hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzen M. Jlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O involuntary movements of the right hand since 8 days and right foot since 3 dyas.
H/O DM & HT.
Has been operated for Potts spine (D5) in 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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

Susceptibility artifacts are seen in the region of the mandible on the left side (dental prosthesis/fillings).

Irregularly defined areas of hypointensity are seen on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images within the thalamus bilaterally.

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 left maxillary sinus.

IMPRESSION :

The MRI features are suggestive of areas of altered signal intensity within the thalamus bilaterally. These may represent infarcts (? venous ? arterial).

The possibility of this being a demyelinating process cannot be entirely ruled out though less likely.

Date : 00.00.00

Name of the Patient : Abc XyzPlmn / F / 9 yrs.
Referred by : Dr. Abc Xyzthalani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O gait imbalance since 2 days.
H/O chicken pox 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.

OBSERVATION :

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.

Inflammatory changes are seen within the left maxillary sinus and middle ear and mastoid air cells on the left side. Enlarged adenoids are made note of.

IMPRESSION :

No abnormality detected within the brain per se on this study.

Date : 00.00.00

Name of the Patient : Abc XyzPlmn / F / 9 yrs.
Referred by : Dr. Abc Xyzthalani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O gait imbalance since 2 days.
H/O chicken pox 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.

OBSERVATION :

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.

Inflammatory changes are seen within the left maxillary sinus and middle ear and mastoid air cells on the left side. Enlarged adenoids are made note of.

IMPRESSION :

No abnormality detected within the brain per se on this study.

/81 Date : 00.00.00

Name of the Patient : Abc XyzViblmn / M / 57 yrs.
Referred by : Dr. Abc Xyzrade.
Examination : M.R.I. of the Brain and Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O headaches.

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.

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

BRAIN :

Prominent Virchow-Robin spaces are noted within the centrum semiovale bilaterally.

Note is made of an empty sella.

There is mild prominence of the cerebral cortical sulci and 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.

Mild inflammatory changes are seen in the right maxillary sinus and in the ethmoidal air cells.

INTRACRANIAL MRA :

The left posterior communicating artery is seen to continue as the left posterior cerebral artery.



- 2 -

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, vertebral arteries and right posterior cerebral artery also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

The MRI features are suggestive of an empty sella.

No significant abnormality is detected on the intracranial /neck MRA on this study.

Date : 00.00.00

Name of the Patient : Abc XyzShlmn / F / 21 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain and Intracranial and Neck M.R.A/M.R.V.

CLINICAL PROFILE :

Known C/O venous angioma in the left orbit with extension in the left cerebral hemisphere and right cerebellum.
H/O left frontal craniotomy with excision of orbital angioma in June 0000.
Received 4 sittings of sclerotherapy.

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 FLAIR coronal images.

3 mm thick oblique sagittal images.

5 mm thick T1 Weighted sagittal images.

Intracranial and neck MRA was performed with 3D TOF and 2D TOF sequences.

OBSERVATION :

There are seen susceptibility artifacts in the left frontal region, the result of previous intervention.

There is a well-defined lesion which is seen to involve the superior rectus, medial rectus, inferior rectus and probably the superior oblique muscles which appear bulky on the T1 Weighted images. These are seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. The left eye ball is displaced antero-inferiorly.

There is a large ill-defined lesion in the left antero-lateral aspect of the upper jaw which is isointense to muscles on the T1 Weighted images and turns heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images and measures approximately 2.1 x 2.4 cms. No bony erosion or destruction is noted.

There are serpingenous flow void areas noted in the right cerebellar hemisphere, in the postero-lateral aspect of the pons, region of the inferior colliculus and in the region of vein of Galen which appears prominent and reepresents dilated vessels.

The optic nerve on the left side cannot be differentiated from the lesion. The right optic nerve shows normal signal intensity on the STIR images.

The cavernous sinuses are unremarkable.

Note is made of convex superior margin of the pituitary and which may be a normal for the patients age.

IMPRESSION :

In a known C/O lymphagioma the MRI features are suggestive of :

A well-defined lesion involving the superior rectus, medial rectus, inferior rectus and probably the superior oblique muscles.

A large ill-defined lesion in the left antero-lateral aspect of the upper jaw and measures approximately 2.1 x 2.4 cms.

/77 Date : 00.00.00

Name of the Patient : Abc Xyzhav Shirdhalmn / M / 8 1/2 yrs.
Referred by : Dr. Abc Xyzhiri.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O mental retardation with seizure disorder.

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 T2 Weighted coronal images.

5 mm thick T1 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

The hippocampal complex is unremarkable on this study.

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 bilateral maxillary sinusitis, inflammatory changes in the ethmoidal air cells, mastoiditis and enlarged adenoids.

IMPRESSION :

No abnormality detected within the Brain on this study.

/77 Date : 00.00.00

Name of the Patient : Abc Xyzhav Shirdhalmn / M / 8 1/2 yrs.
Referred by : Dr. Abc Xyzhiri.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O mental retardation with seizure disorder.

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 T2 Weighted coronal images.

5 mm thick T1 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

The hippocampal complex is unremarkable on this study.

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 bilateral maxillary sinusitis, inflammatory changes in the ethmoidal air cells, mastoiditis and enlarged adenoids.

IMPRESSION :

No abnormality detected within the Brain on this study.

ke/sb-sb/ke
/375/380 Date : 00.00.00

Name of the Patient : Abc XyzShlmn / F / 21 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain and Intracranial and Neck M.R.A/M.R.V.

CLINICAL PROFILE :

Known C/O venous angioma/lymphangioma in the left orbit.
H/O left frontal craniotomy with excision of orbital angioma in June 0000.
Received 4 sittings of sclerotherapy.

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 STIR coronal images.

3 mm thick T1 Weighted oblique sagittal images.

5 mm thick T1 Weighted sagittal images.

The MRA/MRV was performed using 2D TOF sequence.

OBSERVATION :

There are susceptibility artifacts in the left frontal region, the result of previous surgical intervention.

There is still seen a well-defined, intermediate signal intensity mass lesion on the T1 Weighted images in the left orbit. This lesion appears hyperintense on the proton, T2 Weighted and STIR images. The lesion extends from the orbital apex upto the posterior margin of the globe. Extension into the upper eyelid and inner canthus of the left orbit is also noted. The lesion is intraconal and extraconal in location and is seen to encase the superior rectus, medial rectus, inferior rectus and probably the superior oblique muscles. The left optic nerve is not well-identified separately from the lesion and is encased by the mass lesion. The left eye ball is displaced antero-inferiorly. Thinning of the roof and medial wall of left orbit is noted.
...2/..







- 2 -


There is a large, well-marginated lesion in the soft tissues, deep to the subcutaneous fat in the left maxillary region antero-inferior to the left maxillary sinus. This is isointense to normal muscle on the T1 Weighted images and turns heterogeneously hyperintense on the proton, T2 Weighted and STIR images and measures approximately 2.1 x 2.4 cms. No bony erosion or destruction is noted.

There are serpingenous flow void areas noted in the right cerebellar hemisphere, in the postero-lateral aspect of the pons, in the region of the inferior colliculus and in the region of vein of Galen which appears prominent and represent dilated vessels. Prominent vessels are also noted along the lateral wall of the left lateral ventricle.

There is no intracranial extension of the left orbital mass lesion. The right orbit, right optic nerve and the cavernous sinuses are unremarkable.

Note is made of a convex superior margin of the pituitary gland , which may be a normal for the patients age.

On the MRA and MRV, there is seen a fairly large vein draining into the vein of Galen on the left side. This vessel is seen in the left perimesencephalic cistern. The straight sinus, left transverse and sigmoid sinuses and the superior sagittal sinuses are prominent. The internal cerebral veins are unremarkable.

In the region of the left orbit, there is seen a prominent vascular channel in the left orbit (probably superior to the globe) which is seen to drain into a superficial vein in the left temporal region. This vessel, probably drains into the prominent vessel in the left perimesencephalic cistern, which then joins the vein of Galen.

The venous angioma in the right cerebellar hemisphere is not well delineated on the MRV.

No obvious arterial anomaly is identified on this study.

IMPRESSION :

In a known C/O venous angioma/lymphangioma the MRI features are suggestive of :

1. A recurrent/residual mass lesion in the left orbit with extensions as described.

2. A focal mass lesion in the soft tissues, deep to the subcutaneous fat in the left maxillary region antero-inferior to the left maxillary sinus. This lesion may also represent an angioma/lymphangioma.
..3/..





- 3 -


3. A prominent vascular channel in the left orbit which drains into a superfical vein in the left temporal region, which then, probably, drains intracranially, into a prominent venous channel in the left perimesencephalic cistern.

4. A prominent vein in the left perimesencephalic cistern, which drains into the vein of Galen, with prominent straight sinus, left transverse and sigmoid sinus.

5. No obvious arterial anomaly is identified on this study.

As compared to the previous MRI dated 00.00.00, there is increase in the size of the left orbital lesion.

ke/sb-sb/ke
/375/380 Date : 00.00.00

Name of the Patient : Abc XyzShlmn / F / 21 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain and Intracranial and Neck M.R.A/M.R.V.

CLINICAL PROFILE :

Known C/O venous angioma/lymphangioma in the left orbit.
H/O left frontal craniotomy with excision of orbital angioma in June 0000.
Received 4 sittings of sclerotherapy.

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 STIR coronal images.

3 mm thick T1 Weighted oblique sagittal images.

5 mm thick T1 Weighted sagittal images.

The MRA/MRV was performed using 2D TOF sequence.

OBSERVATION :

There are susceptibility artifacts in the left frontal region, the result of previous surgical intervention.

There is still seen a well-defined, intermediate signal intensity mass lesion on the T1 Weighted images in the left orbit. This lesion appears hyperintense on the proton, T2 Weighted and STIR images. The lesion extends from the orbital apex upto the posterior margin of the globe. Extension into the upper eyelid and inner canthus of the left orbit is also noted. The lesion is intraconal and extraconal in location and is seen to encase the superior rectus, medial rectus, inferior rectus and probably the superior oblique muscles. The left optic nerve is not well-identified separately from the lesion and is encased by the mass lesion. The left eye ball is displaced antero-inferiorly. Thinning of the roof and medial wall of left orbit is noted.
...2/..







- 2 -


There is a large, well-marginated lesion in the soft tissues, deep to the subcutaneous fat in the left maxillary region antero-inferior to the left maxillary sinus. This is isointense to normal muscle on the T1 Weighted images and turns heterogeneously hyperintense on the proton, T2 Weighted and STIR images and measures approximately 2.1 x 2.4 cms. No bony erosion or destruction is noted.

There are serpingenous flow void areas noted in the right cerebellar hemisphere, in the postero-lateral aspect of the pons, in the region of the inferior colliculus and in the region of vein of Galen which appears prominent and represent dilated vessels. Prominent vessels are also noted along the lateral wall of the left lateral ventricle.

There is no intracranial extension of the left orbital mass lesion. The right orbit, right optic nerve and the cavernous sinuses are unremarkable.

Note is made of a convex superior margin of the pituitary gland , which may be a normal for the patients age.

On the MRA and MRV, there is seen a fairly large vein draining into the vein of Galen on the left side. This vessel is seen in the left perimesencephalic cistern. The straight sinus, left transverse and sigmoid sinuses and the superior sagittal sinuses are prominent. The internal cerebral veins are unremarkable.

In the region of the left orbit, there is seen a prominent vascular channel in the left orbit (probably superior to the globe) which is seen to drain into a superficial vein in the left temporal region. This vessel, probably drains into the prominent vessel in the left perimesencephalic cistern, which then joins the vein of Galen.

The venous angioma in the right cerebellar hemisphere is not well delineated on the MRV.

No obvious arterial anomaly is identified on this study.

IMPRESSION :

In a known C/O venous angioma/lymphangioma the MRI features are suggestive of :

1. A recurrent/residual mass lesion in the left orbit with extensions as described.

2. A focal mass lesion in the soft tissues, deep to the subcutaneous fat in the left maxillary region antero-inferior to the left maxillary sinus. This lesion may also represent an angioma/lymphangioma.
..3/..





- 3 -


3. A prominent vascular channel in the left orbit which drains into a superfical vein in the left temporal region, which then, probably, drains intracranially, into a prominent venous channel in the left perimesencephalic cistern.

4. A prominent vein in the left perimesencephalic cistern, which drains into the vein of Galen, with prominent straight sinus, left transverse and sigmoid sinus.

5. No obvious arterial anomaly is identified on this study.

As compared to the previous MRI dated 00.00.00, there is increase in the size of the left orbital lesion.

Date : 00.00.00

Name of the Patient : Abc Xyzhandra Dolmn / M / 86 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O facial palsy on 00.00.00.

EXAMINATION :

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

INTRACRANIAL MRA :

There is marked ectasia of the vertebro-basilar system with marked prominence of the left vertebral artery and basilar artery.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, right basilar, right vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

The MRA features are suggestive of marked ectasia of the vertebro-basilar system.