Date : 00.00.00

Name of the Patient : Abc XyzO.T. Dslmn / F / 31 yrs.
Referred by : Dr. Abc XyzShah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with numbness in the LLE since 00.00.00.

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 sacralization of the L5 vertebra and the L1 vertebral body is as marked on the film.

A large left paracentral and left far lateral disc herniation is seen at the L4-L5 level with anterior compression of the thecal sac and bilateral neural foraminal narrowing, left more than right. A disc fragment is seen to migrate inferiorly in the left lateral recess of L5 vertebra with impingement of the traversing left L5 nerve root. A small disc portion is also seen to migrate superiorly in the left lateral recess of L4 vertebra. There is mild indentation upon the exiting left L4 nerve root at the L4-L5 level. The right L5 nerve root appears thickened ? inflamed.

A posterior disc herniation is seen at the L3-L4 level with anterior indentation of the thecal sac.

The L3-L4 , L4-L5 and L5-S1 intervertebral discs show loss of water content.

Type II degenerative changes are noted in the postero-superior aspect of the L5 vertebra.

The rest of 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 modularize terminates at the D11-D12 level and the theca sac terminates at the S1 level.
..2/.




- 2 -


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

24.0 mm at L1-L2

18.0 mm at L2-L3

14.0 mm at L3-L4

10.0 mm at L4-L5

5.0 mm at L5-S1

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. A large left paracentral and left far lateral disc herniation at the L4-L5 level with a disc fragment migrating inferiorly in the left lateral recess of L5 vertebra impinging the traversing left L5 nerve root with a small disc portion seen to migrate superiorly in the left lateral recess of L4 vertebra. There is mild indentation upon the exiting left L4 nerve root at the L4-L5 level. The right L5 nerve root appears thickened ? inflamed.

3. A posterior disc herniation at the L3-L4 level.

Date : 00.00.00

Name of the Patient : Abc Xyzerclmn / F / 36 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O paresthesias in the cervico-dorsal region with paresthesias in the LUE and LLE since 2 days.
H/O right sided hemiparesis since 15 days.

EXAMINATION :

M.R.I of the cervico-dorsal 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.

After administration of contrast, 4 mm thick T1 Weighted sagittal images of the cervical and dorsal spines and 7 mm thick T1 Weighted axial images were obtained.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

The cervical spinal cord appears swollen and shows a hypointense signal within the cord centrally and slightly to the right of the midline on the T1 Weighted images extending over the cervico-medullary junction to the D2 vertebral level. This is seen to turn heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. The normally oval shape of the spinal cord is altered over the C3-C4 to C6-C7 levels with suspicious thickening of the meninges.

After administration of contrast, there is patchy enhancement along the periphery of the spinal cord in the cervical and upper dorsal regions.

Few upper cervical intervertebral discs show loss of water content.





- 2 -


The visualized cervico-dorsal 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 L1 level.

A right parahilar enlarged lymph node is visualized.

IMPRESSION :

Altered signal in the spinal cord extending over the cervico-medullary junction to the D2 vertebral level predominantly involving the lateral and posterior columns is not specific for a single etiology.

This may represent myelitis with ? arachnoiditis.

The possibility of demyelination/ischemia seems less likely.

Date : 00.00.00

Name of the Patient : Abc Xyzerclmn / F / 36 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O paresthesias in the cervico-dorsal region with paresthesias in the LUE and LLE since 2 days.
H/O right sided hemiparesis since 15 days.

EXAMINATION :

M.R.I of the cervico-dorsal 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.

After administration of contrast, 4 mm thick T1 Weighted sagittal images of the cervical and dorsal spines and 7 mm thick T1 Weighted axial images were obtained.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

The cervical spinal cord appears swollen and shows a hypointense signal within the cord centrally and slightly to the right of the midline on the T1 Weighted images extending over the cervico-medullary junction to the D2 vertebral level. This is seen to turn heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. The normally oval shape of the spinal cord is altered over the C3-C4 to C6-C7 levels with suspicious thickening of the meninges.

After administration of contrast, there is patchy enhancement along the periphery of the spinal cord in the cervical and upper dorsal regions.

Few upper cervical intervertebral discs show loss of water content.





- 2 -


The visualized cervico-dorsal 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 L1 level.

A right parahilar enlarged lymph node is visualized.

IMPRESSION :

Altered signal in the spinal cord extending over the cervico-medullary junction to the D2 vertebral level predominantly involving the lateral and posterior columns is not specific for a single etiology.

This may represent myelitis with ? arachnoiditis.

The possibility of demyelination/ischemia seems less likely.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzalmn / F / 22 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O TB hilar lymphadenopathy with seizures since 3 months. On eptoin ?? HIV.
C/O weakness of BUE and BLE since February 01, 0000 with lower cranial nerve palsies.

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 are well-circumscribed hyperintense areas in the right lentiform nucleus, subthalamus and the right corona radiata on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images and would represent calcification/paramagnetic substances/methemoglobin. Similar ill-defined hyperintense areas are noted in the left cerebellar hemisphere in the posterior aspect on the T1 Weighted images.

Small, hypointense areas are seen in the thalami, subthalami and cerebral peduncles bilaterally on the proton, T2 Weighted and FLAIR images which are seen to remain hypointense on the T1 Weighted images. These lesions have a peripheral hyperintense rim on the proton, T2 Weighted and FLAIR images with a spectacled appearance.

An ill-defined hyperintense area is seen in the right periatrial deep white matter which is seen to follow CSF signal characteristics on all the pulse sequences. Hypointense areas are seen at the periphery of this lesion on the T1 Weighted images which turns hyperintense on the proton and T2 Weighted and FLAIR images and would represent areas of gliosis. There is slight dilatation of the atrium of the right lateral ventricle and would represent areas of cystic encephalomalacia.





- 2 -


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 bilateral maxillary sinusitis, inflammatory changes in the ethmoidal air cells on the right side and sphenoid sinus.

The cervico-medullary junction is unremarkable. Screening of the upper cervical spinal cord reveals no feature of note.

IMPRESSION :

Altered signal in the right lentiform nucleus, right corona radiata, in the left cerebellar hemisphere, thalami, subthalami and cerebral peduncles bilaterally is most likely due to a
granulomatous infective lesion ike toxoplasmosis.

The possibility of this lesion being tuberculous in origin or a neoplastic process like secondaries is less likely.

A contrast enhanced scan would be useful if clinically indicated.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzalmn / F / 22 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O TB hilar lymphadenopathy with seizures since 3 months. On eptoin ?? HIV.
C/O weakness of BUE and BLE since February 01, 0000 with lower cranial nerve palsies.

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 are well-circumscribed hyperintense areas in the right lentiform nucleus, subthalamus and the right corona radiata on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images and would represent calcification/paramagnetic substances/methemoglobin. Similar ill-defined hyperintense areas are noted in the left cerebellar hemisphere in the posterior aspect on the T1 Weighted images.

Small, hypointense areas are seen in the thalami, subthalami and cerebral peduncles bilaterally on the proton, T2 Weighted and FLAIR images which are seen to remain hypointense on the T1 Weighted images. These lesions have a peripheral hyperintense rim on the proton, T2 Weighted and FLAIR images with a spectacled appearance.

An ill-defined hyperintense area is seen in the right periatrial deep white matter which is seen to follow CSF signal characteristics on all the pulse sequences. Hypointense areas are seen at the periphery of this lesion on the T1 Weighted images which turns hyperintense on the proton and T2 Weighted and FLAIR images and would represent areas of gliosis. There is slight dilatation of the atrium of the right lateral ventricle and would represent areas of cystic encephalomalacia.





- 2 -


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 bilateral maxillary sinusitis, inflammatory changes in the ethmoidal air cells on the right side and sphenoid sinus.

The cervico-medullary junction is unremarkable. Screening of the upper cervical spinal cord reveals no feature of note.

IMPRESSION :

Altered signal in the right lentiform nucleus, right corona radiata, in the left cerebellar hemisphere, thalami, subthalami and cerebral peduncles bilaterally is most likely due to a
granulomatous infective lesion ike toxoplasmosis.

The possibility of this lesion being tuberculous in origin or a neoplastic process like secondaries is less likely.

A contrast enhanced scan would be useful if clinically indicated.

Date : 00.00.00

Name of the Patient : Abc Xyzi A. Thlmn / F / 5 1/2 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures.
H/O mumps 1 year back.

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 and 5 mm thick FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

Subtle hyperintense signal is noted within the body and tail of the hippocampus bilaterally , right more than the left on the T2 Weighted images. There also appears to be reduction of the volume of the hippocampus bilaterally, with prominence of the temporal horns.

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 hippocampal sclerosis bilaterally.

Date : 00.00.00

Name of the Patient : Abc Xyzmmed Almn / M / 4 mnths.
Referred by : Dr. Abc Xyzlande / Dr. Abc Xyzooq.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O lumbar meningocele.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
3 mm thick T1 Weighted coronal images.

OBSERVATION :

There is evidence of an open spinal canal at the L3 and L4 vertebral levels.

There is tethering of the spinal cord with the conus seen to lie at the L5 level.

A hypointense tract is seen extending from the spinal canal to the surface of the skin at the L3-L4 level on the T1 Weighted images which is seen to turn heterogeneously hyperintense on the T2 Weighted images. This tract is seen to be in connection with a large lesion on the surface of the skin which measures approximately 6.5 x 6.1 cms. This lesion has a mixed signal intensity characteristics in the centre, with a peripheral hyperintense rim on the T1 Weighted images. This lesion is seen to turn heterogeneously hyperintense on the T2 Weighted images with the periphery remaining hypointense.

There is a suggestion of a small syrinx at the L2 and L3 levels. A cleft is seen anteriorly in the spinal cord anteriorly suggestive of a ventral myelochisis.

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

IMPRESSION :

1. Tethering of the spinal cord with the conus seen to lie at the L5 level.
2. Lipomyelomeningocele in the lumbar region as described.

/395 Date : 00.00.00
hs/sb
Name of the Patient : Abc Xyzram Chaudlmn / M / 59 yrs.
Referred by : Dr. Abc XyzShah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O pain, weakness and inability to lift up the LUE since 00.00.00 and slurred speech.
Known diabetic & hypertensive. On Rx.

EXAMINATION :

The brain was screened with the help of 5 mm thick T2 Weighted axial images .

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

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

Areas of hyperintensity on the T2 Weighted images are noted within the white matter in the fronto-parietal lobes, lentiform nuclei and corona radiata bilaterally and within the right cerebral peduncle and these are most likely ischemic in etiology. A probable recent ischemic lesion is noted in the left corona radiata.

There is fullness of the third and both the lateral ventricles. There is prominence of the basal cisternal spaces, cerebral cortical sulci and cerebellar folia bilaterally. There is no shift of the midline structures.

Inflammatory changes are seen in the right maxilllary sinus.

INTRACRANIAL MRA :

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 and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
..2/.








- 2 -

.
NECK MRA :

There is tortuousity of the neck vessels.

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 :

1. Areas of altered signal within the white matter in the fronto-parietal lobes, lentiform nuclei and corona radiata bilaterally and within the right cerebral peduncle are most likely ischemic in etiology.

2. No significant abnormality detected on the intracranial or neck MRA on this study.

Date : 00.00.00

Name of the Patient : Abc Xyz Kamrunnlmn / F / 60 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O 3-4 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a well-defined lesion in the right parietal cortex which measures approximately 1.5 x 1.0 cms. This lesion is slightly hyperintense to the white matter on the T1 Weighted images. The periphery is seen to turn hypointense on the proton, T2 Weighted and FLAIR images. Few hypointnese specks are noted within this lesion on the T1 Weighted images which are seen to turn hyperintense on the proton and T2 Weighted images. The centre of the lesion is seen to follow CSF characteristics on all the pulse sequences. There is surrounding white matter edema with slight effacement of the adjacent sulci. A suspicious eccentric speck is visualized on the FLAIR images suggestive of a scolex.

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 :

The MRI features are suggestive of a granulomatous infective lesion following the signal characteristics of a cysticercus in the right high parietal cortex as described with surrounding mass effect. A follow-up study may be worthwhile.

Date : 00.00.00

Name of the Patient : Abc Xyz Kamrunnlmn / F / 60 yrs.
Referred by : Dr. Abc Xyzidhungat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O 3-4 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a well-defined lesion in the right parietal cortex which measures approximately 1.5 x 1.0 cms. This lesion is slightly hyperintense to the white matter on the T1 Weighted images. The periphery is seen to turn hypointense on the proton, T2 Weighted and FLAIR images. Few hypointnese specks are noted within this lesion on the T1 Weighted images which are seen to turn hyperintense on the proton and T2 Weighted images. The centre of the lesion is seen to follow CSF characteristics on all the pulse sequences. There is surrounding white matter edema with slight effacement of the adjacent sulci. A suspicious eccentric speck is visualized on the FLAIR images suggestive of a scolex.

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 :

The MRI features are suggestive of a granulomatous infective lesion following the signal characteristics of a cysticercus in the right high parietal cortex as described with surrounding mass effect. A follow-up study may be worthwhile.