hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Dslmn / M / 25 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache since 3 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 a small posterior disc herniation with peridiscal osteophytes indenting the thecal sac and causing mild neural foraminal narrowing bilaterally at the L4-L5 level.

A posterior disc bulge with small peridiscal osteophytes is seen at the L5-S1 level.

The L4-L5 and L5-S1 facet joints show degenerative changes.

There appears to be a spina bifida at the S1 vertebral level.

The L4-L5 intervertebral disc shows mild loss of water content.

The lumbar vertebral bodies and the remaining intervertebral discs reveal 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 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 :

19.0 mm at L1-L2
15.0 mm at L2-L3
13.0 mm at L3-L4
12.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A small posterior disc herniation with peridiscal osteophytes at the L4-L5 level.

2. Facetal arthropathy at the L4-L5 and L5-S1 levels.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzang Shilmn / M / 48 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

H/O backache with pain radiating to the LLE since 2-3 months.
C/O acute retention of urine since 15 days and weakness of the LLE.

EXAMINATION :

M.R.I of the lumbo-sacral 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 L5 vertebra is as marked on the film. Please correlate with plain radiographs.

The lumbar intervertebral discs show loss of water content. Type II degenerative changes are seen within the L4, L5 and S1 vertebral bodies adjacent to the intervertebral discs.

A large posterior disc extrusion is seen to compress upon the thecal sac and narrow both neural foramina with impingement of the exiting left L5 nerve root at the L5-S1 level. A disc portion is seen within the anterior epidural space at the S1 vertebral level with resultant impingement of both the traversing S1 nerve roots.

A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level.

A postero-central disc herniation with peridiscal osteophytes is seen to indent the thecal sac at the L1-L2 level.

Bilateral far lateral (extraforaminal) disc bulges are seen at the L1-L2, L4-L5 and L5-S1 levels.

The L4-L5 and L5-S1 facet joints show hypertrophic degenerative changes. The L1-L2, L2-L3 and L3-L4 facet joints show degenerative changes.

A posterior disc bulge is noted at the L3-L4 level. Small posterior peridiscal osteophytes are seen at the L4-L5 and L5-S1 levels.

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

The conus medullaris terminates at the D12 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
14.0 mm at L2-L3
11.0 mm at L3-L4
10.0 mm at L4-L5
4.0 mm at L5-S1.

The dorsal spine was screened with 5 mm thick T2 Weighted sagittal images and which does not reveal any significant feature of note.

IMPRESSION :

The MRI features are suggestive of :

1. A large posterior disc extrusion at the L5-S1 level with severe canal stenosis and a disc portion seen within the anterior epidural space at the S1 vertebral level impinging both the traversing S1 nerve roots.
..3/.






- 3 - Scan-00004



2. A posterior disc herniation at the L4-L5 level with a tight canal.

3. A postero-central disc herniation with peridiscal osteophytes at the L1-L2 level.

4. Hypertrophic facetal arthropathy at the L4-L5 and L5-S1 levels and facetal arthropathy at the L1-L2, L2-L3 and L3-L4 levels.

ke/sb/nl/nl
/625 Date : 00.00.00

Name of the Patient : Abc Xyzabh Slmn / M / 12 yrs.
Referred by : Dr. Abc XyzS. Sawant.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O inability to lift the RUE since 2-3 months.
H/O the RUE being pulled prior to this.
H/O aspiration and exploration of the swelling in the right scapular/infrascapular region done on 00.00.00.

EXAMINATION :

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

5 mm thick T2 Weighted sagittal images.

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

5 mm thick T1 Weighted coronal images.

OBSERVATION :

The visualized cervical and 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 paraspinal muscles and the visualized muscles around the scapula on the right show normal signal intensity. There is no obvious mass lesion or collection noted on this study. The visualized pleural space appears to be normal.

IMPRESSION :

Normal study of the cervico-dorsal spine and the paravertebral/ paraspinal region.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzJhlmn / F / 32 yrs.
Referred by : Dr. Abc XyzSingh.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches, giddiness and (occasional) momentary blackouts since 3-4 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.

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.

hs/ke/rg/nl
/22 Date : 00.00.00

Name of the Patient : Abc Xyzrlmn / M / 38 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches with giddiness since 2 years.
Now C/O weakness of the LUE, heaviness and paresthesias since 15 days.
Also C/O diplopia on the left side.

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 evidence of an area of hyperintensity on the T2 Weighted images involving the cortical gray and white matter in the right temporo-occipital region. This most likely represents an area of ischemia/infarction (watershed of the right middle cerebral and right posterior cerebral arteries).

Lacunar infarcts (isointense to CSF) are seen within the right thalamus and left cerebellar hemisphere.

There is mild prominence of the cerebellar folia bilaterally.

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 seen within the right maxillary sinus and ethmoidal air cells.
Scan-00000/622



INTRACRANIAL MRA :

The calibre of the cavernous segment of the right internal carotid artery is smaller as compared to the left side.

The petrous and supraclinoid segments of the internal carotid arteries bilaterally and cavernous segment of the left internal carotid artery shows 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 :

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 within the right temporo-occipital region most likely represents an area of ischemia/infarction (watershed of the right middle cerebral and right posterior cerebral arteries).

2. Lacunar infarcts within the right thalamus and left cerebellar hemisphere.

3. Smaller calibre of the cavernous segment of the right internal carotid artery as compared to the left side.

hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzbai Suterlmn / F / 76 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O pain on the right side of the face.

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.

MR Cisternogram was obtained in the coronal plane.

OBSERVATION :

Subtle areas of hyperintensity on the proton, T2 Weighted and FLAIR images (iso to hypointense to normal white matter on the T1 Weighted images) are seen within the pons, left lentiform nucleus, thalamus bilaterally and the fronto-parietal and periatrial white matter bilaterally. These are most likely ischemic in etiology.

There is mild fullness of the third and both the lateral ventricles. There is prominence of the cerebral cortical sulci bilaterally. Also seen is mild prominence of the cerebellar folia bilaterally.

Punctate signal voids vascular loops are seen adjacent to the cisternal components of both trigeminal nerves. However there is no deformity of the root entry zones of these nerves bilaterally.

Prominent perivascular spaces are seen within both cerebral hemispheres.
Scan-00009


The fourth ventricle is normal. There is no shift of the midline structures.

Incidental note is made of pansinusitis.

IMPRESSION :

The MRI features are suggestive of :

1. Areas of altered signal intensity within the pons, left lentiform nucleus, thalamus bilaterally and the fronto-parietal and periatrial white matter bilaterally and these are most likely ischemic in etiology.

2. Small vascular loops adjacent to the cisternal components of both trigeminal nerves without deforming the same.

hs/ke/rg.
Date : 00.00.00

Name of the Patient : Abc XyzHlmn / F / 25 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : Intracranial MR Venogram.

CLINICAL PROFILE :

H/O abortion at 5 months, 15 days back with convulsions 12 days back.
Loss of consciousness since then.

EXAMINATION :

The brain was screened with the help of 5 mm thick T1 Weighted and T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images.

MRV was performed using a 2D TOF technique.

OBSERVATION :

There is evidence of a diffuse area of hypointensity on the T1 Weighted images which turns hyperintense on the T2 Weighted images involving the white matter and the cortical gray matter in the left temporo-fronto-parietal lobes with effacement of the adjacent cerebral cortical sulci. Areas of hyperintensity on the T1 Weighted images within this lesion would most likely represent subacute blood.

A small hyperintense area is noted on the T2 Weighted images in the pons on the left side and is hypointense on the T1 Weighted images. This is probably ischemic in etiology.

There is compression upon the left lateral ventricle, aqueduct and the third ventricle and left cerebral peduncle with a shift of the midline to the right. Also seen is left uncal herniation and effacement of the left perimesencephalic cistern.

There is mild dilatation of the right lateral ventricle.

Inflammatory changes are seen within the mastoid air cells bilaterally.
..2/.






INTRACRANIAL MRV :

On the MRV a streak of flow is seen within the left transverse and sigmoid sinuses (? hypoplastic ? recanalized thrombus).

The rest of the visualized dural and deep venous sinuses show normal flow characteristics.

IMPRESSION :

The MRV features are suggestive of :

1. An area of altered signal within the left temporo-fronto-parietal lobes which most likey represents a haemorrhagic infarct (probably venous).

2. Ischemic focus in the pons on the left side.

3. Inflammatory changes within the mastoid air cells bilaterally.

4. A streak of flow within the left transverse and sigmoid sinuses (? hypoplastic ? recanalized thrombus).

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzayan Ylmn / M / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O wasting of the LLE with difficulty in walking since 3 1/2 months.

EXAMINATION :

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images. No significant feature of note was identified. Hence a cervical spine study was performed.

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 loss of water content of the cervical intervertebral discs.

There is a fairly large posteriorly extruded disc with a peridiscal osteophyte at the C6-C7 level. Slight superior migration of the disc fragment is noted. The cervical spinal cord at this level appears slightly atrophied and shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images (hypointense on the T1 Weighted images) suggesting myelomalacic changes.

A posteriorly herniated disc with a peridiscal osteophyte is noted at the C5-C6 level, with cord compression.



Postero-central protruded discs with peridiscal osteophytes are noted at the C2-C3, C3-C4 and C4-C5 levels.

Facetal hypertrophy is noted at the C3-C4 level on the right and at the C6-C7 level bilaterally.

Slight ligamentum flavum hypertrophy is noted at the D1-D2 and D2-D3 levels.

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

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

Screening, T2 Weighted sagittal images of the dorsal spine reveal slight facetal hypertrophy at the D8-D9 and D9-D10 levels.

IMPRESSION :

1. A fairly large posteriorly extruded disc with a peridiscal osteophyte at the C6-C7 level with slight superior migration of the disc fragment and resultant canal stenosis.

2. Atrophy of the cord at the C6-C7 level with cord signal alteration suggests myelomalacic changes.

3. A posteriorly herniated disc with a peridiscal osteophyte at the C5-C6 level, with cord compression.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza B. Mahlmn / F / 25 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever with weakness of BLE with bladder involvement since 4 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.

SOME 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/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzen lmn / F / 75 yrs.
Referred by : Dr. Abc Xyzrikh.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O loss of speech from 5.00 pm on 00.00.00 with 1 episode of vomiting and loss of consciousness.
H/O headaches on the same day.

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 is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the cerebellar hemispheres bilaterally and at the right occipital pole. This lesion appears hypointense to normal white matter on the T1 Weighted images and represents a recent infarct. Resultant effacement of the cerebellar folia is noted bilaterally.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the subcortical white matter in the fronto-parietal regions bilaterally, posterior parietal periventricular white matter bilaterally and in the left thalamus. These appear iso to hypointense to white matter on the T1 Weighted images and represent ischemic changes.







There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

There is no evidence of haemorrhage on this study.

IMPRESSION :

1. Non-haemorrhagic, recent infarcts in the cerebellar hemispheres bilaterally and at the right occipital pole.

2. Altered signal in the subcortical white matter in the fronto-parietal regions bilaterally, posterior parietal periventricular white matter bilaterally and in the left thalamus represent ischemic changes.