hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzJalmn / M / 36 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O diplopia on looking left with sudden onset of giddiness and gait ataxia since 2 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.

3 mm thick T1 Weighted and STIR coronal images.

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

OBSERVATION :

BRAIN :

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

The optic nerves, visualized orbits and cavernous sinuses on either side are 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.

Polyps are seen within the right maxillary sinus and sphenoid sinus on the left side.
..2/.





- 2 - Scan-00002


INTRACRANIAL MRA :

The right vertebral artery is not well-visualized.

The predominant supply of both posterior cerebral arteries appears to be from the posterior communicating arteries.

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

NECK MRA :

The calibre of the right vertebral artery is smaller as compared to the left side and is most likely hypoplastic.

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

IMPRESSION :

The MRI/MRA features are suggestive of :

1. Smaller calibre of the right vertebral artery is most likely hypoplastic. The intracranial component is not well-visualized.

2. Polyps within the right maxillary sinus and sphenoid sinus on the left side.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzidalmn / M / 27 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to BUE with paresthesias since 5-6 months.
H/O similar complaints in 0000.

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 :

The facet joints on the left side at the C4-C5 and C5-C6 levels show degenerative changes.

The cervical vertebral bodies and the 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 :

The MRI features are suggestive of facetal arthropathy at the C4-C5 and C5-C6 levels on the left side.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz S. Chlmn / M / 11 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures.

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.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzTriplmn / M / 64 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O gait imbalance since 2 1/2 years.

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 loss of normal cervical curvature.

The cervical intervertebral discs show loss of water content.

There is a large postero-central disc herniation with peridiscal osteophytes at the C4-C5 level and anterior compression of the spinal cord. The spinal cord at the C4-C5 and C5 levels shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images. These are isointense to cord on the T1 Weighted images and suggestive of cord edema/ischemia.

Posterior disc herniations with peridiscal osteophytes are noted at the C5-C6 and C6-C7 levels with anterior indentation of the thecal sac.

Small, postero-central disc protrusions are noted at the C2-C3 and C3-C4 levels.

The C3-C4 and C4-C5 facet joints on the left side show degenerative changes.
..2/.




- 2 - Scan-00009


Ligamentum flavum hypertrophy is noted at the C3-C4, C4-C5 and C6-C7 levels with resultant tight canal over these levels.

Fatty changes are noted in the cervical vertebrae. Hypointense signal on the T1 Weighted images in the right antero-lateral aspect of the C6 vertebral body on all the pulse sequences would represent sclerosis.

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.

IMPRESSION :

The MRI features are suggestive of gross degenerative changes in the cervical spine with ;

1. A large postero-central disc herniation with peridiscal osteophytes at the C4-C5 level and ligamentum flavum hypertrophy with cord compression and cord signal alteration at the C4-C5 and C5 levels suggestive of cord edema/ischemia with canal stenosis.

2. Posterior disc herniations with peridiscal osteophytes at the C5-C6 and C6-C7 levels

3. Ligamentum flavum hypertrophy at the C3-C4 and C6-C7 levels with resultant tight canal.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Jagtlmn / F / 60 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyz. Pai.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided weakness with loss of memory 2 weeks back.
Similar complaints (off & on) since then.

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 is a small hypointense area on the T1 Weighted images in the right corona radiata. This seen to turn hyperintense on the proton, T2 Weighted and FLAIR images and may represent a fresh infarct.

Hyperintense areas are noted on the proton, T2 Weighted and FLAIR images in the fronto-parietal deep white matter. These are iso to hypointense to white matter on the T1 Weighted images and are probably ischemic in etiology.

Lacunar infarcts (iso to hyperintense to CSF) on all the pulse sequences) are seen in bilateral lentiform nucleii, left thalamus and bilateral corona radiata.

There is mild dilatation of both the lateral ventricles. The third and fourth ventricles are normal. There is 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.


IMPRESSION :

1. A probable fresh infarct in the right corona radiata.

2. Altered signal in the fronto-parietal deep white matter are probably ischemic in etiology.

3. Lacunar infarcts in bilateral lentiform nucleii, left thalamus and bilateral corona radiata.

hs/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz M. Almn / F / 65 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias since 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.

OBSERVATION :

There is retroplacement of the L2 vertebra over the L3 vertebra.

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

There is a small postero-central disc herniaton indenting the thecal sac at the L5-S1 level. A large left far lateral (extraforaminal) disc herniation is seen to indent the extraforaminal portion of the exiting left L5 nerve root at this level.

Bilateral postero-lateral (foraminal) disc herniations with peridiscal osteophytes are seen to narrow both neural foramina at the L2-L3 and L3-L4 levels.

The L4-L5 and L5-S1 facet joints show severe hypertrophic degenerative changes. Ligamentum flavum hypertrophy is also noted at these levels.
..2/.





R>
Small far lateral (extraforaminal) disc herniations are seen bilaterally at the L4-L5 level and on the right side at the L5-S1 level. Bilateral far lateral (extraforaminal) disc bulges are noted at the L2-L3 and L3-L4 levels.

An anterior disc herniation with large peridiscal osteophytes is seen at the L3-L4 level. Anterior disc herniations are noted at the L1-L2 and L2-L3 levels.

The lumbar vertebral bodies show Type II degenerative changes.

The lumbar intervertebral discs show loss of water content.

Schmorls nodes are noted in the lumbar region.

The pedicles of the lumbar vertebrae appear to be congenitally short in their antero-posterior dimensions.

Posteriorly bulging discs are noted in the visualized lower dorsal region.

The paraspinal muscles in the lumbar region show atrophy.

The rest of 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 :

15.0 mm at L1-L2
14.0 mm at L2-L3
12.0 mm at L3-L4
9.0 mm at L4-L5
8.0 mm at L5-S1.
..3/.






- 3 - Scan-00007


IMPRESSION :

The MRI features are suggestive of :

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

2. A small postero-central disc herniaton at the L5-S1 level with a large left far lateral (extraforaminal) disc herniation indenting the extraforaminal portion of the exiting left L5 nerve root at this level.

4. Bilateral postero-lateral (foraminal) disc herniations with peridiscal osteophytes at the L2-L3 and L3-L4 levels.

5. Severe hypertrophic facetal arthropathy with ligamentum flavum hypertrophy at the L4-L5 and L5-S1 levels

6. Congenitally short lumbar vertebrae in their antero-posterior dimensions.

ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Ylmn / M / 12 yrs.
Referred by : Dr. Abc Xyzidhwa.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

Known C/O epilepsy since the age of 4 years.
C/O backache with pain radiating to BLE since 3-4 weeks.

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 posterior disc herniation, more to the left of the midline at the L5-S1 level with mild indentation upon the left S1 nerve root. Left neural foraminal narrowing is noted. Mild inferior migration of the disc is seen. A small right far lateral disc bulge is also seen at the L5-S1 level with mild indentation upon the extraforaminal portion of the right L5 nerve root.

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 D12-L1 level and the thecal sac terminates at the S1 level.



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

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

The cervico-dorsal spine was screened with 4 mm thick T2 Weighted sagittal images which does not reveal any diagnostic feature of note.

IMPRESSION :

The MRI features are suggestive of :

1. A posterior disc herniation, more to the left of the midline at the L5-S1 level with mild indentation upon the left S1 nerve root.

2. A small right far lateral disc bulge at the L5-S1 level with mild indentation upon the extraforaminal portion of the right L5 nerve root.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzen Marlmn / F / 68 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with 1 episode of vomiting since 7.00 am of 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.

OBSERVATION :

There is an intermediate signal intensity lesion on the T1 Weighted images in the prepontine, suprasellar and the quadrigeminal cisterns. This is seen to hyperintense on the proton, T2 Weighted and FLAIR images. Similar altered signal is also noted in the frontal temporal sulcal spaces and Sylvian fissures bilaterally with effacement of the sulci. This would represent subarachnoid haemorrhage.

There is slight fullness of both the lateral ventricles. The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. The vertebro-basilar system is ectatic. Blooming on the Fast Scan (T2 *) images is seen in the globus pallidi and this would represent calcification/deposition of paramagnetic substances.

Incidental note is made of bilateral maxillary polyps.
R>

IMPRESSION :

The MRI findings are suggestive of altered signal intensity areas within the basal cisterns as described and this most likely represents subarachnoid haemorrhage.

An MR angiograph/DSA would be worthwhile.

hs/ke/rg/nl
Date : 00.00.00Name of the Patient : Abc Xyzben lmn / F / 63 yrs.Referred by : Dr. Abc Xyzshar.Examination : M.R.I. of the Brain.
CLINICAL PROFILE : Known C/O adenocarcinoma of lung with metastasis to the brain. Gamma knife radiosurgery for the brain metastasis was performed in August 0000.
C/O seizures 2 days back. 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.5 mm thick FLAIR coronal 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 an approximately 4.2 x 3.5 x 3.2 cms sized well marginated, predominantly hyperintense lesion on the proton, T2 Weighted and FLAIR images in the left parieto-occipital- parafalcine region. This lesion appears hypointense on the T1 Weighted images. Faint hyperintense signal is noted within this lesion on the T1 Weighted images (? paramagnetic substances, ?? haemorrhage). This lesion enhances patchily after contrast
Scan-00004


administration. There is perilesional edema with effacement of the sulcal spaces in the left parieto-occipital region and mild compression and anterior displacement of the occipital horn and atrium of the left lateral ventricle. Edema is also seen to encroach into the splenium of the corpus callosum on the left side and the posterior limb of the internal capsule.
A smaller, ring enhancing lesion is noted in the right parieto-occipital region, measuring approximately 1.2 cms in maximum transverse dimension. Mild perilesional edema is also noted around this lesion. Another very small, enhancing focus is noted in the right posterior temporo-occipital region.
There is slight shift of the midline structures to the right side.
Small bright foci on FLAIR images are noted in the frontal white matter bilaterally. The right lateral and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.There is no other focal area of abnormal enhancement in the brain parenchyma or the meninges.
Note is made of an empty sella.
IMPRESSION :The MRI features suggest multiple metastasis in the brain parenchyma as described above. As compared to the previous MRI (study no:00009) dated 00.00.00, there is no significant change noted.

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzar Blmn / M / 35 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to the LUE with paresthesias.
Alleged H/O vehicular accident prior to this.

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.

4 mm thick T2 Weighted coronal images.

OBSERVATION :

There is forward translation of the C5 over the C6 vertebral body and retroplacement of the C6 over the C7 vertebra.

The posterior aspect of the C6 vertebral body is seen to indent the anterior aspect of the cord.

Pseudoposterior disc herniations with peridiscal osteophytes are noted at the C5-C6 and C6-C7 levels.

A small posterior disc bulge is seen at the C4-C5 level. The cervical intervertebral discs show loss of water content.

The C4-C5 facet joint on the left side show degenerative changes. Suspicious diastasis of the C5-C6 facet joint on the left is noted. There is widening of the interspinous distance between the C5 and C6 spinous processes. A probable fracture of C5 lamina on the left is noted.
..2/.





- 3 - Scan-00003


There is a probable nerve root avulsion at the C4-C5 level on the left (scans 104.11, 206.10).

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. Forward translation of the C5 over the C6 vertebral body with retroplacement of the C6 over the C7 vertebra.

2. Posterior aspect of the C6 vertebral body is seen to indent the anterior aspect of the cord.

3. Pseudoposterior disc herniations with peridiscal osteophytes at the C5-C6 and C6-C7 levels.

4. Suspicious diastasis of the C5-C6 facet joint on the left.

5. Probable nerve root avulsion at the C4-C5 level on the left.