Date : 00.00.00

Name of the Patient : Abc XyzKalmn / F / 24 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 5-6 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 :

Small posterior disc bulges are noted at the L4-l5 and L5-S1 levels.

The lumbar vertebral bodies and ntervertebral 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 :

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

IMPRESSION :

The MRI features are suggestive of small posterior disc bulges at the L4-l5 and L5-S1 levels.

Date : 00.00.00

Name of the Patient : Abc XyzKalmn / F / 24 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 5-6 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 :

Small posterior disc bulges are noted at the L4-l5 and L5-S1 levels.

The lumbar vertebral bodies and ntervertebral 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 :

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

IMPRESSION :

The MRI features are suggestive of small posterior disc bulges at the L4-l5 and L5-S1 levels.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzndra T. Galmn / M / 63 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O tooth extraction 1 1/2 months back with numbness on the left side of face and inability to shut left eye since then.

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.

MR cisternogram was also obtained in the coronal plane.

OBSERVATION :

There is a small bright focus on the proton and T2 Weighted images in the head of the right caudate nucleus (scans 102.12 and 105.19). This most likely represents ischemic changes.

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 slight prominence of the cerebral cortical sulci, bilaterally. There is no shift of the midline structures.

Slow flow is noted in the left transverse and sigmoid sinuses.

The seventh and eighth cranial nerve complex and the trigeminal nerves are unremarkable on either side. There is no vascular loop deforming the root exit zone of the seventh and eighth cranial nerve complexes or the root entry zone of the trigeminal nerves on either side.

A polyp is noted in the left maxillary antrum.

IMPRESSION :

An ischemic focus in the head of the right caudate nucleus.

No other significant abnormality is detected on this study.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzndra T. Galmn / M / 63 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O tooth extraction 1 1/2 months back with numbness on the left side of face and inability to shut left eye since then.

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.

MR cisternogram was also obtained in the coronal plane.

OBSERVATION :

There is a small bright focus on the proton and T2 Weighted images in the head of the right caudate nucleus (scans 102.12 and 105.19). This most likely represents ischemic changes.

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 slight prominence of the cerebral cortical sulci, bilaterally. There is no shift of the midline structures.

Slow flow is noted in the left transverse and sigmoid sinuses.

The seventh and eighth cranial nerve complex and the trigeminal nerves are unremarkable on either side. There is no vascular loop deforming the root exit zone of the seventh and eighth cranial nerve complexes or the root entry zone of the trigeminal nerves on either side.

A polyp is noted in the left maxillary antrum.

IMPRESSION :

An ischemic focus in the head of the right caudate nucleus.

No other significant abnormality is detected on this study.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzji Malmn / F / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 5 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.

5 mm thick FLAIR coronal images.

After administration of contrast, 5 mm thick T1 Weighted axial and coronal images (with magnetization transfer) and 5 mm thick T1 Weighted sagittal images were obtained.

OBSERVATION :

There is seen a diffuse, ill-defined, hypointense lesion on the T1 Weighted images in the left fronto-temporo-parietal region, involving the cortex and subcortical white matter. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images. Resultant effacement of the cerebral cortical sulci in the left cerebral hemisphere is noted. There is indentation and compression of the left lateral and third ventricles with mild shift of the midline to the right. Left sided uncal herniation is also noted, with indentation on the left cerebral peduncle and slight distortion of the upper brainstem axis. There is also seen a diffuse ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the left parieto-occipital, parafalcine region, in the periventricular white matter bilaterally and in the corpus callosum. This signal appears iso to hypointense to normal white matter on the T1 Weighted images.

The right lateral and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebellar folia bilaterally. No obvious vascular anomaly is identified on this study.

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

- 2 -


A polyp is noted in the left maxillary sinus.

The tip of the odontoid process is directed slightly posteriorly.

IMPRESSION :

Diffuse, non-enhancing, altered signal intensity lesion in the left fronto-temporo-parietal region and in the left parieto-occipital, parafalcine region as described, is not specific for a single etiology. This most likely represents a glial cell tumor.

Diffuse altered signal in the periventricular white matter bilaterally and in the corpus callosum as described may also represent glial cell lesion.

Gliomatosis cerebri may be considered as a likely possibility.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzji Malmn / F / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 5 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.

5 mm thick FLAIR coronal images.

After administration of contrast, 5 mm thick T1 Weighted axial and coronal images (with magnetization transfer) and 5 mm thick T1 Weighted sagittal images were obtained.

OBSERVATION :

There is seen a diffuse, ill-defined, hypointense lesion on the T1 Weighted images in the left fronto-temporo-parietal region, involving the cortex and subcortical white matter. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images. Resultant effacement of the cerebral cortical sulci in the left cerebral hemisphere is noted. There is indentation and compression of the left lateral and third ventricles with mild shift of the midline to the right. Left sided uncal herniation is also noted, with indentation on the left cerebral peduncle and slight distortion of the upper brainstem axis. There is also seen a diffuse ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the left parieto-occipital, parafalcine region, in the periventricular white matter bilaterally and in the corpus callosum. This signal appears iso to hypointense to normal white matter on the T1 Weighted images.

The right lateral and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebellar folia bilaterally. No obvious vascular anomaly is identified on this study.

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

- 2 -


A polyp is noted in the left maxillary sinus.

The tip of the odontoid process is directed slightly posteriorly.

IMPRESSION :

Diffuse, non-enhancing, altered signal intensity lesion in the left fronto-temporo-parietal region and in the left parieto-occipital, parafalcine region as described, is not specific for a single etiology. This most likely represents a glial cell tumor.

Diffuse altered signal in the periventricular white matter bilaterally and in the corpus callosum as described may also represent glial cell lesion.

Gliomatosis cerebri may be considered as a likely possibility.

Date : 00.00.00
sb/hs
Name of the Patient : Abc Xyzam R. Jalmn / M / 65 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 3-4 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 reduction in height of the L5-S1 disc and loss of water content of the lumbar intervertebral discs.

Posterior peridiscal osteophytes are noted at the L5-S1 level with right neural foraminal narrowing and impingement of the foraminal segment of the exiting right L5 nerve root and on the traversing right S1 nerve root (scans 103.6, 105.2).

A posteriorly herniated disc is noted at the L4-L5 level with bilateral neural foraminal narrowing and indentation on the traversing left L5 nerve root . A left far lateral (extraforaminal) disc bulge is also noted at this level.

Right far lateral (extraforaminal) disc herniations are seen to indent the extraforaminal portion of the exiting right L4 and L5 nerve roots at the L4-L5 and L5-S1 levels, respectively.

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

A small posteior disc herniation with peridiscal osteophytes is noted at the L2-L3 level with bilateral neural foraminal narrowing.

A right postero-lateral and right far lateral (extraforaminal) disc bulge is noted at the L1-L2 level, with right neural foraminal narrowing.
- 2 -


Type II degenerative marrow changes are noted adjacent to the L5-S1 disc.

The facet joints at the L4-L5 and L5-S1 levels show hypertrophic degenerative changes. Facetal hypertrophy is seen at the L3-L4 level.

The rest of the lumbar vertebral bodies show normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

Incidental note is made of fat in the filum terminale at the L2 and L3 vertebral levels.

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 :

15.0 mm at L1-L2
15.0 mm at L2-L3
15.0 mm at L3-L4
12.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. Posterior peridiscal osteophytes at the L5-S1 level with right neural foraminal narrowing and indentation upon the foraminal segment of the exiting right L5 nerve root.

2. A posteriorly herniated disc at the L4-L5 level with bilateral neural foraminal narrowing and indentation on the traversing left L5 nerve root.

3. A small posterior disc herniation with peridiscal osteophytes at the L2-L3 level.

4. Right far lateral (extraforaminal) disc herniations indenting the extraforaminal portion of the exiting right L4 and L5 nerve roots at the L4-L5 and L5-S1 levels, respectively.

5. Hypertrophic facetal arthropathy at the L4-L5 and L5-S1 levels.

Date : 00.00.00
sb/hs
Name of the Patient : Abc Xyzam R. Jalmn / M / 65 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 3-4 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 reduction in height of the L5-S1 disc and loss of water content of the lumbar intervertebral discs.

Posterior peridiscal osteophytes are noted at the L5-S1 level with right neural foraminal narrowing and impingement of the foraminal segment of the exiting right L5 nerve root and on the traversing right S1 nerve root (scans 103.6, 105.2).

A posteriorly herniated disc is noted at the L4-L5 level with bilateral neural foraminal narrowing and indentation on the traversing left L5 nerve root . A left far lateral (extraforaminal) disc bulge is also noted at this level.

Right far lateral (extraforaminal) disc herniations are seen to indent the extraforaminal portion of the exiting right L4 and L5 nerve roots at the L4-L5 and L5-S1 levels, respectively.

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

A small posteior disc herniation with peridiscal osteophytes is noted at the L2-L3 level with bilateral neural foraminal narrowing.

A right postero-lateral and right far lateral (extraforaminal) disc bulge is noted at the L1-L2 level, with right neural foraminal narrowing.
- 2 -


Type II degenerative marrow changes are noted adjacent to the L5-S1 disc.

The facet joints at the L4-L5 and L5-S1 levels show hypertrophic degenerative changes. Facetal hypertrophy is seen at the L3-L4 level.

The rest of the lumbar vertebral bodies show normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

Incidental note is made of fat in the filum terminale at the L2 and L3 vertebral levels.

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 :

15.0 mm at L1-L2
15.0 mm at L2-L3
15.0 mm at L3-L4
12.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. Posterior peridiscal osteophytes at the L5-S1 level with right neural foraminal narrowing and indentation upon the foraminal segment of the exiting right L5 nerve root.

2. A posteriorly herniated disc at the L4-L5 level with bilateral neural foraminal narrowing and indentation on the traversing left L5 nerve root.

3. A small posterior disc herniation with peridiscal osteophytes at the L2-L3 level.

4. Right far lateral (extraforaminal) disc herniations indenting the extraforaminal portion of the exiting right L4 and L5 nerve roots at the L4-L5 and L5-S1 levels, respectively.

5. Hypertrophic facetal arthropathy at the L4-L5 and L5-S1 levels.

sb/bv
Date : 00.00.00

Name of the Patient : Abc XyzEngilmn / M / 62 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O severe backache radiating to the RLE since 6 months.
H/O surgery for PID in 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 loss of water content of the lumbar intervertebral discs.

There is Grade I spondylolisthesis of the L5 over the S1 vertebra and L4 over the L5 vertebra. Probable spondylolysis at the L5 level is noted.

There is evidence of laminectomy at the L5 vertebral level with post-operative changes in the soft tissues in the posterior lumbar region at these levels.

A posteriorly bulging disc with posterior peridiscal osteophytes is noted at the L5-S1 level.

A pseudo-posterior disc herniation with peridiscal osteophytes is noted at the L4-L5 level with bilateral neural foraminal narrowing. There is facetal and ligamentum flavum hypertrophy at the L4-L5 and L5 levels with a tight lumbar canal at these levels. Minimal facet joint effusion is noted at the L4-L5 and L5 levels.

Small posterior disc bulges with peridiscal osteophytes are noted at the L3-L4, L2-L3 , L1-L2 and D12-L1 levels.

The intrathecal nerve roots show normal distribution.
..2/.






- 2 -

.
The lumbar vertebral bodies show spotty fatty marrow changes. The rest of 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 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
16.0 mm at L2-L3
15.0 mm at L3-L4
9.0 mm at L4-L5

Screening T2 Weighted sagittal images of the dorsal spine reveal reduction in height and loss of water content of the dorsal intervertebral discs. Posterior peridiscal osteophytes are noted in the lower dorsal region. Slight facetal hypertorphy is also noted at the D9-D10 and D10-D11 levels.

IMPRESSION :

1. Post-operative status.

2. Grade I spondylolisthesis of the L5 over the S1 vertebra and L4 over the L5 vertebra with probable spondylolysis at L5 level is noted.

3. A posteriorly bulging disc with posterior peridiscal osteophytes at the L5-S1 level.

4. A pseudo-posterior disc herniation with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing with facetal and ligamentum flavum hypertrophy at the L4-L5 and L5 levels with a tight lumbar canal at these levels.

As compared to the previous MRI (scan no:448) dated 00.00.00, there is now evidence of a Grade I spondylolisthesis of the L4 over the L5 vertebra with a tight lumbar canal at the L4-L5 level.

Date : 00.00.00
hs/sb
Name of the Patient : Abc XyzHuslmn / M / 18 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O uncontrolled seizures since 9 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 abnormal signal intensity within the brain parenchyma.

The hippocampal complex on either side is unremarkable.

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

IMPRESSION :

No abnormality detected within the brain on this study.