sb/hs/nl/nl
/38 Date : 00.00.00

Name of the Patient : Abc Xyz Rampuralmn / F / 14 yrs.
Referred by : Dr. Abc Xyzpadia.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O spinal deformity since 12 years.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.
6 mm thick T1 Weighted coronal images.
6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is scoliosis of the dorsal spine with convexity to the left. The apex of the scoliotic curve is noted at about the D7, D8 and D9 vertebral levels. Resultant rotational anomaly of the dorsal and lumbar vertebrae is noted. It was difficult to label the vertebral levels on the axial images due to the scoliotic deformity. There is however, no obvious cord compression or cord signal alteration noted on this study. There is no evidence of a dysraphic spine.

The visualized vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1-L2 level.

IMPRESSION :

Scoliotic deformity of the dorsal spine with convexity to the left. The apex of the scoliosis is approximately at the level of the D6 to D9 vertebral levels. There is no obvious evidence of cord signal alteration or cord compression.

sb.hs.rg.
Date : 00.00.00

Name of the Patient : Abc XyzArif Anlmn / M / 33 yrs.
Referred by : Dr. Abc Xyzshi / Dr. Abc Xyzhah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias since 8 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 :

The L5 vertebral body is as marked on the film. Please correlate with plain radiographs.

Mild posterior disc bulges are noted at the L4-L5 and L5-S1 levels.

The lumbar vertebral bodies and the 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 L2 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 :

19.0 mm at L1-L2
18.0 mm at L2-L3
17.0 mm at L3-L4
16.0 mm at L4-L5
15.0 mm at L5-S1.
..2/.



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IMPRESSION :

The MRI features are suggestive of mild posterior disc bulges at the L4-L5 and L5-S1 levels.

sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyziclmn / M / 42 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzadhan.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 10-12 years. On anti-epileptics.
Now C/O memory impairment since 1 month.

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 coronal images.

OBSERVATION :

There is a CSF signal intensity lesion on all the pulse sequences in the left occipital lobe. This lesion represents an area of cystic encephalomalacia, most likely the sequelae of a previous vascular insult. A subtle hyperintense signal on the T1 Weighted images at the periphery of this lesion, which appears hypointense on the T2 Weighted images may represent haemoglobin breakdown products/paramagnetic substance deposition. Perilesional white matter hyperintense signal on the proton, T2 Weighted and FLAIR images may represent gliotic changes. Resultant focal dilatation of the occipital horn, atrium and posterior body of the left lateral ventricle is noted.

Lacunar infarcts (isointense to hyperintense to CSF) are noted in the pons on the left, periatrial white matter on the right, thalamus and lentiform nucleus bilaterally and in the corona radiata and centrum semiovale bilaterally.

Ill-defined hyperintense signal on the proton, T2 Weighted and FLAIR images in the posterior parietal periventricular white matter on the right and in the left frontal periventricular white matter may also represent ischemic changes.

The hippocampal complex on either side is unremarkable.
..2/.





A hyperintense speck (se/im 104.18) on the T1 Weighted images is seen within the left frontal lobe (? petechial haemorrhage/? calcium).

There is mild fullness of both the lateral and the 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 :

1. An area of cystic encephalomalacia in the left occipital lobe, most likely the sequelae of a previous vascular insult.

2. Lacunar infarcts in the pons on the left, periatrial white matter on the right, thalamus and lentiform nucleus bilaterally and in the corona radiata and centrum semiovale bilaterally.

3. Altered signal in the right posterior parietal and left frontal periventricular white matter may represent ischemic changes.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Matlmn / M / 55 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden loss of consciousness.
Known hypertensive.

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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a fairly large, approximately 6.0 x 6.5 x 5.8 cms sized well marginated intermediate signal intensity mass lesion on the T1 Weighted images in the left deep temporo-parietal region (most likely in the region of the left lentiform nucleus/external capsular region). This lesion appears relatively hyperintense to normal white matter on the proton and T2 Weighted images and shows a peripheral hypointense rim on the Fast Scan (T2 *) images. Along the periphery of the lesion there is a cystic component which is slightly hyperintense to CSF on all the pulse sequences and would represent serum due to clot retraction. Extension of the above described lesion into the left thalamus, brainstem and subsequently into the fourth ventricle is noted. There is effacement of the cerebral cortical sulci bilaterally with compression of the left lateral and third ventricles and subfalcine herniation of the ventricles to the right. Perilesional edema is noted around this lesion.
Scan-00003



There is mild dilatation of the right lateral ventricle with periventricular hyperintense signal in the right occipital region, ? due to periventricular CSF ooze. The basal cisternal spaces are effaced.

No obvious vascular anomaly is identified on this study.

Incidentally noted are inflammatory changes in the right frontal and bilateral maxillary sinuses.

Left eye pthysis bulbi is also noted.

IMPRESSION :

A fairly large, approximately 6.0 x 6.5 x 5.8 cms sized mass lesion in the left deep temporo-parietal region extending into the brain stem and the fourth ventricle as described, follows the signal characteristics of a hyperacute to acute intracerebral hematoma. There is resultant significant mass effect.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzGlmn / M / 48 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain 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 small, right paracentral disc herniation at the C5-C6 level with antero-lateral indentation of the cord.

A small postero-central protruded disc is noted at the C3-C4 level. Posterior peridiscal osteophytes are noted at the C3-C4 and C5-C6 levels. Small disc herniation is noted at the D1-D2 level. The cervical intervertebral discs show loss of water content.

Focal fatty changes are noted in the upper cervical vertebrae. The rest of the cervical vertebral bodies 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 small, right paracentral disc herniation at the C5-C6 level.

2. A small postero-central protruded disc at the C3-C4 level.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlal Dlmn / M / 71 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 4-5 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 Grade I spondylolisthesis of the L5 over the S1 vertebra with bilateral spondylolysis at the L5 level.

A pseudoposterior disc herniation is seen at the L5-S1 level. A right far lateral disc herniation is also noted at this level with impingement of the foraminal portion of the right L5 nerve root.

Diffuse posterior disc herniations are seen at the L3-L4 and L4-L5 levels with anterior indentation of the thecal sac and bilateral neural foraminal narrowing.

Small posterior disc herniations are noted at the L1-L2 and L2-L3 levels.

Anterior disc herniations are noted over the L1-L2 to the L4-L5 levels. The lumbar intervertebral discs show loss of water content.

Anterior and posterior peridiscal osteophytes are seen over the L1-L2 to L4-L5 levels.

The L3-L4 and L4-L5 facet joints show hypertrophic degenerative changes. Effusion is seen within the L3-L4 facet joint on the left side and L4-L5 facet joint on the right side.

Focal fatty changes are noted in the lumbar vertebrae.

The remaining 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 S1 level.

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

15.0 mm at L1-L2
12.0 mm at L2-L3
10.0 mm at L3-L4
16.0 mm at L4-L5
16.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L5 over the S1 vertebra with spondylolysis at the L5 level, bilaterally.

2. A pseudoposterior disc herniation at the L5-S1 level with a right far lateral disc herniation impinging the foraminal portion of the right L5 nerve root.
..3/.












- 3 - Scan-00001



3. Diffuse posterior disc herniations at the L3-L4 and L4-L5 levels.

4. Small posterior disc herniations at the L1-L2 and L2-L3 levels.

5. Hypertrophic facetal arthropathy at the L3-L4 and L4-L5 levels with effusion within the L3-L4 facet joint on the left side and within the L4-L5 facet joint on the right side.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyznnisa lmn / F / 55 yrs.
Referred by : Dr. Abc Xyzpase.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE since 2-3 months.
C/O weakness of BLE since 15 days.

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 :

There is slight wedging of the D9 and D10 vertebral bodies which appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The D9-D10 intervertebral disc is also involved and appears more hyperintense (as compared to normal) on the T2 Weighted images.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the anterior epidural space over the D9 and D10 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. There is resultant cord compression at these levels with cord signal alteration (hyperintense on the T2 Weighted images and iso to hypointense on the T1 Weighted images) over D9 to D10 vertebral levels, suggesting cord edema/ischemia. Similar signal intensity soft tissue lesion is also noted in the left paravertebral region over D8 and D9 vertebral levels with resultant involvement of the costo-transverse and costo-vertebral joints at the D9 vertebral level. The pedicles of these vertebrae are also involved by the pathologic process.




Involvement of the left transverse process of D9 is also noted. Minimal soft tissue extension is noted in the prevertebral region at the D9/D10 vertebral levels.

The rest of the visualized dorsal vertebral bodies show spotty fatty marrow changes. The remaining dorsal intervertebral discs show slight loss of water content. The facet joints are unremarkable.

The conus medullaris terminates at the D12-L1 level.

The T1 Weighted sagittal images of the lumbar spine show degenerative changes in the upper and mid lumbar region.

IMPRESSION :

Altered signal of the D9 and D10 vertebral bodies and the D9-D10 intervertebral disc as described, most likely represents osteitis with discitis, probably tuberculous in etiology. Anterior epidural and left paravertebral soft tissue lesion would represent granulation tissue/abscess. There is resultant cord compression and cord signal alteration over the D9 and D10 vertebral levels which represent cord edema/ischemia.

The possibility of this lesion representing a neoplasm seems less likely.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzevi Plmn / F / 15 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain, stiffness and swelling over the left side of neck since 6 months. On AKT since 00.00.00.

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 replacement of the normal marrow by hypointense areas on the T1 Weighted images, of the C2, C3, C4 as well as the left lateral mass of atlas. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. There is left paravertebral soft tissue extension of the lesion from the level of the foramen magnum to the C2 level. There is encroachment inbetween the odontoid process and the lateral mass of the atlas bilaterally. This lesion is hypointense to muscle on the T1 Weighted images and turns hyperintense on the T2 Weighted images and would represent an abscess formation. Extension into the left paraspinal muscles is also noted over the C2 to the C3-C4 levels. A large anterior epidural extension is seen over the C2 to the C5 vertebral levels with compression of the spinal cord maximum at the C3 level. The spinal cord at the C3 vertebral level shows a subtle hyperintense signal on the T2






Weighted and Fast Scan (T2 *) images (isointense to normal cord on the T1 Weighted images) suggestive of cord edema/ischemia/myelitis. There is encroachment into the C2-C3 and C3-C4 neural foramina on the right side with encasement of the C3 and C4 nerve roots. There is a suggestion of involvement of the C2-C3, C3-C4 and C4-C5 intervertebral discs.

The rest of the cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka and the visualized prevertebral soft tissues are unremarkable.

The cervico-medullary junction is unremarkable.

Incidental note is made of enlarged deep cervical lymph nodes bilaterally, left more than right.

The dorsal spine was screened with the help of 4 mm thick T1 Weighted sagittal images and 6 mm thick T1 Weighted coronal images which shows hypointense areas replacing the normal marrow of the D5, D6, D7 and D8 vertebral bodies with pre and paravertebral soft tissue extension and probably minimal epidural extension at the D6 level with encroachment into the D6-D7 neural foramen on the left side.

IMPRESSION :

In a known C/O Kochs spine the MRI features suggest involvement of the atlanto-axial region, upper cervical and dorsal vertebrae as described with paravertebral and anterior epidural abscess with granulation tissue.

The possibility of a round cell tumor is less likely.

hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzana lmn / F / 55 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O vomiting with giddiness (8 days back) and retention of urine with inability to walk and speak since 10 days.

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 small bright foci on the proton, T2 Weighted and FLAIR images within the white matter in the frontal lobes bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

A lacune (iso to hyperintense to CSF) is seen within the pons on the right side.

There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally. Also seen is mild fullness of the ventricular system.

Hyperintense signal on all the pulse sequences is seen within the sigmoid and transverse sinuses on the left side and this may represent slow flow.

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

Inflammatory changes are noted within both the maxillary sinuses.


IMPRESSION :

The MRI features are suggestive of :

1. Foci of altered signal within the frontal lobes bilaterally
is most likely ischemic in etiology.

2. A lacune within the pons on the right side.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzDlmn / M / 40 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Right Knee Joint.

CLINICAL PROFILE :

C/O pain in the right knee with locking since 2 days.
H/O aspiration of the right knee done in 0000.

EXAMINATION :

M.R.I of the right knee joint was performed using the following parameters :

4 mm thick T1 Weighted, proton and GRASS sagittal images.
4 mm thick T1 Weighted and STIR coronal images.
4 mm thick Fast Scan (T2 *) axial images.

OBSERVATION :

There is slight medial and posterior subluxation of the right femur over the right tibia.

Menisci :

There is an ill-marginated, hyperintense signal on all the pulse sequences in the posterior horn of the medial meniscus of the right knee joint, extending upto the inferior articular margin. This most likely represents a meniscal tear.

The posterior horn of the lateral meniscus and anterior horns of the lateral and medial menisci reveal normal configuration and signal characteristics.

Cruciate Ligaments :

There is slight thinning and irregularity of the anterior cruciate ligament at its femoral attachment, without change in signal intensity which may suggest a chronic partial tear of the anterior cruciate ligament. Buckling of the posterior cruciate ligament is noted without change in signal intensity.
..2/.





Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.

There is irregularity of the medial patellar retinaculum.

Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

The articular cartilage overlying the patella, tibia and femur appears normal.

There is a small, subchondral degenerative cyst/pit along the inferior articular margin of the medial femoral condyle (scans 105.11, 106.11).

A small amount of fluid is noted in the right knee joint.

IMPRESSION :

1. Slight medial and posterior subluxation of the right femur over the right tibia.

2. Meniscal tear in the posterior horn of the medial meniscus of the right knee joint.

3. Chronic partial tear of the anterior cruciate ligament towards its femoral attachment, with buckling of the posterior cruciate ligament.

4. Degenerative subchondral cyst/pit along the inferior articular margin of the medial femoral condyle.

5. Small amount of fluid in the right knee joint.