Date : 00.00.00

Name of the Patient : Abc Xyzn R. Nilmn / M / 31 yrs.
Referred by : Dr. Abc Xyziya.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O giddiness with vomiting on 00.00.00 with left sided hemiplegia since then.
Patient is in altered sensorium.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images.
Intracranial MRA was performed with 3D TOF sequence.

The study could not be completed as the patient was not very co-operative and could not be sedated as per the referring physicians instruction.

OBSERVATION :

The T2 Weighted axial images of the brain reveal an ill-defined hyperintense signal in the right cerebellar hemisphere, posteriorly, in the pons and at the junction of the midbrain and pons, centrally, in the right cerebral peduncle, right thalamus and in the right temporo-parietal region. This signal change suggest ischemic changes, in the given clinical setting. Limited MRA sequence which was possible identifies the cavernous and supraclinoid segments of the internal carotid arteries, proximal anterior and middle cerebral arteries and the posterior cerebral arteries bilaterally. These vessels do not reveal significant feature of note. The distal basilar artery is not well identified on the collapsed angiograpy images.
..2/.




- 2 -


Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable.There is no shift of the midline structures.

IMPRESSION :

Altered signal in the right cerebellar hemisphere, posteriorly, in the pons and at the junction of the midbrain and pons, centrally, in the right cerebral peduncle , right thalamus and in the right temporo-parietal region most likely represents recent ischemic lesions, in the given clinical setting. There is no obvious haemorrhage noted.

The MR angio sequences needs to be repeated when the patient is co-operative.

Name of the Patient : Abc Xyznshu Katlmn / M / 2 yrs.
Referred by : Dr. Abc XyzKher.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O delayed milestones.

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 T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is no focal area of abnormal signal intensity in the brain parenchyma.

Ill-defined hyperintense signal on the T2 Weighted images in the posterior parietal periventricular white matter bilaterally most likely represents areas of terminal myelination.

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 :

Normal study of the brain.

Date : 00.00.00

Name of the Patient : Abc Xylmn / M / 6 yrs.
Referred by : Dr. Abc Xyzhalani.
Examination : M.R.I. of the Sella and Perisellar Region.

CLINICAL PROFILE :

Full Term ceasarian delivery with normal growth and development till 5 months of age. Disproportionate short stature and frontal bossing. HGH not detected. Thyroid hormones normal.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.

3 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

There is seen a hyperintense focus on the T2 Weighted images in the subcortical white matter in the left occipital region. The ventricular system is unremarkable. There is no midline shift.

The pituitary gland measures 3.0 mms in height and shows normal contour and signal characteristics. The posterior pituitary gland shows a normal hyperintense signal on the T1 Weighted images.

The pituitary stalk is in the midline.

The cavernous sinuses and the supra sellar cistern are unremarkable.

IMPRESSION :

1. Altered signal in the subcortical white matter in the left occipital region is of ? etiology, ?? lacune.

2. The pituitary gland measures 3.0 mms in height without focal mass lesion.

Date : 00.00.00

Name of the Patient : Abc Xylmn / M / 6 yrs.
Referred by : Dr. Abc Xyzhalani.
Examination : M.R.I. of the Sella and Perisellar Region.

CLINICAL PROFILE :

Full Term ceasarian delivery with normal growth and development till 5 months of age. Disproportionate short stature and frontal bossing. HGH not detected. Thyroid hormones normal.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.

3 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

There is seen a hyperintense focus on the T2 Weighted images in the subcortical white matter in the left occipital region. The ventricular system is unremarkable. There is no midline shift.

The pituitary gland measures 3.0 mms in height and shows normal contour and signal characteristics. The posterior pituitary gland shows a normal hyperintense signal on the T1 Weighted images.

The pituitary stalk is in the midline.

The cavernous sinuses and the supra sellar cistern are unremarkable.

IMPRESSION :

1. Altered signal in the subcortical white matter in the left occipital region is of ? etiology, ?? lacune.

2. The pituitary gland measures 3.0 mms in height without focal mass lesion.

Date : 00.00.00

Name of the Patient : Abc Xylmn / M / 45 yrs.
Referred by : Dr. Abc Xyzbrani.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O pain in the right hip joint since 2 1/2 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.

The hip joints were screened with 5 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There is slight loss of water content of the L5-S1 intervertebral disc.

Posteriorly bulging discs are noted at the L4-L5 and L5-S1 levels with minimal indentation on the anterior dural theca. Slight hypertrophy of the facet joints at these levels is also noted.

Type II degenerative change is noted in the antero-superior portion of the L5 vertebral body.

Fat is noted in the filum terminale at the L3-L4 level.

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.

The conus medullaris terminates at the D12-L1 level and the theca sac terminates at the S2 level.


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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

11.0 mm at L4-L5

8.0 mm at L5-S1.

Screening images of the hip hoints reveal an ill-defined hypointense signal on the T1 Weighted images in the left iliac bone adjacent to the left sacro-iliac joint. This lesion appears hyperintense on the STIR images.

Bone islands are noted in the head of the right femur. No other significant abnormality is detected in the hip joints on either side.

IMPRESSION :

1. Posteriorly bulging discs at the L4-L5 and L5-S1 levels with slight facetal hypertrophy at these levels.

2. Altered signal in the iliac bone adjacent to the left sacro-iliac joint may suggest sacro-ilitis.

If clinically indicated a dedicated study of the sacro-iliac joints would be worthwhile.

Date : 00.00.00

Name of the Patient : Abc Xyzarayan Ylmn / M / 28 yrs.
Referred by : Dr. Abc Xyzrdikar.
Examination : M.R. Cholangiogram.

CLINICAL PROFILE :

C/O pain in the abdomen since 4 months.
C/O vomiting for 15 days in January 0000.
C/O jaundice since 1 month.

EXAMINATION :

The upper abdomen was scanned with 7 mm thick T1 Weighted and T2 Weighted axial images and 8 mm thick T2 Weighted coronal images.

MR cholangiogram was also obtained.

OBSERVATION :

There is moderate dilatation of the intrahepatic biliary radicles, the common bile duct and the pancreatic duct. Cut-off of the common bile duct and the pancreatic duct at the level of the uncinate process/periampullary region is noted. An intermediate signal intensity lesion on the T1 Weighted images which is relatively hypointense on the T2 Weighted images is noted in the periampullary region. The gall bladder is also moderately distended with evidence of layering. The pancreatic margins appear irregular with a beaded appearance of the pancreatic duct that is dilated.

There is no focal area of altered signal in the liver parenchyma. Mild hepatomegaly is noted.

Both the kidneys, spleen and the adrenal glands are unremarkable.

There are no abnormally enlarged abdominal lymph nodes or free fluid noted.

IMPRESSION :

Moderately dilated intrahepatic biliary radicles, common bile duct and the pancreatic duct with cut-off at the level of the uncinate process/periampullary region. Suspicious soft tissue lesion is noted in the periampullary region. A periampullary mass lesion (? malignant or as a result of chronic pancreatitis) should be ruled out.

ke/bv
Date : 00.00.00

Name of the Patient : Abc Xyzm R. Rohlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O progressive gait imbalance with inability to walk since 6-7 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 slight retroplacement of the C5 over the C6 vertebra.

There is a posterior disc herniation at the C5-C6 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing, right more than left. A large posterior peridiscal osteophyte is seen at this level.

A postero-central disc herniation is seen at the C4-C5 level with anterior indentation of the cord. The joint of Luschka on the right side show slight degenerative changes at this level with right neural foraminal narrowing.

Posterior peridiscal osteophytes are also noted at this level.

Small posterior disc bulges are noted at the C2-C3 and C3-C4 levels.

The cervical intervertebral discs show loss of water content.

Mild ligamentum flavum hypertrophy is noted at the C4-C5 and C5-C6 levels.

The C5-C6 intervertebral disc shows hypointense areas on all the pulse sequences suggestive of calcification/vacuum phenomena.
...2/..







- 2 -


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

The cervical spinal cord reveals normal signal intensity.

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

The brain was screened with 5 mm thick T2 Weighted axial images which shows hyperintense areas in the periatrial deep white matter, suggestive of areas of ischemic changes. A lacunar infarct is noted in the right lentiform nucleus with mild age related cerebral atrophy. Note is made of right maxillary sinusitis.

IMPRESSION :

1. A posterior disc herniation with a large posterior peridiscal osteophyte
at the C5-C6 level.

2. A postero-central disc herniation with small posterior peridiscal osteophytes at the C4-C5 level.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 38 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O high blood pressure with left hemiparesis on 00.00.00. Patient is in subconscious state.
Known hypertensive. On Rx.

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 :

There is a large lesion which measures approximately 6.2 x 4.5 x 6.1 cms in the right lentiform nucleus/external capsular region. Superiorly this lesion is seen to extend into the right corona radiata and inferiorly into the right temporal lobe. This lesion has a thick hyperintense periphery with a hypointense centre on the T1 Weighted images. The periphery is seen to remain hyperintense and the centre heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images and would represent hemoglobin breakdown products. There is a complete hypointense rim better appreciated on the Fast Scan (T2 *) images which represents haemosiderin rim and the lesion in toto represents a subacute hematoma. Hypointense areas peripherally which are slightly hyperintense to CSF on the T1 Weighted images are seen






to turn hyperintense on the proton and T2 Weighted images would represent serum due to clot retraction. There is dissection of the hematoma in the body of the right lateral ventricle. There is surrounding edema in the right cerebral hemisphere region with effacement of the adjacent sulci and compression upon the right lateral and the third ventricles and shift of the midline structures to the left. There is effacement of the right Sylvian fissure.

Hypointense areas are seen within the thalamus, caudate nucleus, subthalamus, midbrain, pons and the occipital lobe on the right side on the T1 Weighted images which are seen to turn hyperintense on the proton, T2 Weighted and FLAIR images would represent an infarct.

There is dilatation of the left lateral and the fourth ventricle with periventricular CSF ooze.

There is prominence of the cerebellar folia bilaterally.

No obvious vascular anomaly is identified on this study.

Incidental note is made of inflammatory changes in the mastoid air cells, sphenoid and maxillary sinus.

IMPRESSION :

The MRI features are suggestive of :

1. A large subacute hematoma measuring approximately 6.2 x 4.5 x 6.1 cms in the right lentiform nucleus and external capsular region with extensions as described.

2. Altered signal within the thalamus, caudate nucleus, subthalamus, midbrain, pons and the occipital lobe on the right side would represent an infarct.

Scan No : Date : .0000

Name of the Patient :
Referred by :
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :



EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

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

The visualized dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

IMPRESSION :

Normal study of the Dorsal Spine.

Scan No : Date : .0000

Name of the Patient :
Referred by : Dr.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :


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

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

Both the lateral, third and 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 scan.

IMPRESSION :

Normal study of the Brain.