ke/hs/rg.
Date : 00.00.00

Name of the Patient : Abc XyzRulmn / M / 45 yrs.
Referred by : Dr. Abc Xyzenoy / Dr. Abc Xyzgsarkar
Examination : M.R.I. of the Left Ankle.

CLINICAL PROFILE :

C/O pain in the left ankle with swelling since 1 month.
Patient was kept in a plaster.

EXAMINATION :

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

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

4 mm thick T1 Weighted and STIR coronal images.

4 mm thick T1 Weighted and GRASS (with fat saturation) sagittal images.

OBSERVATION :

There is an ill-defined, hypointense signal on the T1 Weighted images in the anterior portion of the calcaneum. This is seen to turn hyperintense on the T2 Weighted, STIR and Gradient images. There is slight thinning of the cortex in that region. Small well-circumscribed areas with similar signal characeteristics are seen within the talus and calcaneum adjacent to the talo-calcaneal joint.

Fluid is seen along the flexor hallucis longus tendon.

The rest of the visualized tendons and ligament show normal signal intensity.


IMPRESSION :

The MRI features are suggestive of :

1. Altered signal in the anterior portion of the calcaneum is not specific for a single etiology (? bone edema).

2. Minimal fluid along the flexor hallucis longus tendon.

In the given clinical setting, reflex sympathetic dystrophy
syndrome should be excluded.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzfula B. Slmn / F / 30 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

Known C/O TB Meningitis.
C/O paraparesis since 1 month with neurogenic bladder (since 8 days).

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.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is central and anterior wedging of the D5, D6, D7 and D8 vertebral bodies. The D3 to D10 vertebral bodies show an ill-defined hypointense signal on the T1 Weighted images which appears hyperintense on the T2 Weighted images. The D5-D6 and D7-D8 intervertebral discs are also involved. There is erosion of the anterior and lateral margins of the D2 to D10 vertebral bodies. There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the pre and paravertebral regions over D2 to D10 vertebral levels. This lesion appears hyperintense on the T2 Weighted images and represents an abscess/granulation tissue in the given clinical setting.

The margins of the dorsal spinal cord over D3 to D7 vertebral levels appear slightly irregular. There is a hyperintense signal on the T2 Weighted images in the dorsal spinal cord over the D3 to D5 vertebral levels. This signal is isointense to normal cord on the T1 Weighted images. There is no cord compression. Minimal soft tissue is noted in the anterior epidural space at the D7 and D8 vertebral levels.
..2/.






The facet joints are unremarkable.

The conus medullaris terminates at the L2 level.

IMPRESSION :

Altered signal of the D3 to D10 vertebral bodies and the D5-D6 and D7-D8 intervertebral discs most likely represent osteitis with discitis probably tuberculous in given clinical setting. Prevertebral and paravertebral soft tissue would represent granulation tissue/abscess.

Irregularity of the cord margins over the D3 to D7 vertebral levels with altered signal of the cord over D3 to D5 vertebral levels may be the sequelae of tuberculous meningitis and subsequent ischemic changes.

The possibility of a neoplasm is less likely.

ke/hs/rg.
Date : 00.00.00

Name of the Patient : Abc XyzS. Avlmn / F / 4 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever with chills, vomiting, (right focal) seizures and altered sensation (for 8 days) in July 0000.
Now C/O speech disturbances.

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 coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are areas which are iso to hyperintense to CSF on all the pulse sequences in the thalami bilaterally. These are surrounded by hyperintense areas on the proton, T2 Weighted and FLAIR images and would represent gliotic changes. These would represent old infarcts.

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.

Incidental note is made of enlarged adenoids.

IMPRESSION :

The MRI features are suggestive of old infarcts in the bilateral thalami.

sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Khalmn / F / 35 yrs.
Referred by : Dr. Abc Xyzhalani.
Examination : M.R.I. of the Brain & Sella.

CLINICAL PROFILE :

C/O occasional severe headaches since the age of 15 years.
Also C/O giddiness (on & off).

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

The sella was studied with 3 mm thick T1 Weighted and T2 Weighted coronal images and 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.

The pituitary gland is normal in its size, contour and location and reveals normal signal intensity. The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. The pituitary stalk is in the midline. The hypothalamus is unremarkable. The cavernous sinuses and the suprasellar cisterns are unremarkable.

IMPRESSION :

No abnormality detected within the Brain and Sella on this study.

sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzsalmn / M / 30 yrs.
Referred by : Dr. Abc Xyzdy.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE since 15 days.
Alleged H/O fall prior to this.

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 appears to be sacralization of the L5 vertebra and the L1 vertebral body is as marked on the film. Please correlate with plain radiographs.

There is mild retroplacement of the L4 vertebra over the L5 vertebra.

There is loss of water content of the L4-L5 intervertebral disc.

There is a posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing. Slight inferior migration of the disc fragment is noted more to the right of the midline with indentation on the traversing right L5 nerve root.

Facetal hypertrophy is seen in the lumbar region.

A minimal posterior disc bulge is noted at the L3-L4 level.

..2/.





R>
The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. 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 :

20.0 mm at L1-L2
18.0 mm at L2-L3
17.0 mm at L3-L4
12.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra and the L1 vertebral body is as marked on the film. Please correlate with plain radiographs.

2. A posteriorly herniated disc with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing. Slight inferior migration of the disc fragment is noted more to the right of the midline with indentation on the traversing right L5 nerve root.

3. Facetal hypertrophy in the lumbar region.

Date : 00.00.00

Name of the Patient : Abc Xyza Almn / F / 41 yrs.
Referred by : Dr. Abc Xyzctor / Dr. Abc Xyzpadia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 15-20 days.

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.

4 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is a small postero-central protruded disc at the L5-S1 level.

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 :

18.0 mm at L1-L2
14.0 mm at L2-L3
14.0 mm at L3-L4
14.0 mm at L4-L5
13.0 mm at L5-S1.
..2/.





R> There is seen an approximately 3.0 cms diameter sized well-defined, intermediate signal intensity mass lesion on the T1 Weighted images in the prevertebral region to the right of the midline at about the L3-L4 disc level. This lesion appears heterogeneously hyperintense on the T2 Weighted images. The lesion is placed between the aorta and the inferior vena cava. The inferior vena cava is compressed and displaced posteriorly.

IMPRESSION :

No significant abnormality is detected in the lumbo-sacral spine per se.

An approximately 3.0 cms diameter sized mass lesion in the prevertebral region to the right of the midline at about the L3-L4 disc level between the aorta and the IVC as described is not specific for a single etiology. This most likely represents a lymphnodal mass.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc XyzShlmn / M / 24 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 3 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.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is volume loss of the right cerebellar hemisphere, inferiorly and in the left parieto-occipital parafalcine region. The cortex in these areas appears hypointense on the T1 Weighted images and follows CSF signal on all pulse sequences, representing areas of cystic encephalomalacia, most likely the sequelae of a previous vascular insult. Hyperintense areas on the T2 Weighted and FLAIR images at the periphery of the lesion in the left parieto-occipital region would represent gliotic changes. A focus of similar signal is also noted in the left thalamus.

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 slight prominence of the cerebellar folia bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Polyps are noted in the maxillary antra bilaterally.
..2/.





- 2 - Scan-00009


IMPRESSION :

Volume loss of the right cerebellar hemisphere, inferiorly and in the left parieto-occipital parafalcine region with altered signal along their cortex, represents areas of cystic encephalomalacia, most likely the sequelae of a previous vascular insult. An ischemic focus is also noted in the left thalamus.

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzilal N. Laplmn / M /52 yrs.
Referred by : Dr. Abc Xyzre.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 15-20 days.

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.

6 mm thick T1 Weighted coronal images.

5 mm thick T1 Weighted sagittal images through the cervico-dorsal region.

OBSERVATION :

There is sacralization of the L5 vertebra which is as marked on the film.

There is scoliosis of the lumbar spine with convexity to the left. Resultant clockwise rotational anomaly of the lumbar vertebrae is noted.

There is reduction in height of L2-L3 and L3-L4 intervertebral discs and loss of water content of the lumbar intervertebral discs.

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

A right postero-lateral disc herniation with peridiscal osteophytes is noted at the L3-L4 level, with right neural foraminal narrowing.
..2/.




R>
Facetal hypertrophy is noted at the L2-L3, L3-L4 and L4-L5 levels.

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.

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

12.0 mm at L1-L2
14.0 mm at L2-L3
11.0 mm at L3-L4
14.0 mm at L4-L5
14.0 mm at L5-S1.

The cervico-dorsal spine was screened with the help of 5 mm thick T1 Weighted sagittal images which does not reveal any diagnostic feature of note.

IMPRESSION :

1. Sacralization of the L5 vertebra which is as marked on the film.

2. Scoliosis of the lumbar spine with convexity to the left with resultant clockwise rotational anomaly of the lumbar vertebrae.

3. Small posterior disc bulges with peridiscal osteophytes at the L2-L3 and L4-L5 levels.

4. A right postero-lateral disc herniation with peridiscal osteophytes at the L3-L4 level, with right neural foraminal narrowing.

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

sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Mlmn / M / 67 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the RLE 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 scoliosis of the lumbar spine with convexity to the right.

There is reduction in height of all the lumbar intervertebral discs except the L5-S1 disc and loss of water content of all the lumbar intervertebral discs.

Slight retroplacement of the L4 over L5 and L3 over L4 vertebrae is noted.

Posterior peridiscal osteophytes are noted at all the lumbar intervertebral disc levels. There is a right postero-lateral and far lateral disc herniation at the L4-L5 level with right neural narrowing and impingement of the right L4 nerve root in the right neural foramen at the L4-L5 level. There is also ligamentum flavum and facetal hypertrophy at the L4-L5 level with a tight canal.

Bilateral neural foraminal narrowing is noted at the L3-L4 level.


Type II degenerative marrow changes are noted in the lumbar vertebral bodies adjacent to all the intervertebral discs except the L5-S1 disc.

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 :

18.0 mm at L1-L2
16.0 mm at L2-L3
17.0 mm at L3-L4
11.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. Scoliosis of the lumbar spine with convexity to the right.

2. Slight retroplacement of the L4 over L5 and L3 over L4 vertebrae.

3. Posterior peridiscal osteophytes at all the lumbar intervertebral disc levels.

4. A right postero-lateral and far lateral disc herniation at the L4-L5 level with impingement of the right L4 nerve root in the right neural foramen at the L4-L5 level. There is also ligamentum flavum and facetal hypertrophy at the L4-L5 level with a tight canal.

sb/hs/rg.
Date :00.00.00

Name of the Patient : Abc Xyz Mlmn / M / 35 yrs.
Referred by : Dr. Abc Xyznghal.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O giddiness and pain in the left half of the body with weakness on 00.00.00.
No complaints at present.

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 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.

Inflammatory changes are noted in the paranasal sinuses.

INTRACRANIAL MRA :

There is hypoplasia of the left vertebral artery and the A1 segment of the left anterior cerebral artery.

The posterior communicating arteries are well-identified.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized right anterior cerebral, middle cerebral, basilar, right vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
..2/.




R>
NECK MRA :

The left vertebral artery in the neck also appears 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 :

No significant abnormality is detected on the intracranial and neck MRA on this study.