ke/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzd Jhalmn / M / 58 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O occasional gidiness with fall for a minute.

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 foci on the T2 Weighted images in the periatrial white matter and are probably ischemic in etiology.

A retrocerebellar arachnoid pouch is noted.

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

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.







NECK MRA :

There is a very small filling defect in the postero-lateral aspect of the internal carotid artery on the left side just after the bifurcation of the left common carotid artery and probably represents an atherosclerotic plaque.

The common carotid arteries are unremarkable.

IMPRESSION :

1. Foci of altered signal in the periatrial white matter are probably ischemic in etiology.

2. A very small filling defect in the postero-lateral aspect of the internal carotid artery on the left side just distal to its origin most probably represents an atherosclerotic plaque.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzalmn / M / 35 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

Alleged H/O fall at 8.00 pm on 00.00.00 with paraplegia and bladder involvement.

EXAMINATION :

M.R.I of the dorso-lumbar 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 anterior wedging of the L1 vertebral body with slight retropulsion of the L1 body and a resultant kyphus at that level. The L1 vertebral body and the superior half of the L3 vertebral body appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. There is compression of the thecal sac at the L1 vertebral body by the retropulsed vertebral body with clumping of the intrathecal nerve roots at that level. Fracture of the left lamina and pedicles bilaterally, of L1 is noted. The superior cortical endplate of L1 also appears broken. Minimal prevertebral and paravertebral soft tissue lesion is noted at the L1 vertebral level which may represent soft tissue injury. There is also rupture of the anterior and posterior longitudinal ligaments.

A small postero-central disc herniation is noted at the L4-L5 level.
Scan-00007


The rest of the lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The visualized lower dorsal spinal cord shows normal signal intensity.

The conus medullaris terminates at the D12 level.

IMPRESSION :

Anterior wedging of the L1 vertebral body with retropulsion and change in the signal intensity of the L1 and L3 vertebral bodies as described most likely is the sequelae of previous trauma. There is resultant thecal sac compression at the L1 vertebral level.

sb/bv/nl/rg.
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 Lumbo-sacral Spine.

CLINICAL PROFILE :

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

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 lumbar intervertebral discs.

There is a very small, left paracentral disc herniation at the L5-S1 level with minimum indentation on the traversing left S1 nerve root.

There is a small posterior disc bulge with a left postero-lateral (foraminal) disc protrusion at the L4-L5 level narrowing the left neural foramen at that level.

There is a left far lateral (extraforaminal) disc herniation at the L3-L4 level with minimum indentation on the extraforaminal segment of the left L3 nerve root.

A small posterior peridiscal osteophyte is noted at the L1-L2 level.


Focal fatty marrow changes are noted in the L2 and L4 vertebral bodies.

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

The conus medullaris terminates at the 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 :

18.0 mm at L1-L2
19.0 mm at L2-L3
19.0 mm at L3-L4
17.0 mm at L4-L5
16.0 mm at L5-S1.

IMPRESSION :

1. A very small, left paracentral disc herniation at the L5-S1 level with minimum indentation on the traversing left S1 nerve root.

2. A small posterior disc bulge with a left postero-lateral (foraminal) disc protrusion at the L4-L5 level.

3. A left far lateral (extraforaminal) disc herniation at the L3-L4 level with minimum indentation on the extraforaminal segment of the left L3 nerve root.

sb/bv/nl/rg
Date : 00.00.00

Name of the Patient : Abc XyzDallmn / F / 36 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O being operated for a left sided C. P. angle meningioma in September 0000.
C/O vision loss on the left side in 0000 and diminished vision on the right side.
For follow up.

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 FLAIR coronal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and 4 mm thick T1 Weighted coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a right occipital craniectomy.

There is still seen a well marginated, extraaxial, intermediate signal intensity mass lesion on the T1 Weighted images in the right cerebello-pontine angle cistern. This lesion appears hypointense on the T2 Weighted and FLAIR images and has its broad base towards the right petrous temporal bone. The lesion measures approximately 2.0 (B) x 3.8 (H) x 3.0 (L) cms. After administration of contrast, there is intense uniform enhancement of the above described lesion. A dural tail is also identified along the broad base of the lesion.
..2/.






There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the right cerebellar hemisphere. This lesion appears hypointense on the T1 Weighted images. Slight reduction in volume of the right cerebellar hemisphere is noted. These changes represent gliotic changes and are the sequelae of previous surgery.

A shunt tube is seen to traverse the left temporo-parietal region and its tip is seen to lie in the right thalamus. Mild fullness of the left lateral ventricle is noted as compared to the right. The third ventricle is normal. The fourth ventricle is mildly dilated.

There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Slight increased enhancement of the right tentorial leaflet is also noted after contrast administration.

A polyp is noted in the left maxillary antrum.

IMPRESSION :

In a known C/O meningioma, the MRI features are suggestive of :

1. Post-operative and post-shunt status.

2. An approximately 2.0 x 3.8 x 3.0 cms well marginated, extraaxial, uniformly enhancing mass lesion in the right cerebello-pontine angle cistern, with its broad base towards the petrous bone, as described, most likely represents a residual meningioma.

No preoperative investigations were available for comparison. As compared to the previous CT Scan dated January 0000 and September 0000, the lesion appears unchanged in size.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 22 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O delivery 2 months back with behavioural changes, and loss of consciousness since 1 month.
C/O pregnancy induced hypertension.

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.

OBSERVATION :

There are ill-defined, hypointense areas on the T1 Weighted images involving the cortex and subcortical white matter in the frontal and parietal regions bilaterally and to some extent in the left occipital region. These areas appear hyperintense on the proton, T2 Weighted and FLAIR images. A hyperintense signal on the T1 Weighted images is noted along the cortex in the right high parietal region. This signal change may either represent paramagnetic substance deposition or hemoglobin breakdown products.

There is mild dilatation of both the lateral, third and the fourth ventricles. Hypointense signal is seen in the posterior third ventricle and aqueduct suggesting increased flow. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the mastoid air cells on the right side. The pituitary gland has a superior convex margin which is consistent with the patients physiological status.
..2/.







IMPRESSION :

Altered signal involving the cortex and subcortical white matter in the frontal and parietal regions bilaterally and to some extent in the left occipital region represent gliotic/ encephalomalacic changes, most likely the sequelae of a previous vascular insult. Mild communicating hydrocephalus is also noted.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xylmn / M / 54 yrs.
Referred by : Dr. Abc Xyzmat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O single episode of loss of consciousness for half a minute 6 months back.
Known hypertensive/diabetic.

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 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.

Inflammatory changes are noted in the right maxillary sinus.

INTRACRANIAL MRA :

There is slight concentric narrowing of the cavernous and supraclinoid segments of the left internal carotid artery. The A1 segment of the left anterior cerebral artery is not well identified and is probably hypoplastic. Slight irregularity of the anterior cerebral arteries and some of the Sylvian branches of the left middle cerebral artery is noted.
Scan-00003


The petrous, cavernous and supraclinoid segments of the right internal carotid artery bilaterally show normal signal and calibre. The visualized right 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 :

There is a small atheromatous plaque along the postero-medial wall of the proximal right internal carotid artery just at the bifurcation of right common carotid artery.

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

IMPRESSION :

1. Slight concentric narrowing of the cavernous and supraclinoid segments of the left internal carotid artery with slight irregularity of the anterior cerebral arteries and some of the Sylvian branches of the left middle cerebral artery, may be atherosclerotic in etiology.

2. A small atheromatous plaque along the postero-medial wall of the proximal right internal carotid artery just at the bifurcation of right common carotid artery.

3. No significant abnormality is detected in the brain parenchyma per se on this study.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi lmn / F / 30 yrs.
Referred by : Dr. Abc Xyzon.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O speech disturbance with memory impairement since 2 days.
C/O acute myeloid leukemia since June 0000. Received 2 cycles of chemotherapy with cytosar. To R/O any structural lesions.

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.

FEW IMAGES SHOW PATIENT MOTION.

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.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyznt Khlmn / M / 25 yrs.
Referred by : Dr. Abc Xyzrkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with slight weakness of BLE.

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 slight loss of water content of the D12-L1 and L1-L2 intervertebral discs.

There are small posterior disc bulges at the L2-L3, L3-L4 and L4-L5 levels. Small posterior peridiscal osteophytes are identified at the L2-L3 and L3-L4 levels.

A small, postero-central disc herniation with peridiscal osteophytes is noted at the L1-L2 level, indenting the dural theca anteriorly.

Small postero-central protruded disc with peridiscal osteophytes is noted at the D12-L1 level.

Schmorls nodes are seen in the upper lumbar region.

There is slight posterior wedging of the L2 vertebral body, with focal fatty marrow changes. Slight anterior wedging of the L1 vertebral body without change in signal intensity.

The pedicles of the lower lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
..2/.






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.

The conus medullaris terminates at the 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 :

11.0 mm at L1-L2
10.0 mm at L2-L3
9.0 mm at L3-L4
11.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

1. Small posterior disc bulges at the L2-L3, L3-L4 and L4-L5 levels.

2. A small, postero-central disc herniation with peridiscal osteophytes at the L1-L2 level.

3. Small postero-central protruded disc with peridiscal osteophytes at the D12-L1 level.

4. Slight posterior wedging of the L2 vertebral body and anterior wedging of the L1 vertebral body, is ? the sequelae of previous trauma.

5. Tight canal at the L3-L4 level.

PROVISIONAL REPORT
sb/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 18 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O neckpain with swelling over the neck since 2-3 months.
C/O weakness of all four extremities with bladder involvement.

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.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is collapse of C7, D2 and D3 vertebral bodies with a kyphus at that level. The C6 to D4 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. Some of the intervening intervertebral discs also appear more hyperintense on the T2 Weighted images. The posterior elements of C7, D1 and D2 vertebrae appear to be destroyed.

There is seen a fairly large, intermediate signal intensity mass lesion on the T1 Weighted images in the prevertebral and paravertebral soft tissues, extending over C5 to D6 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Extension into the epidural space, circumferentially over the C6 to D2 vertebral levels is noted with resultant cord compression. The cervico-dorsal










spinal cord over these levels appears hyperintense on the T2 Weighted images, suggesting cord edema/ischemia. There is also extension of this soft tissue lesion into the posterior paraspinal region at D2 vertebral level.

Probable involvement of the head and neck of the first and second ribs is noted bilaterally.

The mediastinal structures are displaced anteriorly by the prevertebral soft tissue lesion.


Suspicious signal change is noted in the D9 and D11 vertebral bodies. The visualized lumbar vertebrae do not show any obvious signal change on this study.

The conus medullaris terminates at the D12-L1 level.

IMPRESSION :

Collapse of the C7, D2 and D3 vertebral bodies with altered signal of the C6 to D4 vertebral bodies and some of the intervening intervertebral discs as described, most likely represents osteitis with discitis, probably tuberculous in etiology.

Fairly large pre and paravertebral soft tissue lesion over C5 to D6 vertebral levels represents an abscess. Extension of the soft tissue lesion into the epidural space is noted, with cord compression and cord signal alteration as described, suggesting cord edema/ischemia.

The possibility of the above described lesion being neoplastic lesion seems less likely.

ke/sb/nl/rg.
/692 Date : 22/00.00.00

Name of the Patient : Abc Xylmn / M / 63 yrs.
Referred by : Dr. Abc Xyzatt.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O 2 episodes of seizures (first on 00.00.00 and second 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 FLAIR and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

After administration of contrast the following parameters were used :

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

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a well-marginated, approximately 2.0 x 2.8 x 2.2 cms sized hypointense mass lesion on the T1 Weighted images in the right temporal lobe. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images with a central, relatively hypointense area within. There is perilesional edema with effacement of the sulcal spaces and the right Sylvian cistern in that region.
Scan-00009/692


After administration of contrast there is thick peripheral enhancement of the lesion. There is no other abnormal area of enhancement within the brain parenchyma or the meninges.

There is mild fullness 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 :

An approximately 2.0 x 2.8 x 2.2 cms sized rim enhancing mass lesion in the right temporal lobe as described, is not specific for a single etiology. A glial cell tumor or metastasis may be considered as differential diagnosis. The possibility of an infective/inflammatory pathology is less likely.