ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzKathlmn / M / 40 yrs.
Referred by : Dr. Abc Xyzndhi.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias 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 is a small posterior disc bulge at the L5-S1 level.

The lumbar vertebral bodies and the 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 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 :

17.0 mm at L1-L2
18.0 mm at L2-L3
16.0 mm at L3-L4
14.0 mm at L4-L5
12.0 mm at L5-S1.

The dorso-lumbar spine was screened with 5 mm thick T1 Weighted sagittal images which shows a small posterior disc bulge with peridiscal osteophyte at the D10-D11 level. Schmorls node is also noted at this level.

IMPRESSION :

No significant abnormality is detected on this study.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Golelmn / M / 34 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

C/O pain in both knees with click since 3 months and limp since 8 days.

EXAMINATION :

M.R.I of the right 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.

5 mm thick GRASS axial images.

OBSERVATION :

Menisci

There is a linear, intermediate signal intensity lesion on the T1 Weighted images in the posterior horn of the medial meniscus of the right knee joint, extending upto the inferior articular margin. This most likely represents a horizontal flap tear.

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

Cruciate Ligaments :

There is slight buckling of the posterior cruciate ligament. However, it shows normal signal characteristics.

The anterior cruciate ligament shows normal contour and signal characteristics.

Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.
...2/.









- 2 -


Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

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

There is a small right knee joint effusion.

IMPRESSION :

1. A horizontal flap tear in the posterior horn of the medial meniscus of the right knee joint.

2. A small right knee joint effusion.

ke/sb
/4 Date : 00.00.00

Name of the Patient : Abc Xyz M. Kalgulmn / M / 40 yrs.
Referred by : Dr. Abc Xyzisheri / Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 0000. 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 an ill-defined, hypointense signal on the T1 Weighted images in the subcortical white matter in the right high parietal region. This lesion appears hyperintense on the proton and T2 Weighted images . Slight volume loss is noted in that region (scans 103.13-14, 102.12 to 15).

The hippocampal complex is unremarkable on either side.

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 probable, right sided, suboccipital lymph node is noted (scans 103.4-5, 102.3-4, 104.2-3).

IMPRESSION :

Altered signal in the subcortical white matter, in the right high parietal region most likely represents an area of gliosis/encephalomalacia, most likely the sequelae of previous vascular insult.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzPlmn / F / 33 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 14 years.
C/O radicular pain to BLE (left more than right) with paresthesias since 2-3 years.

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 L2-L3 and L3-L4 intervertebral discs.

There is slight anterior wedging of the L2 vertebral body without change in signal intensity. Resultant slight kyphus is noted at this level.

There is a fairly large, left paracentral disc herniation with a peridiscal osteophyte at the L2-L3 level, indenting the anterior dural theca and narrowing the left neural foramen at that level. Probable indentation on the traversing left L3 nerve root is noted.

A small, posterior disc bulge is noted at the L3-L4 level. A transepiphyseal herniation is seen at the antero-superior portion of the L4 vertebra.

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.

Fat is noted in the filum terminal from the L3 to S3 vertebral levels.
...2/.







- 2 -


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

17.0 mm at L1-L2

13.0 mm at L2-L3

14.0 mm at L3-L4

15.0 mm at L4-L5

12.0 mm at L5-S1.

IMPRESSION :

1. Anterior wedging of the L2 vertebral body without change in signal intensity, may be the sequelae of previous trauma.

2. A fairly large, left paracentral disc herniation with a peridiscal osteophyte at the L2-L3 level, with probable indentation on the traversing left L3 nerve root.

3. Fat in filum terminal over the L3 to S3 vertebral levels.

kesb
Date : 00.00.00

Name of the Patient : Abc Xyz Rlmn / M / 20 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tremors, irrelevant talk, dysphagia and slowing of all movements since 1 month.

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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted, FLAIR and Fast Scan (T2 *) images in the pons, midbrain, bilateral thalami and putamen. These are iso to hypointense to normal white matter on the T1 Weighted images.

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. The cerebellar folia are slightly prominent.

IMPRESSION :

The MRI features are suggestive of altered signal in the the pons, midbrain, bilateral thalami and putamen. These changes may be consistent with Wilsons disease.

ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzV. lmn / F / 74 yrs.
Referred by : Dr. Abc Xyz Mehta / Dr. Abc Xyzatt.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O Parkinsonism since 2 years.
C/O stiffening of BLE, inability to speak/express herself and bladder/bowel incontinence since 1 1/2 months.
Known diabetic. On Rx.

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 T2 Weighted coronal images.

OBSERVATION :

There is a hypointense area in the left thalamus on the T1 Weighted images which is seen to turn hyperintense on the T2 Weighted images and would represent an old infarct. Similar signal is also noted in the right lentiform nucleus. An old infarct is also noted in the left high parietal cortex with volume loss.

There are hyperintense areas in the periventricular deep white matter on the proton and T2 Weighted images. These are iso to hypointense to normal white matter on the T1 Weighted images and would represent ischemic changes.

There is mild dilatation of both the lateral and third ventricles with fullness of the fourth ventricle. There is resultant thinning of the corpus callosum. There is prominence of the cortical sulcal spaces in the fronto-parietal regions and the cerebellar folia bilaterally. . The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Note is made of a cavum septum pellucidum and cavum vergae which are also dilated. An empty sella is noted.


- 2 -


IMPRESSION :

1. Altered signal in the left thalamus, left high parietal cortex and in the right lentiform nucleus would represent old infarcts.

2. Altered signal in the periventricular deep white matter represent ischemic changes.

3. Cerebral atrophy.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzi C. Golmn / F / 35 yrs.
Referred by : Dr. Abc Xyzewal.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O fever, headaches, giddiness with nausea and discharge from the left ear since 1 1/2 months.
C/O numbness over the left side of face, head and neck with decreased hearing, inability to swallow solids and loss of taste since 10-12 days.
C/O inability to see clearly from the left side since 10-12 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.

5 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is an intermediate signal intensity mass lesion in the left parapharyngeal space on the T1 Weighted images. This lesion is relatively hypointense on the T2 Weighted images. This is seen to involve the medial and lateral pterygoid muscles as well as the temporalis muscle medially. There is destruction of the pterygoid plate with bulging into the pharyngeal space on the left lateral aspect. Posteriorly, there is compression upon the carotid space and displacement of the carotid sheaths postero-laterally. However, the carotid artery shows normal flow void signal on all the pulse sequences. Medially, there is mild encroachment into the retropharyngeal space. Postero-superiorly there is extension into the left infratemporal fossa with erosion of the temporal bone and intracranial extension (extradural collection) which is seen to compress upon the left temporal lobe. There is mild involvement of the clivus on the left side with slight encroachment into the inferior aspect of the left cavernous sinus. Involvement of the hard palate on the left posteriorly, is also noted. A small hypointense area is seen on the T1 Weighted images in the left paravertebral soft tissue at the C1-C2 level which is seen to turn hyperintense on the T2 Weighted images. This may represent cystic/necrotic area.
...2/.









- 2 -


Note is made of inflammatory changes in the left mastoid air cells, with effacement of the left torus tubarius.

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.

Incidental note is made of right maxillary sinusitis and mild inflammatory changes in the left ethmoidal air cells.

Enlarged, left cervical lymph nodes are also noted.

IMPRESSION :

The MRI features are suggestive of a mass lesion in the left parapharyngeal space with extensions and signal characteristics as described.

An infective lesion like tuberculosis, or a skull base neoplasm should be considered as a differential diagnosis.

A contrast enhanced scan would be worthwhile.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzlata Khanvilmn / F / 52 yrs.
Referred by : Dr. Abc Xyz. Mehta.
Examination : M.R.I. of the Brain and IAM.

CLINICAL PROFILE :

C/O giddiness since 1-2 months.
C/O tinnitus in both ears (right more than left) with decreased hearing.
Known hypertensive.

EXAMINATION :

M.R.I of the brain and IAM 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.

A MR cisternogram was obtained in the coronal plane.

OBSERVATION :

There is an ill-defined, hyperintense signal on the proton and T2 Weighted images in the periventricular white matter, corona radiata and centrum semiovale bilaterally. This signal appears iso to hypointense to normal white matter on the T1 Weighted images.

The seventh and eighth cranial nerve complexes are unremarkable.

There is mild dilatation of the third and both the lateral ventricles. The fourth ventricle is normal.

There is slight prominence of the cerebral cortical sulci in the temporal regions and left fronto-parietal region. The basal cisternal spaces are also prominent. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study. Skull vault marrow inhomogenity and an empty sella is noted.




- 2 -


IMPRESSION :

1. Altered signal in the periventricular white matter, corona radiata and centrum semiovale bilaterally most likely represent ischemic changes. In view of the H/O hypertension, Binswangers disease should be ruled out.

2. Mild cerebral cortical atrophy.

3. The seventh and eighth cranial nerve complexes are unremarkable on either side.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Ganglmn / F / 52 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O radicular pain to the LUE since October 0000.

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 reduction in height of the C4-C5 and C5-C6 discs with loss of water content of the upper cervical intervertebral discs.

Small, postero-central protruded disc is noted at the C3-C4 level

Posteriorly bulging discs with posterior peridiscal osteophytes are noted at the C4-C5 and C5-C6 levels indenting the dural theca anteriorly.

The upper cervical vertebral bodies show spotty fatty marrow changes. The C5 vertebral body shows a subcentimeter, hypointense lesion on the T1 Weighted images which appears hyperintense on the T2 Weighted images. Focal fatty change is also noted in the D4 vertebral body.

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.
..2/.










- 2 -


IMPRESSION :

1. Small postero-central portruded disc at the C3-C4 level.

2. Posteriorly bulging discs with posterior peridiscal osteophytes at the C4-C5 and C5-C6 levels.

3. Focal, subcentimeter lesion in the C5 vertebral body follows the signal characteristics of a bone cyst.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzuddin Shlmn / M / 15 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 1 year of age.
C/O progressive diminished vision bilaterally since 2 years.

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 :

The right hippocampus appears slightly smaller in volume when compared to left and shows a subtle hyperintense signal on the T2 Weighted images. This suggest right hippocampal sclerosis.

The left hippocampal complex 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.

Inflammatory changes are noted in the left maxillary sinus and ethmoidal air cells.

Incidental note is made of enlarged adenoids and Thornwaldts cyst.

IMPRESSION :

The MRI features are suggestive of right hippocampal sclerosis.