hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzR. Galmn / F / 48 yrs.
Referred by : Dr. Abc Xyzhru / Dr. Abc Xyzagwati.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 1 month.

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 vertebra is as marked on the film. (Please correlate with plain radiographs).

The D12-L1, L3-L4 and L4-L5 intervertebral discs show loss of water content.

There is mild forward listhesis of the L3 vertebra over the L4 vertebra.

A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L3-L4 level. There is slight superior migration of the disc posterior to the L3 vertebra. There is mild indentation upon the foraminal portion of both the exiting L3 nerve roots. Bilateral far lateral (extraforaminal) disc herniations are seen at the L3-L4 level.

A postero-central disc herniation is seen to indent the thecal sac at the L4-L5 level.

The L3-L4 facet joints show hypertrophic degenerative changes.
..2/.







Fat is noted within the filum terminale over the L2 to the L4 level.

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

IMPRESSION :

1. Forward listhesis of the L3 vertebra over the L4 vertebra.

2. Posterior and bilateral far lateral (extraforaminal) disc herniations with hypertrophic facetal arthropathy at the L3-L4 level.

3. A postero-central disc herniation at the L4-L5 level.

hs/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Mahlmn / F / 5 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the right hip region with inability to sit since 2 months.

EXAMINATION :

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

4 mm thick T1 Weighted and STIR coronal images.

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

4 mm thick Proton density sagittal images.

OBSERVATION :

There are areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted and STIR images within the right hip joint space per se. This may represents effusion with ? synovial thickening. There is slight irregularity of the lateral aspect of the epiphysis of the right femoral head. It however shows normal signal intensity.

Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted and STIR images are seen within the right acetabulum.

There is no obvious bony destruction or erosions noted. The articular cartilages are unremarkable.

The left hip joint is unremarkable.


The musculature surrounding both the hip joints and the visualized pelvis is normal.

IMPRESSION :

The MRI features are suggestive of a joint efffusion with probable synovial thickening with altered signal of the right acetabulum as described. This may represents an inflammatory/infective process.

hs/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzThlmn / F / 28 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the left hip joint since 5 months.

EXAMINATION :

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

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

5 mm thick T1 Weighted and STIR coronal images.

5 mm Proton Density sagittal images.

OBSERVATION :

There is evidence of an area of hypointensity on the T1 Weighted images which turns hyperintense on the STIR and T2 Weighted images within the left femoral head. This is surrounded by a hypointense rim on all the pulse sequences. A small effusion is seen in the left hip joint. There is slight irregularity of the left femoral head.

An area which is isointense to fat on all the pulse sequences is seen in the antero-superior aspect of the right femoral head. It is also surrounded by a hypointense rim on all the pulse sequences. There is no right hip joint effusion.

The muscles around the hip joints are unremarkable.

A cystic lesion (hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images and STIR images) is seen in the right adnexal region (? ovarian cyst).


IMPRESSION :

The MRI features are suggestive of :

1. Class C avascular necrosis involving the left femoral head.

2. Class A avascular necrosis involving the right femoral head.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzt Mlmn / M / 12 yrs.
Referred by : Dr. Abc XyzGawhale.
Examination : M.R.I. of the Lumbo-sacral Spine.
(Repeat Scan).

CLINICAL PROFILE :

C/O backache with pain radiating to BLE with tingling since 15 days.
C/O bladder involvement since 4 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.

6 mm thick T1 Weighted and T2 Weighted axial images.

The cervico-dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and 7 mm thick T2 Weighted axial images.

OBSERVATION :

Hypointense areas on the T1 Weighted images are seen to replace the normal marrow of the L4 vertebral body and its appendages. These are isointense to normal marrow on the T2 Weighted images. There is slight extension of this pathologic process into the left paravertebral soft tissue and the paraspinal soft tissues bilaterally. The cortical endplates are well-visualized. The adjoining discs are unremarkable.

An intermediate signal intensity lesion on the T1 Weighted images is seen within the spinal canal, most likely extradural in location over the L3 to S1 levels predominantly posteriorly and laterally. This is seen to turn mildly hyperintense on the T2 Weighted images.
..2/.







The thecal sac over the L2 to S1 vertebral levels shows areas which are near isointense to nerve roots on all the pulse sequences. The intrathecal nerve roots cannot be differentiated from this lesion over these levels.

The remaining lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The
screening images of the cervico-dorsal spine are unremarkable.

IMPRESSION :

Altered signal of the L4 vertebra with extension into the extradural space over the L3 to S1 levels with presence of an intradural component over the L2 to S1 levels as described. This is not specific for a single etiology. The possibilities to be considered are :

1. Infective processes like tuberculosis.

2. Neoplasia like round cell tumors - less likely.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Ylmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever 3 months back with altered sensorium 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.

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.

Inflammatory changes are noted in both maxillary sinuses (right more than left) and ethmoidal air cells.

IMPRESSION :

No significant abnormality is detected within the brain per se on this study.

hs/bv/rg.
Date : 00.00.00

Name of the Patient : Abc XyzPanlmn / M / 79 yrs.
Referred by : Dr. Abc Xyzndu.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left hemiplegia with slurred speech since 1 day.
H/O simiar complaints on 00.00.00.
Known hypertensive.

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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There are fairly well-defined areas which are near isointense to CSF on all the pulse sequences within the right temporo-parietal lobes. Adjacent to this are areas which are hypointense on the T1 Weighted images and which turn hyperintense on the Proton, T2 Weighted and FLAIR images and would represent gliotic changes. This lesion in toto would represent an area of cystic encephalomalacia.

Diffuse areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images are seen within the periventricular white matter bilaterally. These are most likely ischemic in etiology. Smaller areas with similar signal characteristics are seen within the medulla, pons and fronto-parietal white matter bilaterally.

Lacunar infarcts (iso to hyperintense to CSF) are seen within the pons on the left side, lentiform nuclei bilaterally and the left paraatrial white matter.
..2/.







Calcification/paramagnetic substance deposition is seen within the left lentiform nucleus.

There is mild dilatation of the ventricular system. There is prominence of the basal cisternal spaces, cerebral cortical sulci and cerebellar folia bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of :

1. Areas of cystic encephalomalacia within the right temporo-parietal lobe as described.

2. Altered signal within the periventricular white matter and fronto-parietal white matter bilaterally and in the pons and medulla are most likely ischemic in etiology.

3. Lacunar infarcts in the pons on the left side, lentiform nuclei bilaterally and the left paraatrial white matter.

4. Mild dilatation of the ventricular system.

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzaiglmn / F / 27 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O oligodendroglioma.
H/O left frontal craniotomy on 00.00.00.
C/O seizures (3 episodes) since July 0000.
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 images with magnetization transfer.
5 mm thick T1 Weighted sagittal and coronal images.

OBSERVATION :

There is evidence of a left frontal craniotomy.

There is a mass lesion in the left high frontal region. This lesion is mildly hypointense with few hyperintense areas within it on the T1 Weighted images. This is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. A small cystic/necrotic component is seen on the FLAIR images. There is mild effacement of the adjacent sulci. The adjacent gyri appear thick and are hypointense to normal gray matter on the T1 Weighted images and turn hyperintense on the proton, T2 Weighted and FLAIR images.
- 2 - Scan-00007


On administration of contrast, there is faint enhancement at the periphery of the cystic/necrotic component. Also seen is enhancement of the meninges adjacent to the surgical site.

A lacune is noted in the right occipital lobe.

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 :

In a known C/O oligodendroglioma, the MRI features are suggestive of :

1. Post-operative status.

2. Residual lesion in the left frontal lobe as described.

Date : 00.00.00

Name of the Patient : Abc Xylmn / F / 15 yrs.
Referred by : Dr. Abc Xyzwhney.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 2 years.
H/O fall from a height 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 :

Mild posterior disc bulges are noted at the L4-L5 and L5-S1 levels.

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 S2 level.

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

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

IMPRESSION :

The MRI features are suggestive of mild posterior disc bulges at the L4-L5 and L5-S1 levels.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzt Slmn / M / 56 yrs.
Referred by : Dr. Abc Xyzaubal / Dr. Abc Xyzhoo.
Examination : M.R.I. of the Pelvis with screening of
Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with numbness since 3-4 months.

EXAMINATION :

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

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

8 mm thick T1 Weighted coronal images.

The lumbo-sacral spine was screened with 5 mm thick T1 Weighted and T2 Weighted sagittal images.

The cervical and dorsal spines were screened with 4 mm thick T1 Weighted sagittal images.

OBSERVATION :

Multiple areas of hypointensity on the T1 Weighted and T2 Weighted images are seen to involve the pelvic bones, right femoral head and all the lumbo-sacral vertebrae. A few hypointense lesions on the T1 Weighted images are seen to turn mildly hyperintense on the T2 Weighted images. Hypointense areas on the T1 Weighted images are also seen to involve most of the cervico-dorsal vertebrae.

Areas of hyperintensity on the T2 Weighted images are seen along the right iliac wing and these may represent edema/extension of the pathologic process per se.


The prostate gland is seen to be enlarged. The urinary bladder is distended with slight thickening of the bladder wall.

A well circumscribed area of hyperintensity on all the pulse sequences is seen within the L1 vertebral body on the right side and this may represent a hemangioma with high fat content.

The ischio-rectal fossae on either side appear normal.

There appear to be enlarged lymphnodes in the lumbar prevertebral region.

No obvious vascular anomaly is noted.

IMPRESSION :

The MRI features are suggestive of areas of altered signal intensity within the pelvic bones, right femoral head and along the spinal axis as described. These MRI findings are strongly suggestive of secondary depositis (probably sclerotic).

Prostatic carcinoma should be ruled out in view of the enlarged prostate gland.

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzon Glmn / M / 48 yrs.
Referred by : Dr. Abc XyzViegas.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fever in November 0000 with gait ataxia (more to the left) and momentary loss of time and place since then.
Known diabetic.

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 an ill-defined, hypointense area on the T1 Weighted images in the right temporo-parietal lobes. This is seen to follow CSF signal characteristics on all the pulse sequences. Hyperintense areas are seen at the periphery of this lesion on the proton, T2 Weighted and FLAIR images. These are hypointense to white matter on the T1 Weighted images and represent gliotic changes. There is dilatation of the occipital horn of the right lateral ventricle and this lesion in toto would represent an area of cystic encephalomalacia. Hyperintense signal on the T1 Weighted images along the gyri in this lesion may represent calcification/paramagnetic deposition.

A lacunar infarct (iso to hyperintense to CSF) is seen in the left thalamus.

Hyperintense areas on the proton and T2 Weighted images are seen within the periatrial white matter and fronto-parietal white matter bilaterally. These are iso to hypointense to white matter on the T1 Weighted images and are most likely ischemic in etiology.
..2/.







There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

There is mild 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. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of cystic encephalomalacia in the right temporo-parietal lobes.