hs/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz U. lmn / F / 31 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE with paresthesias.

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 postero-central disc herniation indenting the thecal sac at the L5-S1 level

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

Mild facetal hypertrophy is noted at the L3-L4, L4-L5 and L5-S1 levels. Mild ligamentum flavum hypertrophy is seen at the L4-L5 and L5 levels.

The lumbar intervertebral discs show mild loss of water content.

The lumbar vertebral bodies 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 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 :

19.0 mm at L1-L2
19.0 mm at L2-L3
19.0 mm at L3-L4
14.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A small postero-central disc herniation at the L5-S1 level

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

hs/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xylmn / F / 13 yrs.
Referred by : Dr. Abc Xyzi.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O ALL. Detected in 0000. Received Chemotherapy and Radiotherapy.
No complaints at present.

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 are diffuse areas of hyperintensity on the proton, T2 Weighted and FLAIR images within the periatrial white matter bilaterally. These are iso to hypointense to normal white
matter on the T1 Weighted images.

Lacunar infarcts (iso to hyperintense to CSF) are noted in the white matter in the left frontal lobe, left centrum semiovale and within the left paraatrial white matter.

There is mild fullness of the ventricular system. There is prominence of the cerebral cortical sulci (more marked in the right high parietal region) and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

R>

IMPRESSION :

1. Altered signal within the periatrial white mater bilaterally most likely represents areas of ischemia/demyelination.

2. Lacunar infarcts in the white matter in the left frontal lobe, left centrum semiovale and within the left paraatrial white matter.

3. Mild cerebral cortical and cerebellar atrophy.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzni lmn / F / 22 mnths.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since the age of 6 months.
C/O delayed milestones.

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.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is no focal area of abnormal signal intensity in the brain parenchyma. Ill-defined hyperintense signal on the T2 Weighted images in the posterior parietal paraventricular white matter bilaterally represents areas of terminal myelination.

The hippocampus complex is unremarkable on either side.

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/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzohd. Qurlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with paresthesias since 20 years.
H/O spinal surgery 15-20 years ago (Details not available).

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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There appears to be sacralization of the L5 vertebra and the L1 vertebra is as marked on the film.

There is laminectomy of the L3 and L4 vertebrae and partial laminectomy of the L2 and L5 vertebrae with post-operative changes within the posterior soft tissues at these levels.

A postero-central disc herniation, more to the left of the midline, with peridiscal osteophytes is seen to indent the thecal sac at the L4-L5 level.

There are bilateral postero-lateral (foraminal) disc herniations with peridiscal osteophytes narrowing both neural foramina at the L3-L4 level.

A posterior disc bulge with peridiscal osteophytes is seen to indent the thecal sac at the L2-L3 level. Bilateral far lateral (extraforaminal) disc bulges are noted at the L2-L3, L3-L4 and L4-L5 levels.
..2/.




The L2-L3, L3-L4 and L4-L5 facet joints show degenerative changes. Mild facetal hypertrophy is noted at the L1-L2 level.

The intrathecal nerve roots at the L3 and L4 levels are irregularly defined and clumped and this may suggest Group I arachnoiditis. The nerve roots at the L5 level are plastered to the periphery of the thecal sac and this may suggest Group II arachnoiditis.

The lumbar intervertebral discs show loss of water content. A hyperintense area on the T2 Weighted images within the L3-L4 intervertebral disc on the left side is noted (? calcified disc).

The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12 level and the thecal sac terminates at the S1 level.

The dorsal spine was screened with 5 mm thick T2 Weighted sagittal images and shows mild facetal hypertrophy at the D9-D10 level.

IMPRESSION :

The MRI features are suggestive of :

1. Post-operative status.

2. Sacralization of the L5 vertebra.

3. A postero-central disc herniation, more to the left of the midline, with peridiscal osteophytes at the L4-L5 level.

4. Bilateral postero-lateral (foraminal) disc herniations with peridiscal osteophytes at the L3-L4 level.
..3/.





- 3 - Scan-00008


5. Facetal arthropathy at the L2-L3, L3-L4 and L4-L5 levels.

6. Arachnoiditis over the L3 to the L5 levels.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Gulam Mehlmn / F / 65 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O gradually progressive loss of vision of the left eye since 2 months.
Now C/O diminished vision on the right side since 2-4 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.
3 mm thick T1 Weighted and STIR coronal images through the optic nerves.

OBSERVATION :

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

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 and cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

The left optic nerve appears smaller in calibre when compared to the right, with increased perioptic CSF. Both optic nerves however show normal signal characteristics. The visualized orbits are also unremarkable.

IMPRESSION :

No significant abnormality is detected within the brain parenchyma per se.

Left optic nerve atrophy.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzShlmn / F / 29 yrs.
Referred by : Dr. Abc Xyznghal.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE 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 loss of water content of the L4-L5 and L5-S1 intervertebral discs.

There is a fairly large, right paracentral extruded disc at the L4-L5 level with right neural foraminal narrowing. Slight inferior migration of the disc fragment is noted with impingement of the traversing right L5 nerve root.

A small, postero-central protruded disc is noted at the L5-S1 level.

The facet joints at the L4-L5 and L5-S1 levels show hypertrophic degenerative changes.

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 L1 level and the thecal sac terminates at the S2 level.

Fat is noted in the filum terminale at the L3 and L4 vertebral levels.

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

21.0 mm at L1-L2
18.0 mm at L2-L3
19.0 mm at L3-L4
14.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. Right paracentral extruded disc at the L4-L5 level with right neural foraminal narrowing and slight inferior migration of the disc fragment impinging the traversing right L5 nerve root.

2. A small, postero-central protruded disc at the L5-S1 level.

3. Hypertrophic facetal arthropathy at the L4-L5 and L5-S1 levels.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Milmn / F / 55 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches since 6-12 months.
C/O mild left sided facial paresis since 1-2 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.

OBSERVATION :

Lacunar infarcts (iso to hyperintense to CSF) are noted in the region of the external capsules bilaterally.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the subcortical and deep white matter in the fronto-parietal regions bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes.

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.

Mucosal thickening is noted in the sphenoid sinus.

IMPRESSION :

1. Lacunar infarcts in the region of the external capsules bilaterally.

2. Altered signal in the subcortical and deep white matter in the fronto-parietal regions bilaterally most likely represent ischemic changes.

/64 Date : 00.00.00

Name of the Patient : Abc Xyzh Milmn / M / 29 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with numbness.

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.

There is loss of water content of the L3-L4 and L5-S1 intervertebral discs.

There is a fairly large, left postero-lateral disc herniation at the L5-S1 level with left neural foraminal narrowing and indentation upon the traversing left S1 nerve root.

A minimal posterior disc bulge is noted at the L4-L5 level.

Slight facetal hypertrophy is noted at the L4-L5 and L5-S1 levels.

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.



- 2 - Scan-00003/64


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
18.0 mm at L2-L3
16.0 mm at L3-L4
14.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

1. A fairly large, left postero-lateral disc herniation at the L5-S1 level with indentation upon the traversing left S1 nerve root.

2. Slight facetal hypertrophy at the L4-L5 and L5-S1 levels.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzo Dhulmn / M / 51 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of the Sacrum.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 1 1/2 months.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

6 mm thick T1 Weighted and T2 Weighted axial images.

4 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

The S1, S2 and S3 sacral segments appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The ala of the sacrum are also involved bilaterally. There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the presacral region, which appears hyperintense on the T2 Weighted images. This soft tissue lesion is more on the left side and extends upto the posterior margin of the left psoas muscle. There is also extension of the soft tissue lesion into the sacral canal with thecal sac compression in the upper sacral region and obliteration of the sacral foramina bilaterally. Irregularity of the margins of the sacro-iliac joint per se is also noted with probable involvement of the left sacro-iliac joint. The S1-S2 intervertebral disc appears unremarkable. There is probable involvement of the iliac wings bilaterally.


Small posterior disc herniations with peridiscal osteophytes are noted at the L2-L3, L3-L4 and L4-L5 levels.

The visualized lumbar vertebral bodies reveal normal signal intensity.

IMPRESSION :

Altered signal of the S1, S2 and S3 sacral segments, with presacral and intraspinal soft tissue lesion as described is not specific for a single etiology. A neoplastic process like a round cell tumor is a likely possibility.

The possibility of an infective etiology (tuberculosis) seems less likely.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzu Shlmn / M / 75 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias since 2 1/2 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 loss of water content of all the lumbar intervertebral discs except the L5-S1 disc.

There is sacralization of the L5 vertebra.

There is a postero-central and right postero-lateral disc herniation at the L4-L5 level with slight right neural foraminal narrowing. A left far lateral disc bulge is also noted at this level.

A small, posterior disc bulge with peridiscal osteophytes is noted at the L3-L4 level with slight right neural foraminal narrowing.

The lumbar vertebral bodies show spotty fatty marrow changes.

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 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
16.0 mm at L2-L3
14.0 mm at L3-L4
12.0 mm at L4-L5
11.0 mm at L5-S1.

Screening T2 Weighted sagittal images of the cervico-dorsal spine reveal degenerative changes in the cervical region.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. A postero-central and right postero-lateral disc herniation at the L4-L5 level with slight right neural foraminal narrowing.

3. A small, posterior disc bulge with peridiscal osteophytes at the L3-L4 level with slight right neural foraminal narrowing.