thick T1 Weighted sagittal images of the dorso-lumbar spine were also obtained which shows slight wedging of the L1 vertebral body without any altered signal intensity.

IMPRESSION :

Partial collapse of the D6 and D7 vertebrae with altered signal intensity is most probably due to previous trauma . Wedging of the D9 and D11 vertebral bodies is also noted. The possibility of this being an infective/neoplastic lesion is less likely.

Cord signal alteration at the D6 vertebral level suggests cord edema/ischemia

ke/sb
/62 Date : 00.00.00

Name of the Patient : Abc XyzD. Ilmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided hemiparesis with difficulty in speech since 3 years.
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 are hyperintense areas on the proton, T2 Weighted and FLAIR images in bilateral corona radiata and centrum semiovale as well as the frontal and parietal deep white matter and right cerebellar hemisphere. These are iso to hypointense to normal white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.

Lacunar infarcts which are hyperintense to CSF on all the pulse sequences are seen in the pons to the right of the midline, bilateral lentiform nuclei, left thalamus, bilateral corona radiata and centrum semiovale, the head and body of the caudate nucleus on the right side and in the left cerebellar hemisphere.

There is mild fullness of both the lateral ventricles. There is prominence of the cerebral cortical sulcal spaces in the parietal regions and cerebellar folia bilaterally.

The third and the fourth ventricles are normal. 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 mild inflammatory changes in the right mastoid air cells and pansinusitis.
...2/..









- 2 -


IMPRESSION :

1. Altered signal in bilateral corona radiata and centrum semiovale as well as the frontal and parietal deep white matter and in the right cerebellar hemisphere are suggestive of areas of ischemia/infarction.

2. Lacunar infarcts in the pons to the right of the midline, bilateral lentiform nuclei, left thalamus, bilateral corona radiata and centrum semiovale, the head and body of the caudate nucleus on the right side and in the left cerebellar hemisphere.

Date : 00.00.00

Name of the Patient : Abc XyzJ. Salulmn / M / 38 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O pain in the cervical and dorsal regions radiating to both the shoulders and paresthesias in BUE and BLE with gait imbalance since 1 1/2 months.
H/O fall 7-8 years back.

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 a large postero-central disc herniation at the C3-C4 level with anterior compression of the spinal cord. A small portion of the disc is seen to lie posterior to the C4 vertebral body. The cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images (isointense to normal cord on the T1 Weighted images) suggestive of cord edema/ischemia.

A right postero-lateral disc herniation is seen at the C4-C5 level with antero-lateral compression of the cord which also shows hyperintense signal on the Fast Scan (T2 *) images suggestive of cord edema/ischemia.

A postero-central disc herniation is seen at the C2-C3 level and small posterior disc herniations are noted at the C5-C6 and C6-C7 levels with anterior indentation of the thecal sac. The cervical intervertebral discs show loss of water content.

Posterior peridiscal osteophytes are noted over the C2-C3 to C6-C7 levels.

The cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
....2/..







- 2 -


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

Incidental note is made of a well-defined oval shaped lesion measuring approximately 1.0 x 0.8 cms in the right lobe of the thyroid gland on the T1 Weighted images and is seen to remain so on the T2 Weighted and Fast Scan (T2 *) images. This may represent a complicated cyst with probable high protein content.

Facetal hypertrophy is noted at the D3-D4 and D4-D5 levels.

IMPRESSION :

1. A large postero-central disc herniation at the C3-C4 level with a small portion of the disc lying posterior to the C4 vertebral body. Cord signal alteration at this level suggests cord edema/ischemia.

2. A right postero-lateral disc herniation at the C4-C5 level with cord compression and cord signal alteration at this level suggesting cord edema/ischemia.

3. A postero-central disc herniation at the C2-C3 level and small posterior disc herniations at the C5-C6 and C6-C7 levels.

4. Posterior peridiscal osteophytes over the C2-C3 to C6-C7 levels.

Date : 00.00.00

Name of the Patient : Abc Xyzam B. Hulmn / M / 40 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

H/O fall from a height of 10 feet on 00.00.00 followed with backache, radiating to BLE
and paresthesias and weakness in BLE since then.

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.

4 mm thick T1 Weighted coronal images.

OBSERVATION :

There is slight forward subluxation of the L5 over the S1 vertebra with a pseudoposterior disc bulge at the L5-S1 level. Small bilateral far lateral disc bulges are also noted at this level. This disc shows a hyperintense signal on all the pulse sequences which may represent calcification or paramagnetic substance deposition.

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

There is evidence of a fracture of the S2 vertebral segment with a kyphus at that level.
There is an ill-defined, hypointense signal on the T1 Weighted images in the sacral segments, which appear hyperintense on the T2 Weighted images. The fat plane around the left S1 nerve root in the left sacral foramen at S1-S2 level is not well-defined. The sacro-iliac joints on either side are unremarkable. A subcentimeter, hypointense focus on all pulse sequences in the sacrum on the right, near the right sacro-iliac joint represents a bone island.

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.
..2/.







- 2 -

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 :

17.0 mm at L1-L2

17.0 mm at L2-L3

14.0 mm at L3-L4

14.0 mm at L4-L5

16.0 mm at L5-S1.

The dorsal spine was screened with 5 mm thick T2 Weighted sagittal images and which does not reveal any significant feature of note.

IMPRESSION :

1. Slight forward subluxation of the L5 over the S1 vertebra with a pseudoposterior disc bulge and small bilateral far lateral disc bulges at the L5-S1 level.

2. Fracture of the S2 vertebral segment with altered signal in the sacral segments suggesting bone bruise.

3. Loss of fat plane around the left S1 nerve root in the left sacral foramen at the S1-S2 level which may suggest nerve root entrapment.

ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzJhalmn / F / 67 yrs.
Referred by : Dr. Abc Xyzaveri.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

C/O pain and swelling over the left knee joint since 6 months.
H/O fall prior to this.

EXAMINATION :

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

4 mm thick T1 Weighted, proton and GRASS sagittal images.

4 mm thick T1 Weighted and T2 Weighted coronal images.

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

OBSERVATION :

Menisci

There is a curvilinear hyperintense signal on the T1 Weighted and GRASS images reaching upto the inferior articular surface in the posterior horn of the medial meniscus and would represent a Grade III meniscal signal (meniscal tear) (se\im 102.13, 103.13, 104.13).

There is a curvilinear hyperintense signal on the T1 Weighted and GRASS images not reaching upto the articular surface in the posterior horn of the lateral meniscus and would represent a Grade II meniscal signal (meniscal degeneration) (se\im 102.3, 103.3, 104.3).

The anterior horns of the lateral and medial menisci reveal normal configuration and signal characteristics.

Cruciate Ligaments :

The anterior and posterior cruciate ligaments show normal contour and signal characteristics.
....2/..








- 2 -


Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.

Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

The articular cartilage overlying the patella, tibia and femur appears normal.

Minimal effusion is noted in the left knee joint.

Hyperintense areas are seen in the subcutaneous fat around the antero-lateral margin of the left knee joint on the T1 Weighted images and would represent soft tissue edema.

Dilated, tortuous, popliteal vessels are noted.

IMPRESSION :

1. Meniscal tear in the posterior horn of the medial meniscus.

2. Grade II meniscal signal (meniscal degeneration) in the posterior horn of the lateral meniscus.

3. Effusion in the left knee joint.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzv Namlmn / M / 2 1/2 yrs.
Referred by : Dr. Abc Xyzo.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

Undescended left testis.

EXAMINATION :

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

4 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 STIR coronal images.

OBSERVATION :

There is a small hypointense area within the left inguinal region on the T1 Weighted images which is seen to turn hyperintense on the T2 Weighted and STIR images. This is oval in shape and measures approximately 2.0 x 0.8 cms. This would be suggestive of a canalicular undescended testis. There is a suggestion of fluid collection in that region ? hydrocele. The left scrotal sac is hypoplastic.

A well-defined, lesion of intermediate signal intensity on the T1 Weighted images is seen in the left inguinal region laterally, just medial to the sartorius muscle and is seen to turn hyperintense on the T2 Weighted images and would represent enlarged lymph node.

Subtle hyperintense signal seen on the T2 Weighted and STIR images in the left gluteal muscle laterally which is probably due to intramuscular injection.

The urinary bladder appears normal.

The ischio-rectal fossae on either side appear normal.

No obvious vascular anomaly is noted.

IMPRESSION :

1. Undescended canalicular testis on the left side with a hydrocele/hernia.
2. A lymph node in the left inguinal region laterally, just medial to the sartorius
muscle.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzg lmn / M / 52 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

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

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 are foci of hyperintensity on the proton, T2 Weighted and FLAIR images within the white matter in the frontal lobes bilaterally and right periatrial white matter. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

There is mild prominence of the cerebellar folia bilaterally.

Focal hypointensities on the Fast Scan (T2 *) images within the globus pallidus bilaterally may represent calcium.

Note is made of an empty sella.

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 pansinusitis.

IMPRESSION :

The MRI features are suggestive of foci of altered signal intensity within the white matter in the frontal lobes bilaterally and right periatrial white matter and these are most likely ischemic in etiology.

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzbanu Shlmn / F / 13 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O acute onset of weakness of BLE (left more than right) with fever since 00.00.00.
H/O backache since 8 days.

EXAMINATION :

M.R.I of the dorsal 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 and T2 Weighted coronal images.

A contrast enhanced scan was refused.

OBSERVATION :

The D8 vertebra appears as marked on the film.

There is evidence of a fairly well-defined intradural/extramedullary mass lesion within the spinal canal at the D7 and D8 vertebral levels. It is seen to measure approximately 2.0 x 2.0 x 3.5 cms. This lesion shows mixed signal characteristics on the T1 Weighted images (with cystic/necrotic changes) and turns hyperintense on the T2 Weighted images. A smaller lesion having a diameter of approximately 1.0 cm is seen at the superior pole of this lesion probably in continuity with the above lesion.

There is resultant compression and anterior displacement (more to the right of the midline) of the spinal cord at the D7 and D8 vertebral levels. The cord over these levels shows a hyperintense signal on the T2 Weighted images and which would suggest cord edema/ischemia.

The visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
..2/..








- 2 -



The conus medullaris terminates at the D12-L1 level.

IMPRESSION :

The MRI features are suggestive of an intradural/extramedullary mass lesion within the spinal canal at the D7 and D8 vertebral levels measuring approximately 2.0 x 2.0 x 3.5 cms. The differential diagnosis to be considered are :

1. Neurofibroma.

2. Meningioma.

3. Metastasis due to CSF seeding.

4. Dermoid/epidermoid.

A contrast enhanced scan would be worthwhile (with ? MRI/CT of the brain).

hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzitsingh Gulmn / M / 3 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O meningocele for which patient was operated at the age of 3 months.
C/O paraplegia with bladder/bowel involvement since then.

EXAMINATION :

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

3 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

The brain was screened with 4 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is an open spinal canal posteriorly in the lower dorsal and lumbar regions with segmentation anomalies of multiple dorsal vertebrae (confirmation with X-rays would be worthwhile). The thecal sac in the visualized dorso-lumbar region is seen to be capacious.

Areas which are near isointense to normal neural tissue are seen within the thecal sac over the L2 to L5 levels and this may represent a neural placode. The filum terminale appears to be inserting into this. Ventral myeloschisis is noted at the D6/D7 and D2/D3 vertebral levels. The spinal cord in the mid and lower dorsal regions appear to be of smaller calibre. However, the visualized dorsal spinal cord shows normal signal intensity.

The remaining visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

On screening the brain there is evidence of a large cervico-medullary kink with herniation of the cerebellar tonsils through the foramen magnum. Also seen is a bulbous/beaked tectum. There is dilatation of the third and both the lateral ventricles. The fourth ventricle is stretched in the supero-inferior direction.
..2/..








- 2 -


Rotational anomaly is seen of both the kidneys.

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. A probable neural placode over the L2 to L5 levels with insertion of the filum terminale.

3. The spinal cord in the mid and lower dorsal regions appears to be of smaller calibre ? atrophy.

4. Features of a Chiari II malformation in the brain with dilatation of the third and both the lateral ventricles.

hs/bv
/00000 Date : 12/00.00.00

Name of the Patient : Abc Xyzshna lmn / M / 49 yrs.
Referred by : Dr. Abc Xyz Shah / Dr. Abc Xyzhta / Dr. Abc Xyzatt.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known hypertensive/diabetic/IHD.
H/O epilepsy since 0000.

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 T1 Weighted and T2 Weighted coronal images.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

Hyperintense foci on the proton density, T2 Weighted and FLAIR images are seen in the left lentiform nucleus and right posterior parietal region and these are probably ischemic in etiology.

Few areas which are iso to hyperintense to CSF on all the pulse sequences are noted within the left thalamus and lentiform nuclei bilaterally and would represent lacunar infarcts.

Dilated perivascular spaces are seen within the centrum semiovale bilaterally.

There is prominence of the cerebellar folia bilaterally.

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.

IMPRESSION :

The MRI features are suggestive of :

1. Lacunar infarcts within the left thalamus and lentiform nuclei bilaterally.
2. Ischemic foci in the left lentiform nucleus and right posterior parietal region.