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.

Date : 00.00.00

Name of the Patient : Abc Xyzatidevi Rajlmn / F / 36 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

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.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

An irregularly defined mass lesion is noted in the region of the medulla and inferior cerebellar vermis. The fourth ventricle at this level cannot be identified separately from the mass lesion.

This lesion is hypointense on the T1 Weighted images and turns hyperintense on the proton, T2 Weighted and FLAIR images. The inferior portion of the lesion is isointense to CSF on the T1 Weighted, T2 Weighted and FLAIR images and hyperintense to CSF on the proton images and would represent a cystic component. It is seen to extend into the upper cervical cord upto the C2 vertebral level.

Multiple curvilinear and punctate signal voids are seen in the region of the mass lesion and would represent blood vessels.

A shunt tube is seen to course through the brain parenchyma with its tip lying in the frontal horn of the left lateral ventricle. Hypointense areas on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images are seen along the shunt tube in the right parietal lobe. This may represent edema/seepage of CSF.

Hyperintense signal on the FLAIR images is noted in the right frontal region, which may be due to shunt tube insertion through the right frontal burr hole.

The third and the lateral ventricles are otherwise unremarkable.

IMPRESSION :

The MRI features are suggestive of a mass lesion in the region of the medulla and inferior cerebellar vermis as described and most likely represent a hemangioblastoma.

Date : 00.00.00

Name of the Patient : Abc Xyzatidevi Rajlmn / F / 36 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

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.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

An irregularly defined mass lesion is noted in the region of the medulla and inferior cerebellar vermis. The fourth ventricle at this level cannot be identified separately from the mass lesion.

This lesion is hypointense on the T1 Weighted images and turns hyperintense on the proton, T2 Weighted and FLAIR images. The inferior portion of the lesion is isointense to CSF on the T1 Weighted, T2 Weighted and FLAIR images and hyperintense to CSF on the proton images and would represent a cystic component. It is seen to extend into the upper cervical cord upto the C2 vertebral level.

Multiple curvilinear and punctate signal voids are seen in the region of the mass lesion and would represent blood vessels.

A shunt tube is seen to course through the brain parenchyma with its tip lying in the frontal horn of the left lateral ventricle. Hypointense areas on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images are seen along the shunt tube in the right parietal lobe. This may represent edema/seepage of CSF.

Hyperintense signal on the FLAIR images is noted in the right frontal region, which may be due to shunt tube insertion through the right frontal burr hole.

The third and the lateral ventricles are otherwise unremarkable.

IMPRESSION :

The MRI features are suggestive of a mass lesion in the region of the medulla and inferior cerebellar vermis as described and most likely represent a hemangioblastoma.

bv/ke
Date : 00.00.00

Name of the Patient : Abc Xyzang Sulmn / M / 43 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 20 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 T1 Weighted sagittal images.

3 mm thick Fast Scan (T2 *) coronal images.

OBSERVATION :

There is a well circumscribed hypointense lesion seen in the left posterior parietal region on the T1 Weighted images. This lesion remains hypointense on the proton and T2 Weighted images and is seen to bloom on the Fast Scan (T2 *) images. Surrounding this lesion are hyperintense areas on the proton and T2 Weighted images suggestive of edema/gliosis.

The clivus is more horizontally placed than normal.

There is evidence of 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 :

1. Granuloma (? calcifying) in the left parietal region with surrounding gliosis.

2. Cerebellar atrophy.

bv/ke
Date : 00.00.00

Name of the Patient : Abc Xyzang Sulmn / M / 43 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 20 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 T1 Weighted sagittal images.

3 mm thick Fast Scan (T2 *) coronal images.

OBSERVATION :

There is a well circumscribed hypointense lesion seen in the left posterior parietal region on the T1 Weighted images. This lesion remains hypointense on the proton and T2 Weighted images and is seen to bloom on the Fast Scan (T2 *) images. Surrounding this lesion are hyperintense areas on the proton and T2 Weighted images suggestive of edema/gliosis.

The clivus is more horizontally placed than normal.

There is evidence of 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 :

1. Granuloma (? calcifying) in the left parietal region with surrounding gliosis.

2. Cerebellar atrophy.

ke/hs
Date : 00.00.00

Name of the Patient : Abc XyzSalmn / M / 53 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain and numbness/tingling in both hands and BLE with gait imbalance since 6-8 months.

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 loss of normal cervical curvature. There is a decrease in the height of the C4 and C5 vertebral bodies with slight anterior wedging of the C3, C4 and C5 vertebral bodies.

There is retroplacement of the C5 vertebra over the C6 vertebra.

There are large posterior peridiscal osteophytes, more to the right of the midline, at the C3-C4, C4-C5 and C5-C6 levels with anterior indentation of the cord and bilateral neural foraminal narrowing.

The spinal cord at the C4-C5 and C5-C6 levels shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images. This is isointense to normal cord on the T1 Weighted images and is suggestive of cord edema/ischemia/gliosis.

The C3-C4, C4-C5 and C5-C6 facet joints show degenerative changes. Anterior disc herniations with anterior peridiscal osteophytes are noted at these levels.

The joints of Luschka on the right side show degenerative changes at the C4-C5 and C5-C6 levels.
..2/.









- 2 -


There is reduction in height of the C3-C4, C4-C5 and C5-C6 intervertebral discs with loss of water content of the cervical and upper dorsal intervertebral discs.

The cervical vertebral bodies show areas of fatty replacement of normal marrow. The
visualized pre and paravertebral soft tissues are unremarkable.

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

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images which shows degenerative changes in the lumbar spine with posterior disc bulges at the L3-L4, L4-L5 and L5-S1 levels and Schmorls nodes in the dorso-lumbar region.

IMPRESSION :

1. Retroplacement of the C5 vertebra over the C6 vertebra.

2. Large posterior peridiscal osteophytes (hard discs) at the C3-C4, C4-C5 and C5-C6 levels with resultant canal stenosis at the C4-C5 and C5-C6 levels.

3. Cord signal alteration at the C4-C5 and C5-C6 levels suggests cord edema/ ischemia/gliosis.

ke/hs
Date : 00.00.00

Name of the Patient : Abc XyzSalmn / M / 53 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain and numbness/tingling in both hands and BLE with gait imbalance since 6-8 months.

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 loss of normal cervical curvature. There is a decrease in the height of the C4 and C5 vertebral bodies with slight anterior wedging of the C3, C4 and C5 vertebral bodies.

There is retroplacement of the C5 vertebra over the C6 vertebra.

There are large posterior peridiscal osteophytes, more to the right of the midline, at the C3-C4, C4-C5 and C5-C6 levels with anterior indentation of the cord and bilateral neural foraminal narrowing.

The spinal cord at the C4-C5 and C5-C6 levels shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images. This is isointense to normal cord on the T1 Weighted images and is suggestive of cord edema/ischemia/gliosis.

The C3-C4, C4-C5 and C5-C6 facet joints show degenerative changes. Anterior disc herniations with anterior peridiscal osteophytes are noted at these levels.

The joints of Luschka on the right side show degenerative changes at the C4-C5 and C5-C6 levels.
..2/.









- 2 -


There is reduction in height of the C3-C4, C4-C5 and C5-C6 intervertebral discs with loss of water content of the cervical and upper dorsal intervertebral discs.

The cervical vertebral bodies show areas of fatty replacement of normal marrow. The
visualized pre and paravertebral soft tissues are unremarkable.

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

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images which shows degenerative changes in the lumbar spine with posterior disc bulges at the L3-L4, L4-L5 and L5-S1 levels and Schmorls nodes in the dorso-lumbar region.

IMPRESSION :

1. Retroplacement of the C5 vertebra over the C6 vertebra.

2. Large posterior peridiscal osteophytes (hard discs) at the C3-C4, C4-C5 and C5-C6 levels with resultant canal stenosis at the C4-C5 and C5-C6 levels.

3. Cord signal alteration at the C4-C5 and C5-C6 levels suggests cord edema/ ischemia/gliosis.

Date : 00.00.00

Name of the Patient : Abc Xyza G. lmn / F / 41 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided weakness on 00.00.00 with loss of consciousness for 2 hours and increased blood pressure.
Patient is a 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.

3 mm thick Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a fairly well-defined space-occupying lesion in the pons on the right side and measuring approximately 1.3 x 2.2 x 1.2 cms. It is hypointense with a hyperintnese rim on the T1 Weighted images and turns hyperintense on the proton and T2 Weighted images and would be suggestive of a subacute bleed. There is mild indentation upon the fourth ventricle.

Few well-defined areas which are iso to hyperintense to CSF on all the pulse sequences are evident within the head of the left caudate nucleus, left thalamus/left cerebral peduncle and right para-atrial white matter. These would most likely represent lacunar infarcts.

Few hyperintense foci on the proton and T2 Weighted images are noted within the corona radiata bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are most likely ischemic in etiology.

There is mild fullness of both the lateral ventricles. The third ventricle and basal cisternal spaces are unremarkable.


- 2 -


There is no shift of the midline structures.

No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of a subacute bleed within the pons on the right side and measuring approximately 1.3 x 2.2 x 1.2 cms.

Date : 00.00.00

Name of the Patient : Abc Xyza G. lmn / F / 41 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided weakness on 00.00.00 with loss of consciousness for 2 hours and increased blood pressure.
Patient is a 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.

3 mm thick Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a fairly well-defined space-occupying lesion in the pons on the right side and measuring approximately 1.3 x 2.2 x 1.2 cms. It is hypointense with a hyperintnese rim on the T1 Weighted images and turns hyperintense on the proton and T2 Weighted images and would be suggestive of a subacute bleed. There is mild indentation upon the fourth ventricle.

Few well-defined areas which are iso to hyperintense to CSF on all the pulse sequences are evident within the head of the left caudate nucleus, left thalamus/left cerebral peduncle and right para-atrial white matter. These would most likely represent lacunar infarcts.

Few hyperintense foci on the proton and T2 Weighted images are noted within the corona radiata bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are most likely ischemic in etiology.

There is mild fullness of both the lateral ventricles. The third ventricle and basal cisternal spaces are unremarkable.


- 2 -


There is no shift of the midline structures.

No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of a subacute bleed within the pons on the right side and measuring approximately 1.3 x 2.2 x 1.2 cms.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyz R. lmn / M / 60 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O Parkinsons disease.

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.

There is mild fullness of the third and both the lateral ventricles. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

The fourth ventricle is normal. 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 giant cisterna magna.

IMPRESSION :

The MRI features are suggestive of mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally and this may be age related.