sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzay Walmn / M / 6 yrs.
Referred by : Dr. Abc Xyz Sampat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since the age of 8 months. 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 no focal area of altered signal intensity within the brain parenchyma.

The hippocampal complex is unremarkable on either side.

The right temporal horn appears slightly larger than the left and may be a normal variant.

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 paranasal sinuses.

IMPRESSION :

Normal study of the Brain.

sb/bv
Date : 00.00.00

Name of the Patient : Abc XyzK. Dlmn / F / 45 yrs.
Referred by : Dr. Abc Xyzo / Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

H/O left sided mastectomy done in 0000 for carcinoma breast, after which patient recovered.
Recurred in November 0000, Received radiotherapy - 32 sittings.
On AKT since 3 months for pulmonary kochs (AFB +ve in sputum).
C/O gait imbalance with bladder involvement since 15 days.

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 T2 Weighted axial images.

OBSERVATION :

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the posterior epidural space at the D8 and D9 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. There is resultant anterior displacement and compression of the dorsal spinal cord at these levels. The dorsal spinal cord shows a hyperintense signal on the T2 Weighted images at the D8 and D9 vertebral levels, suggesting cord edema/ischemia. Probable involvement of the laminae of D8 and D9 is noted.

There is slight loss of water content of the L5-S1 intervertebral disc.

Minimal posterior disc bulges are noted at the L3-L4 and L4-L5 levels.

The visualized dorsal and lumbar vertebral bodies show spotty fatty marrow changes.

The remaining visualized intervertebral discs show normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.


- 2 -


The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.

Incidentally noted is a left sided pleural effusion and a soft tissue lesion in the base of the left lung.

IMPRESSION :

Soft tissue lesion in the posterior epidural space at the D8 and D9 vertebral levels with cord compression and cord signal alteration , is not specific for a single etiology.

In a known C/O pulmonary tuberculosis this may represent tuberculous granulation tissue/abscess.

However, this is less likely to represent a metastatic deposit.

Soft tissue lesion in the base of the left lung with left pleural effusion may be inflammatory in etiology, in view of the AFB positive in sputum or may be due to metastasis.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyza Blmn / F / 56 yrs.
Referred by : Dr. Abc Xyzrikh.
Examination : Screening M.R.I. of Spine.

CLINICAL PROFILE :

? Parkinsonism since 2 years.
Now C/O difficulty in speech and aphasia since 16th of January 0000 with inability to walk.

EXAMINATION :

The cervical, dorsal and lumbo-sacral spines were screened with :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is slight loss of water content of the cervical and upper dorsal discs and the L4-L5 and L5-S1 intervertebral discs.

Small posterior peridiscal osteophytes is noted at the C4-C5 level.

Ligamentum flavum hypertrophy is noted at the C5 and C6 vertebral levels. Hypertrophy of the facet joint/capsular ligament complex is identified at the D11-D12 and D10-D11 levels.

Small postero-central protruded discs with peridiscal osteophytes are noted at the L4-L5 and L5-S1 levels.

The visualized vertebral bodies show spotty fatty marrow changes suggesting osteoporosis.







- 2 -


The visualized prevertebral soft tissues are unremarkable.

The visualized spinal cord reveals normal signal intensity. There is no cord compression.

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

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

IMPRESSION :

The screening MRI images of the spine reveal mild degenerative changes in the cervical, dorsal and lumbo-sacral regions as described.

No other significant abnormality is detected on this study.

ke/bv
Date : 00.00.00

Name of the Patient : Abc XyzBhlmn / M / 35 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O 4 episodes of seizures on 00.00.00.

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.

OBSERVATION :

There is a well-circumscribed hyperintense lesion in the left frontal region measuring approximately 0.5 cms in diameter on the Proton, T2 Weighted and FLAIR images (se/im102.17, 103.17, 106.5, 105.4). This lesion has a hypointense rim on the T2 Weighted and FLAIR images.
This lesion appears isointense on the T1 Weighted images. There is surrounding white matter edema with mass effect and slight effacement of the adjacent sulci.

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 :

1. A granulomatous infective lesion in the left frontal region measuring approximately 0.5 cms (? cysticercus).

2. Mild dilatation of both the lateral ventricles.

A contrast enhanced study and follow up would be worthwhile.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 14 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O occasional headaches with momentary blackouts since 2 months.

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.

OBSERVATION :

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

The hippocampus is unremarkable on either side.

The right lateral ventricle appears prominent as compared to the left and may be a normal variant.

The left 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 a right maxillary sinusitis.

IMPRESSION :

Normal study of the Brain.

Date : 00.00.00
sb/ke
Name of the Patient : Abc Xyz lmn / M / 36 yrs.
Referred by : Dr. Abc Xyzy B. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 7-8 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 loss of water content of the L4-L5 intervertebral disc.

There is a small, postero-central disc herniation with a peridiscal osteophyte at the L4-L5 level, indenting the dural theca anteriorly.

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 D12-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 :

18.0 mm at L1-L2
15.0 mm at L2-L3
14.0 mm at L3-L4
11.0 mm at L4-L5
15.0 mm at L5-S1.

IMPRESSION :

Degenerated L4-L5 disc with a small, postero-central disc herniation with a peridiscal osteophyte at the L4-L5 level.

Date : 00.00.00
sb/ke
Name of the Patient : Abc Xyz lmn / M / 36 yrs.
Referred by : Dr. Abc Xyzy B. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 7-8 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 loss of water content of the L4-L5 intervertebral disc.

There is a small, postero-central disc herniation with a peridiscal osteophyte at the L4-L5 level, indenting the dural theca anteriorly.

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 D12-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 :

18.0 mm at L1-L2
15.0 mm at L2-L3
14.0 mm at L3-L4
11.0 mm at L4-L5
15.0 mm at L5-S1.

IMPRESSION :

Degenerated L4-L5 disc with a small, postero-central disc herniation with a peridiscal osteophyte at the L4-L5 level.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyza Ylmn / F / 42 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 1 year.

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 right far lateral disc bulge at the L3-L4 level with a small posterior peridiscal osteophyte at that level.

The L3-L4 and L4-L5 facet joints bilaterally and the L5-S1 facet joint on the left side show mild degenerative change.

Ligamentum flavum hypertrophy is seen at the L4, L4-L5 and L5-S1 levels.

Anterior disc herniations are seen at the L1-L2 and L3-L4 levels. Anterior peridiscal osteophytes are also noted at the L1-L2 level. These intervertebral discs show slight loss of water content.

Type II degenerative changes are noted in the L1 vertebral body adjacent to the L1-L2 intervertebral disc.

A hemangioma is noted in the L3 vertebral body.

The rest of 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.

- 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 :

18.0 mm at L1-L2

18.0 mm at L2-L3

17.0 mm at L3-L4

16.0 mm at L4-L5

15.0 mm at L5-S1.

IMPRESSION :

1. A small right far lateral disc bulge at the L3-L4 level with a small posterior peridiscal osteophyte at that level.

2. Mild degenerative changes of the L3-L4 and L4-L5 facet joints bilaterally and the L5-S1 facet joint on the left side.

3. Ligamentum flavum hypertrophy at the L4, L4-L5 and L5-S1 levels.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzand Sanlmn / M / 70 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided hemiparesis since 00.00.00.

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 an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the left fronto-temporo-parietal cortex and subcortical white matter, left lentiform nucleus and head of the left caudate nucleus. This lesion appears hypointense on the T1 Weighted images and represents a recent ischemic lesion. There is resultant effacement of the cerebral cortical sulci in the left fronto-temporo-parietal region, indentation and compression of the left lateral and third ventricle and mild bulge of the midline to the right.

There is an ill-defined, hypointense lesion on the T1 Weighted images in the right occipital lobe. Part of this lesion follows CSF signal on all the pulse sequences. Perilesional white matter hyperintense signal is noted in the proton, T2 Weighted and FLAIR images. Resultant mild dilatation of the atrium and occipital horn of the right lateral ventricle is noted.

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the periventricular white matter around the frontal horn of the right lateral ventricle. This lesion appears hypointense on the T1 Weighted images.

There is mild dilatation of the right lateral ventricle. The fourth ventricle is normal.

The basal cisternal spaces are unremarkable.
...2/.









- 2 -


The petrous and cavernous segments of the left internal carotid artery shows an intraluminal hyperintense signal on the T1 Weighted and T2 Weighted images (loss of normal flow void signal). The left vertebral artery is probably hypoplastic.

There is no obvious haemorrhage on this study.

IMPRESSION :

1. Altered signal in the left fronto-temporo-parietal region as described most likely represents a recent ischemic insult.

2. Altered signal in the right occipital region represents an area of cystic encephalomalacia with perilesional gliosis, ? the sequelae of previous vascular insult.

3. Altered signal in the periventricular white matter around the right frontal horn, most likely represents an ischemic lesion.

4. Loss of normal flow void signal in the petrous and cavernous segments of the left internal carotid artery may suggest thrombus/slow flow.

Suggest MRA study for further evaluation.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzand Sanlmn / M / 70 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided hemiparesis since 00.00.00.

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 an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the left fronto-temporo-parietal cortex and subcortical white matter, left lentiform nucleus and head of the left caudate nucleus. This lesion appears hypointense on the T1 Weighted images and represents a recent ischemic lesion. There is resultant effacement of the cerebral cortical sulci in the left fronto-temporo-parietal region, indentation and compression of the left lateral and third ventricle and mild bulge of the midline to the right.

There is an ill-defined, hypointense lesion on the T1 Weighted images in the right occipital lobe. Part of this lesion follows CSF signal on all the pulse sequences. Perilesional white matter hyperintense signal is noted in the proton, T2 Weighted and FLAIR images. Resultant mild dilatation of the atrium and occipital horn of the right lateral ventricle is noted.

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the periventricular white matter around the frontal horn of the right lateral ventricle. This lesion appears hypointense on the T1 Weighted images.

There is mild dilatation of the right lateral ventricle. The fourth ventricle is normal.

The basal cisternal spaces are unremarkable.
...2/.









- 2 -


The petrous and cavernous segments of the left internal carotid artery shows an intraluminal hyperintense signal on the T1 Weighted and T2 Weighted images (loss of normal flow void signal). The left vertebral artery is probably hypoplastic.

There is no obvious haemorrhage on this study.

IMPRESSION :

1. Altered signal in the left fronto-temporo-parietal region as described most likely represents a recent ischemic insult.

2. Altered signal in the right occipital region represents an area of cystic encephalomalacia with perilesional gliosis, ? the sequelae of previous vascular insult.

3. Altered signal in the periventricular white matter around the right frontal horn, most likely represents an ischemic lesion.

4. Loss of normal flow void signal in the petrous and cavernous segments of the left internal carotid artery may suggest thrombus/slow flow.

Suggest MRA study for further evaluation.