ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzMitlmn / F / 16 yrs.
Referred by : Dr. Abc Xyzl.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O scoliosis of the spine with difficulty in walking since 4-5 years.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

8 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is scoliosis of the dorso-lumbar spine with convexity to the right. Segmentation vertebral anomalies are noted in the upper dorsal region.

There is evidence of diastematomyelia extending over the D7 to D12 vertebral levels. A probable bony/fibrous spur is noted at the D10 vertebral level. A syrinx is noted at the D9 vertebral level, anteriorly and at the D3/D4 level.

The tip of the conus is noted at the L3 vertebral level.

The visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.




R>
IMPRESSION :

The MRI features are suggestive of spinal dysraphism with :

1. Segmentation vertebral anomalies in the upper dorsal region.

2. Diastematomyelia extending over the D7 to D12 vertebral levels. A probable bony/fibrous spur at the D10 vertebral level.

3. A syrinx in the dorsal spinal cord at the D9 and D3/D4 level.

As compared to the previous MRI (Study No.0000) dated 00.00.00, there is no significant change noted.

ke.hs.rg.
Date : 00.00.00

Name of the Patient : Abc XyzRalmn / M / 65 yrs.
Referred by : Dr. Abc Xyzai.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O difficulty in speaking since 1 year.

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 mild dilatation of both the lateral and the third ventricles with fullness of the fourth ventricle.

There are small bright foci on the proton, T2 Weighted and FLAIR images in the fronto-parietal white matter. These are isointense to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

Hyperintense areas are noted on the proton, T2 Weighted and FLAIR images in the periventricular deep white matter and these are most likely ischemic in etiology.

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.
Scan-00008


IMPRESSION :

The MRI features are suggestive of :

1. Areas of altered signal intensity within the fronto-parietal white matter and in the periventricular deep white matter and these are most most likely ischemic in etiology.

2. Mild cerebral cortical and cerebellar atrophy.

hs/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Narvlmn / M / 34 yrs.
Referred by : Dr. Abc Xyzisheri.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O gait imbalance since 3-4 days and tremors in both hands.
Alcoholic +.

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

There is fullness of the third and both the lateral ventricles. The fourth ventricle is normal. There is 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.

IMPRESSION :

Mild cerebral and cerebellar atrophy.

hs/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Lokhlmn / F / 17 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O seizures in childhood with delayed milestones.
C/O abnormal movements of the RUE and RLE with weakness of the RUE and altered behaviour since 3 months.
Patient is a C/O ? Wilsons disease.

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.
5 mm thick Fast Scan (T2 *) coronal images.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

The hippocampus is unremarkable on either side.

There is fullness of the third and both the lateral 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.

There is evidence of an area of hyperintensity on the T2 Weighted images within the left pharyngeal wall (? inflammatory in nature). Inflammatory changes are seen in the left maxillary sinus and within the sphenoid sinus on the right side. Note is made of enlarged adenoids.

IMPRESSION :

The MRI features are suggestive of fullness of the third and both the lateral ventricle.

hs/ke/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

C/O seizures since 6 years with altered behaviour since 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.

3 mm thick T2 Weighted coronal images.

4 mm thick T2 Weighted and 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

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

There is beaking of the cerebellar tonsils with herniation through the foramen magnum with slight stretching of the fourth ventricle. There is mild dilatation of the third and both the lateral ventricles.

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

Inflammatory changes are noted in the left maxillary sinus.

IMPRESSION :

The MRI features are suggestive of beaking of the cerebellar tonsils with herniation through the foramen magnum and mild dilatation of the third and both the lateral ventricles and this would be representative of a Chiari malformation.

hs/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Fernalmn / M / 94 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness of the right side of the face and slurred speech.

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 :

Multiple hyperintense areas on the T2 Weighted images are seen within the basal ganglia and left corona radiata and these are most likey ischemic in etiology.

There is mild fullness of the third and both the lateral ventricles. Also seen is prominence of the basal cisternal spaces, cerebral cortical sulci and cerebellar folia bilaterally. The fourth ventricle is normal. There is no shift of the midline structures.

The normal intraocular lens in the right globe is not seen. There appears to be pthysis bulbi on the left side.

INTRACRANIAL MRA :

There is slight attenuation of the flow signal in the right posterior cerebral artery.

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 left posterior cerebral artery also shows normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
..2/.




R>

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. Areas of altered signal intensity within the basal ganglia and the left corona radiata and these are most likely ischemic in etiology.

2. Slight attenuation of the flow signal in the right posterior cerebral artery.

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzPalmn / F / 59 yrs.
Referred by : Dr. Abc Xyzabhat / Dr. Abc Xyza.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness and slight headaches since 00.00.00.
Known hypertensive. On Rx.

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 multiple hyperintense areas on the proton, T2 Weighted and FLAIR images within the white matter in the periatrial and fronto-parietal regions bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

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 :

The MRI features are suggestive of areas of altered signal intensity within the white matter in the periatrial and fronto-parietal regions bilaterally and these are most likely ischemic in etiology.

hs/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzo L. Jlmn / M / 65 yrs.
Referred by : Dr. Abc Xyzatil / Dr. Abc Xyztrak.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O tingling in the left palm and the LLE since 15 days.
Known hypertensive. On Rx.

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.

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

OBSERVATION :

BRAIN :

There are areas of hyperintensity on the proton, T2 Weighted and FLAIR images within the periventricular white matter and fronto-parietal white matter bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

Lacunar infarcts (iso to hyperintense to CSF) are seen within the upper pons on the right side, genu of the corpus callosum on the right side and within the thalamus, lentiform nuclei and periatrial white matter bilaterally.

There is mild prominence of the basal cisternal spaces, cerebral cortical sulci and cerebellar folia bilaterally. Also seen is mild fullness of both the lateral and the third ventricles. The fourth ventricle is normal. There is no shift of the midline structures.
..2/.





INTRACRANIAL MRA :

There is slight attenuation of the distal portion of the right posterior cerebral artery.

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 the left posterior cerebral artery also shows 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 :

The MRI/MRA features are suggestive of :

1. Altered signal within the periventricular white matter and fronto-parietal white matter bilaterally is most likely ischemic in etiology.

2. Lacunar infarcts within the upper pons on the right side, genu of the corpus callosum on the right side and within the thalamus, lentiform nuclei and periatrial white matter bilaterally.

3. Slight attenuation of the distal portion of the right posterior cerebral artery.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzD. Talmn / M / 36 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall 8 years back with injury to the back. Operated for the same.
C/O gradual progressive weakness of BLE and BUE, slurred speech and diminished vision 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.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is a large, well-defined mass lesion in the right parapharyngeal space which measures approximately 3.8 x 4.5 x 3.1 cms. There is indentation upon the right lateral aspect of the oropharynx. This lesion shows an intermediate signal intensity on the T1 Weighted images and is seen to turn hyperintense on the T2 Weighted and FLAIR images at the periphery with the centre turning hypointense. Few septae are noted within this lesion.

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. No obvious vascular anomaly is identified on this study.
R>
IMPRESSION :

The MRI features are suggestive of a large, well-defined mass lesion in the right parapharyngeal space measuring approximately 3.8 x 4.5 x 3.1 cms as described.

The possibilities to be considered are,

1. Mixed tumor of the salivary rest cells in the parapharyngeal space.

2. Nerve sheath tumor.

hs/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlal Malmn / M / 40 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 numbness and loss of sensation in the LLE since 3 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 L3-L4, L4-L5 and L5-S1 intervertebral discs.

There is mild retroplacement of the L5 over the S1 and the L4 over the L5 vertebrae.

There is a large posterior disc extrusion with peridiscal osteophytes at the L5-S1 level with inferior migration of the disc portion with resultant indentation upon both the traversing S1 nerve roots. Also seen is mild bilateral neural foraminal narrowing with indentation upon the exiting L5 nerve roots at this level.

A postero-central disc herniation with peridiscal osteophytes is seen to indent the thecal sac at the L3-L4 level.

A posterior disc herniation with peridiscal osteophytes is seen to indent the thecal sac with slight bilateral neural foraminal narrowing at the L4-L5 level.
..2/.






Bilateral far lateral (extraforaminal) disc herniations are noted at the L4-L5 and L5-S1 levels.

Facetal hypertrophy is seen at the L4-L5 and L5-S1 levels. Also seen is mild ligamentum flavum hypertrophy at these levels.

Type I degenerative changes (hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images) are noted in the L5 and S1 vertebral bodies adjacent to the L5-S1 intervertebral disc.

An anterior disc herniation is seen at the L5-S1 level.

The rest of 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 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 :

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

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and is unremarkable.

IMPRESSION :

The MRI features are suggestive of :

1. A posterior disc extrusion with peridiscal osteophytes at the L5-S1 level with inferior migration of the disc portion and indentation upon both the traversing S1 nerve roots. ..3/.


- 3 - Scan-00008

3. A postero-central disc herniation with peridiscal osteophytes at the L3-L4 level.

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

4. Facetal hypertrophy at the L4-L5 and L5-S1 levels with mild ligamentum flavum hypertrophy at these levels.

5. Canal stenosis at L5-S1 level and a tight canal at the L4-L5 level.

6. Type I degenerative changes in the L5 and S1 vertebral bodies adjacent to the L5-S1 intervertebral disc (less likely to be osteitis).