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Sunday, 27 December 2015 16:48

14688

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzee Malmn / F / 80 yrs.
Referred by : Dr. Abc Xyzgaonkar.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O giddiness since 1 month.

EXAMINATION :

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

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

OBSERVATION :

There are hyperintense areas on the T2 Weighted images in thalami bilaterally, lentiform nuclei, corona radiata, centrum semiovale and the periventricular deep white matter and are ischemic in etiology.

There is blunting of the right cerebral peduncle.

The left Sylvian cistern and the sulcal spaces in the
left temporo-parietal and bilateral occipital regions are prominent, probably the result of previous vascular insult.

Lacunar infarcts are seen in the left internal capsule, right corona radiata and genu of the internal capsule on either side.

There is mild to moderate dilatation of both the lateral ventricles. The third and fourth ventricles are normal. There is prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Incidentally noted is an empty sella and inflammatory changes in the ethmoidal air cells and sphenoid sinus.
..2/.






INTRACRANIAL MRA :

There is slight irregularity of the left middle cerebral artery. Paucity of the left Sylvian vessels is noted. The A1 segment of the right anterior cerebral artery is hypoplastic. The vertebro-basilar system is ectatic. Concentric narrowing of the cavernous and supraclinoid segments of the right internal carotid artery is noted.

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

NECK MRA :

The left internal carotid artery is tortuous.

The left vertebral artery is smaller in calibre as compared to the right.

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

IMPRESSION :

1. Altered signal in bilateral thalami, lentiform nuclei, corona radiata, centrum semiovale and the periventricular deep white matter are ischemic in etiology.

2. Lacunar infarcts in the left internal capsule, right corona radiata and genu of the internal capsule on either side.

3. Slight irregularity of the left middle cerebral artery.
..3/.






- 3 - Scan-00008

4. Paucity of the left Sylvian vessels.

5. Concentric narrowing of the cavernous and supraclinoid segments of the right internal carotid artery may be due to atherosclerotic changes.

6. Cerebral cortical and cerebellar atrophy.
Sunday, 27 December 2015 16:48

14687

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 30 yrs.
Referred by : Dr. Abc Xyztchha.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the RUE with paresthesias.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There is a postero-central and right paracentral disc herniation with peridiscal osteophytes at the C4-C5 level with anterior indentation of the spinal cord. Superior and inferior migration of the disc in the right lateral recess of the C4 and C5 vertebral bodies is noted with impingement of the right C5 and the C6 nerve roots. There is also disc material identified in the right neural foramen at the C4-C5 level with compression of the right C5 nerve root.

A right postero-lateral disc herniation is seen at the C5-C6 level with mild right neural foraminal narrowing and indentation upon the right C6 nerve root. The C5-C6 intervertebral disc shows loss of water content.

Small peridiscal osteophytes are seen at the C3-C4 and C5-C6 levels.







The cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. 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.

IMPRESSION :

1. A postero-central and right paracentral disc herniation with peridiscal osteophytes at the C4-C5 level with superior and inferior migration of the disc in the right lateral recess of the C4 and C5 vertebrae and in the right neural foramen at this level with impingement of the right C5 and C6 nerve roots.

2. A right postero-lateral disc herniation at the C5-C6 level with indentation upon the right C6 nerve root.
Sunday, 27 December 2015 16:48

14686

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzini Dhalmn / F / 30 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the LLE and LUE with pain and inability to lift the LUE and memory impairment since 1 year, ? extrapyramidal 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.

5 mm thick FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is no focal area of altered signal intensity in 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.

IMPRESSION :

Normal study of the Brain.













Sunday, 27 December 2015 16:48

14685

bv/ke/rg.
Date : 00.00.00

Name of the Patient : Abc XyzMlmn / M / 34 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias since 1 month.

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 loss of water content of the L5-S1 intervertebral disc.

There is a fairly large posterior and right paracentral extruded disc at the L5-S1 level with posterior displacement of the thecal sac and the right S1 nerve root. There is rupture of the posterior longitudinal ligament. Fairly large posterior peridiscal osteophytes are noted at this level.

A small posterior disc bulge is seen at the L4-L5 level.

An anterior disc herniation is noted at the L2-L3 level. This disc shows slight loss of water content. Type II degenerative changes are seen in the antero-superior portion of the L3 vertebral body adjacent to the L2-L3 disc.

The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
..2/.







The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 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
17.0 mm at L3-L4
17.0 mm at L4-L5
4.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of a fairly large posterior and right paracentral extruded disc with peridiscal osteophytes at the L5-S1 level with posterior displacement of the thecal sac and the right S1 nerve root.

Sunday, 27 December 2015 16:48

14684

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzakala Slmn / F / 24 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches, giddiness with drooping of the right eyelid since 1 month and diplopia.

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 through the optic pathway.
5 mm thick T1 Weighted sagittal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images with magnetization transfer.
3 mm thick T1 Weighted sagital and coronal images.

OBSERVATION :

The pituitary gland appears bulky with irregularity of the pituitary stalk which appears thickened. The normal hyperintense signal of the posterior pituitary gland is not visualized on this study. There is a central necrotic area within the pituitary gland which turns hyperintense on the T2 Weighted images. There is compression upon the cavernous sinus on either side, more marked on the right side. After administration of contrast, there is thick peripheral enhancement of the pituitary with a non-enhancing centre (? necrotic). The pituitary stalk also shows homogeneous enhancement. There is extension of the soft tissue into the cavernous sinus on the right side.




The cavernous portion of the internal carotid arteries on either side show normal flow void signal on all the pulse sequences.

The optic chaisma is not well-visualized separately from the lesion. The intraconal optic nerves show normal signal intensity on the STIR images.

There is mild dilatation of both the lateral and third ventricles. 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.

IMPRESSION :

The MRI features are suggestive of an enlarged pituitary gland with central necrosis with thickening of the stalk and extension into the right cavernous sinus is not specific for a single etiology. Such features may be seen with Shehans syndrome (post-partum necrosis).














Sunday, 27 December 2015 16:48

14683

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzTrilmn / F / 44 yrs.
Referred by : Dr. Abc Xyzndya.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 3 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

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

The hippocampal complex on either side is 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.

IMPRESSION :

Normal study of the Brain.













Sunday, 27 December 2015 16:48

14682

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzV. Klmn / F / 30 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since the age of 10 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

The right hippocampal complex appears slightly smaller in volume when compared to the left and shows a hyperintense signal on the T2 Weighted images suggesting hippocampal sclerosis.

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 right sided hippocampal sclerosis.












Sunday, 27 December 2015 16:48

14681

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Dslmn / F / 24 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the S. I. Joints.

CLINICAL PROFILE :

C/O pain on the left side of the low back since 1 1/2 months.

EXAMINATION :

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

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

5 mm thick T1 Weighted and STIR coronal images.

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is sacralization of the L5 vertebra.

Both the sacro-iliac joints appear normal. The iliac bones and the sacral ala show normal signal intensity. There is no bony destruction or erosion. The visualized soft tissues are unremarkable.

The visualized musculature of the pelvis appears normal. Incidental note is made of right ovrian cyst.

No significant abnormality is detected on the screening images of the lumbar spine.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. No significant abnormality is detected within the sacro-iliac joints on this study.


Sunday, 27 December 2015 16:48

14680

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzra lmn / M / 60 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O backache and neckpain with pain radiating to the RUE and RLE.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There is slight scoliosis of the cervical spine with convexity to the left.

There is loss of water content of the cervical intervertebral discs.

small postero-central protruded discs with peridiscal osteophytes are noted at the C5-C6 and C6-C7 levels.

Slight degenerative changes of the joint of Luschka on the right is noted at the C6-C7 level. Slight facetal hypertrophy is noted at the C3-C4 and C4-C5 levels on the left.

There is anterior wedging of the C5 and C6 vertebrae without any change in signal intensity.

The cervical vertebral bodies show normal signal intensity. The remaining 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.

IMPRESSION :

1. Small postero-central protruded discs with peridiscal osteophytes at the C5-C6 and C6-C7 levels.

2. Slight degenerative changes of the joint of Luschka on the right at the C6-C7 level.

3. Slight facetal hypertrophy at the C3-C4 and C4-C5 levels on the left.


Sunday, 27 December 2015 16:48

14679

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 26 yrs.
Referred by : Dr. Abc Xyzwalla.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O pain in the right shoulder and pain on the left side of chest.

EXAMINATION :

M.R.I of the cervico-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 :

There is evidence of a congenital block D2 and D3 vertebra. The spinous processes of these vertebrae appear fused. No signal change is noted in these vertebral bodies. The C5-C6, D1-D2 and D3-D4 intervertebral discs show slight loss of water content.

A small postero-central protruded disc is noted at the C5-C6 level.

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

The visualized cervico-dorsal spinal cord reveals normal signal intensity. There is no cord compression.

IMPRESSION :

1. Congenital block D2 and D3 vertebra with fusion of the spinous processes of these vertebrae, without signal change or cord compression.

2. A small postero-central protruded disc at the C5-C6 level.