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.

hs/ke
Name of the Patient : Abc Xyzr S. Jalmn / M / 40 yrs.
Referred by : Dr. Abc Xyzgla.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left facial twitching, below the eye.

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.

MR cisternogram was obtained in the coronal plane.

OBSERVATION :

There is evidence of a focal hyperintensity on the T2 Weighted, proton and FLAIR images (hypointense on the T1 Weighted images) within the left middle cerebellar peduncle.

The seventh and eighth cranial nerve complex on either side are 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.

Incidental note is made of bilateral maxillary sinusitis.

IMPRESSION :

The MRI features are suggestive of a focal signal alteration within the left middle cerebellar peduncle and this may represent demyelination/ischemia.

hs/ke
Name of the Patient : Abc Xyzr S. Jalmn / M / 40 yrs.
Referred by : Dr. Abc Xyzgla.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left facial twitching, below the eye.

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.

MR cisternogram was obtained in the coronal plane.

OBSERVATION :

There is evidence of a focal hyperintensity on the T2 Weighted, proton and FLAIR images (hypointense on the T1 Weighted images) within the left middle cerebellar peduncle.

The seventh and eighth cranial nerve complex on either side are 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.

Incidental note is made of bilateral maxillary sinusitis.

IMPRESSION :

The MRI features are suggestive of a focal signal alteration within the left middle cerebellar peduncle and this may represent demyelination/ischemia.

Date : 00.00.00

Name of the Patient : Abc Xyza Hlmn / F / 52 yrs.
Referred by : Dr. Abc Xyzrdiwalla.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to the RLE with paresthesias.

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 :

A postero-central disc herniation is seen at the L5-S1 level. This intervertebral disc is dessicated.

A small posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level.

The right L4-L5 facet joint shows degenerative changes.

The rest of the lumbar intervertebral discs show mild loss of water content. A well-circumscribed hyperintensity on all the pulse sequences within the L2 vertebral body may represent a hemangioma with high fat content.

The rest of the lumbar vertebral bodies show normal signal intensity. The remaining 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 S1 level.













- 2 -

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

19.0 mm at L1-L2

20.0 mm at L2-L3

18.0 mm at L3-L4

19.0 mm at L4-L5

15.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A postero-central disc herniation at the L5-S1 level.

2. A small posterior disc herniation and facetal arthropathy on the right side at the L4-L5 level.

Date : 00.00.00

Name of the Patient : Abc Xyza Hlmn / F / 52 yrs.
Referred by : Dr. Abc Xyzrdiwalla.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to the RLE with paresthesias.

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 :

A postero-central disc herniation is seen at the L5-S1 level. This intervertebral disc is dessicated.

A small posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level.

The right L4-L5 facet joint shows degenerative changes.

The rest of the lumbar intervertebral discs show mild loss of water content. A well-circumscribed hyperintensity on all the pulse sequences within the L2 vertebral body may represent a hemangioma with high fat content.

The rest of the lumbar vertebral bodies show normal signal intensity. The remaining 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 S1 level.













- 2 -

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

19.0 mm at L1-L2

20.0 mm at L2-L3

18.0 mm at L3-L4

19.0 mm at L4-L5

15.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A postero-central disc herniation at the L5-S1 level.

2. A small posterior disc herniation and facetal arthropathy on the right side at the L4-L5 level.

hs/ke
Date : 00.00.00

Name of the Patient : Abc Xyzra D. Klmn / M / 26 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O neck pain (nape) with numbness of the tongue on the left side with difficulty in speaking and swallowing.
H/O fever.
O/E lower cranial nerve (X, XI and XII) palsy.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted , proton and T2 Weighted axial images.

4 mm thick GRASS coronal images through the region of interest.

5 mm thick GRASS and T1 Weighted axial images. .

OBSERVATION :

Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted and GRASS images are seen to involve the left lateral mass of the atlas and the left occipital condyle with involvement of the left atlanto-occipital joint. There is extension into the left paravertebral soft tissues and left anterior epidural space with indentation upon the cord and cervico-medullary junction at this level.

Enlarged lymph nodes are noted in the cervical region. Inflammatory changes are seen within the paranasal sinuses.

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.
..2/.









- 2 -


IMPRESSION :

The MRI features are suggestive of a pathologic process involving the left atlanto-occipital joint and enlarged lymph nodes in the cervical region. This is most likely the result of an infective process like tuberculosis.

The possibility of this being a neoplastic process is less likely.

Date : 00.00.00

Name of the Patient : Abc Xyzla Nagbhulmn / F / 39 yrs.
Referred by : Dr. Abc XyzV. Shah / Dr. Abc XyzVani.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to the RLE since 2 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 mild retrolisthesis of the L4 vertebra over the L5 vertebra. The L3-L4 and L4-L5 intervertebral discs show loss of water content.

A small posterior disc bulge is noted at the L5-S1 level. This intervertebral disc shows slight loss of water content. The L5-S1 facet joints shows severe hypertrophic degenerative changes.

A postero-central disc herniation is seen to indent the thecal sac at the L4-L5 level. Left postero-lateral and left far lateral disc herniations are seen to narrow the left neural foramen and indent the exiting left L4 nerve root at the L4-L5 level.

A posterior disc bulge is seen to indent the thecal sac at the L3-L4 level. A left postero-lateral disc protrusion is seen to narrow the left neural foramen at this level.

Facetal hypertrophy is noted at the L3-L4 and L4-L5 levels.

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 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 :

17.0 mm at L1-L2

17.0 mm at L2-L3

12.0 mm at L3-L4

9.0 mm at L4-L5

7.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A small posterior disc bulge and severe hypertrophic facetal arthropathy with canal stenosis at the L5-S1 level.

2. A posterior disc herniation with canal stenosis at the L4-L5 level.

3. Left postero-lateral and left far lateral disc herniations at the L4-L5 level.

4. Facetal hypertrophy at the L3-L4 and L4-L5 levels.

Date : 00.00.00

Name of the Patient : Abc Xyzla Nagbhulmn / F / 39 yrs.
Referred by : Dr. Abc XyzV. Shah / Dr. Abc XyzVani.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to the RLE since 2 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 mild retrolisthesis of the L4 vertebra over the L5 vertebra. The L3-L4 and L4-L5 intervertebral discs show loss of water content.

A small posterior disc bulge is noted at the L5-S1 level. This intervertebral disc shows slight loss of water content. The L5-S1 facet joints shows severe hypertrophic degenerative changes.

A postero-central disc herniation is seen to indent the thecal sac at the L4-L5 level. Left postero-lateral and left far lateral disc herniations are seen to narrow the left neural foramen and indent the exiting left L4 nerve root at the L4-L5 level.

A posterior disc bulge is seen to indent the thecal sac at the L3-L4 level. A left postero-lateral disc protrusion is seen to narrow the left neural foramen at this level.

Facetal hypertrophy is noted at the L3-L4 and L4-L5 levels.

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 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 :

17.0 mm at L1-L2

17.0 mm at L2-L3

12.0 mm at L3-L4

9.0 mm at L4-L5

7.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A small posterior disc bulge and severe hypertrophic facetal arthropathy with canal stenosis at the L5-S1 level.

2. A posterior disc herniation with canal stenosis at the L4-L5 level.

3. Left postero-lateral and left far lateral disc herniations at the L4-L5 level.

4. Facetal hypertrophy at the L3-L4 and L4-L5 levels.

Date : 00.00.00

Name of the Patient : Abc Xyz Nlmn / F / 20 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Plelvis.


CLINICAL PROFILE :

C/O primary amenorrhea.
Follow up.
H/O surgery 1 year ago. Details of this surgery were unavailable to us as the patient/relatives refused to reveal the same.

EXAMINATION :

M.R.I. of the pelvis was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

6 mm thick T1 Weighted and T2 Weighted (with fat saturation) sagittal images.

6 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There is seen an approximately 9.5 x 4.5 x 6.0 cms sized well-defined, hyperintense mass lesion on the T1 Weighted image between the rectum and the uterus more to the left of the midline. This lesion appears significantally more hyperintense on the T2 Weighted and STIR images. Layering is noted within this lesion.

An approximately, 4.0 x 3.0 x 4.5 cm sized multiseptated cystic lesion is noted in the left adnexal region (which is slightly more hyperintense when compared to urine in the urinary bladder).

The uterus is displaced to the right and is antiverted. The endometrium is unremarkable. Both the ovaries are not well-identified, separately.

The urinary bladder shows no intrinsic lesion.

There are no abnormally enlarged pelvic lymphnodes identified. There is no free fluid in the pelvis.
- 2 -


IMPRESSION :

1. An approximately 9.5 x 4.5 x 6.0 cms sized mass lesion between the uterus and the rectum more to the left of the midline is not specific for a single etiology. This may represent a haemorrhagic collection/fluid with high protein content in the region of the vagina (? due to vaginal atresia/vaginal septum - ? distended horn of a bicornuate uterus) .

2. An approximately, 4.0 x 3.0 x 4.5 cm sized multiseptate cystic lesion in the left adnexal region may represent an ovarian cyst.

Date : 00.00.00

Name of the Patient : Abc Xyzhandra Dolmn / M / 86 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O facial palsy 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 Fast Scan (T2 *) and FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular deep white matter in the corona radiata and centrum semiovale bilaterally, the lentiform nucleus on the right side posteriorly and inferior cerebellar vermis. Few smaller lesions are also noted in the temporal lobes bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are suggestive of ischemic areas.

There is mild dilatation of the ventricular system. There is prominence of the cerebral cortical sulcal spaces in the fronto-parietal regions and 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.

Incidental note is made of an empty sella.

IMPRESSION :

Areas of altered signal intensity in the periventricular deep white matter, corona radiata and centrum semiovale bilaterally, inferior cerebellar vermis, right lentiform nucleus and temporal lobes represent ischemic changes.