ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzahad Aleslmn / M / 48 yrs.
Referred by : Dr. Abc Xyzain.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

H/O injury to brachial plexus 25 years ago.
C/O inability to move LUE since then.

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 T1 Weighted and T2 Weighted (with fat saturation) coronal images.

3 mm thick T1 Weighted oblique sagittal images.

OBSERVATION :

There is an extradural lesion in the left neural foramen at the C6-C7 and C7-D1 levels. This lesion is seen to follow CSF signal intensity characteristics on all the pulse sequences and would represent a pseudomeningocele, probably the result of previous trauma and subsequent nerve root avulsion. The anterior and posterior horns on the left side at this level are not well-visualized. Slight irregularity of the cord is noted at the C7-D1 level on the left.

Small posterior disc bulges are noted at the C3-C4 and C4-C5 levels.

Left postero-lateral disc herniations with peridiscal osteophytes are noted at the C5-C6, C6-C7 and C7-D1 levels.



The cervical intervertebral discs show loss of water content.

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 :

The MRI features are suggestive of extradural lesions in the left neural foramen at the C6-C7 and C7-D1 levels, following CSF signal and would represent pseudomeningoceles, probably the result of previous trauma and subsequent nerve root avulsion.

ke/sb/rg/nl
Date : 00.00.00 Name of the Patient : Abc XyzJlmn / F / 27 yrs.Referred by : Dr. Abc Xyzdar.Examination :.R.I. of the Brain.CLINICAL PROFILE :
Known C/O intracranial tuberculoma since 00.00.00. On AKT since then. 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.3 mm thick T2 Weighted coronal images.
5 mm thick T1 Weighted sagittal images.
OBSERVATION :
There is still seen an approximately 1.9 x 1.6 x 2.1 cms sized well-defined iso to hypointense mass lesion on the T1 Weighted images in the left parieto-occipital, parafalcine region. This lesion appears significantly hypointense on the proton and T2 Weighted images with central hyperintense signal. There is mild to moderate perilesional edema with effacement of the sulcal spaces and anterior displacement of the atrium and occipital horn of the left lateral ventricle, which appears slightly effaced. Edema is also noted within the splenium of the corpus callosum on the left side. Multiple, small, satellite lesions are noted along the postero-superior margin of the lesion.
The right 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 the right maxillary sinus.
R>
IMPRESSION :An approximately 1.9 x 1.6 x 2.1 cms sized mass lesion in the left parieto-occipital, parafalcine region as described follows the signal characteristics of a tuberculoma. Multiple, small, satellite lesions are noted along the postero-superior margin of the lesion.
As compared to the previous MRI dated 00.00.00 (scan no:00000), the lesion shows necrotic changes, centrally. Multiple small, satellite lesions are noted along the postero-superior margin of the lesion. There is increase in the perilesional edema.

A contrast enhanced scan may be worthwhile.

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzQurlmn / F / 36 yrs.
Referred by : Dr. Abc Xyzspati.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE 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 posterior disc herniation, more to the right of the midline which is seen to indent the right S1 nerve root at the L5-S1 level. Small posterior peridiscal osteophytes are also noted at this level.

A posterior disc bulge with a left far lateral disc herniation is seen at the L4-L5 level with anterior indentation of the thecal sac and the extraforaminal portion of the traversing left L4 nerve root.

The L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.

The lower lumbar facet joints show degenerative changes.

Type II degenerative changes are noted in the L3 and L4 vertebral bodies, anteriorly adjacent to the L3-L4 intervertebral disc.
Scan-00001



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 L1-L2 level and the thecal sac terminates at the L5-S1 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
17.0 mm at L3-L4
14.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A small posterior disc herniation, with peridiscal osteophytes, more to the right of the midline indenting the right S1 nerve root.

2. A posterior disc bulge with a left far lateral disc herniation at the L4-L5 level indenting the extraforaminal portion of the traversing left L4 nerve root.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz A. Dlmn / M / 24 yrs.
Referred by : Dr. Abc Xyzikhalikar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures 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.

5 mm thick FLAIR coronal images.

OBSERVATION :

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

The hippocampal complex is unremarkable on either side.

Note is made of a cavum septum pellucidum and cavum vergae.

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/sb/rg/nl
Date: 00.00.00

Name of the Patient : Abc Xyzeer Almn / M / 10 yrs.
Referred by : Dr. Abc Xyzah.
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 hippocampus 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.

Note is made of cavum septum pellucidum and cavum vergae.

Incidental note is made of enlarged adenoids and inflammatory changes in the ethmoidal air cells.

IMPRESSION :

Normal study of the Brain.

sb/hs/nl/rg.
/9 Date: 00.00.00

Name of the Patient : Abc Xyz G. Blmn / M / 68 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O giddiness and slurred speech for a day, 8 days back.
C/O neck pain radiating to BUE and BLE with tingling in the RUE and RLE since 8 days.

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 :

Small areas of hyperintensity on the T2 Weighted images are seen within the fronto-parietal white matter and periatrial white matter and are most likely ischemic in etiology.

There is slight fullness of both the lateral ventricles. There is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.

The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

INTRACRANIAL MRA :

There is slight attenuation of flow signal in the right posterior cerebral artery. The right posterior communicating artery is well-visualized.

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 arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
..2/.




NECK MRA :

There is fusiform dilatation of the proximal left internal carotid artery with slight narrowing distal to it.

The right vertebral artery appears smaller in calibre as compared to the left and is probably hypoplastic.

The common carotid arteries appear normal bilaterally.

IMPRESSION :

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

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

3. Fusiform dilatation of the proximal left internal carotid
artery with slight narrowing distal to it.

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Jarilmn / M / 12 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain since 1 year.

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 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.

Small subcentimeter lymphnodes are noted deep to the sternocliedomastoid muscles bilaterally.

No significant abnormality is detected in the visualized lower skull or the dorsal spine on this study.

IMPRESSION :

No significant abnormality detected on this study.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza M. Glmn / F / 45 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 1 year.

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 normal lumbar lordosis and loss of water content of the L2-L3, L3-L4 and L4-L5 intervertebral discs.

There is a fairly large, posteriorly extruded disc at the L4-L5 level with thecal sac compression and bilateral neural foraminal narrowing. There is indentation on the traversing L5 nerve roots bilaterally. There is also slight facetal hypertrophy and canal stenosis at that level.

Minimal, posterior disc bulges are noted at the L3-L4 and L5-S1 levels.

Anterior disc herniations with anterior peridiscal osteophytes are noted in the lumbar region.

Type II degenerative marrow changes are noted adjacent to the L2-L3, L3-L4 and L4-L5 intervertebral discs.




Schmorls nodes are seen at the L3 and L4 vertebral levels.

The pedicles of the lower lumbar vertebrae appear smaller in their antero-posterior dimensions.

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

Fat is noted in the filum terminale over the L3 to S1 vertebral levels.

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

16.0 mm at L1-L2
14.0 mm at L2-L3
12.0 mm at L3-L4
7.0 mm at L4-L5
8.0 mm at L5-S1.

IMPRESSION :

1. A fairly large, posteriorly extruded disc at the L4-L5 level with indentation on the traversing L5 nerve roots bilaterally with facetal hypertrophy and canal stenosis at this level.

2. Congenitally short pedicles of the lower lumbar vertebrae in their antero-posterior dimensions.

sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzTelmn / M / 40 yrs.
Referred by : Dr. Abc Xyza.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

Known C/O pituitary adenoma. Detected in 0000. On Tablet Bromocryptine. No complaints at present.
For follow up.

EXAMINATION :

M.R.I. of the sella and perisellar region was performed using the following parameters :4 mm thick T1 Weighted and T2 Weighted sagittal images. 4 mm thick T1 Weighted and T2 Weighted coronal images.The brain was screened with 5 mm thick T2 Weighted axial images. OBSERVATION :There is near complete destruction of the clivus and the sella.

There is seen a fairly large, predominantly cystic (hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images) in the region of the clivus and sella turcica. The lesion extends anteriorly into the floor of the anterior cranial fossa, which is eroded. Extension into the posterior ethmoidal air cells and right orbital apex is noted. Laterally there is indentation on the medial temporal pole on the right and extension into the right cavernous sinus. The cavernous segment of the right internal carotid artery is encased by the lesion but shows normal flow void signal. Mild lateral displacement of the cavernous segment of the left internal carotid artery is noted. The supraclinoid segments of the internal carotid arteries




bilaterally and the proximal anterior cerebral arteries are also encased by the lesion. Posteriorly the lesion extends upto the dorsum sella. Inferiorly there is erosion of the floor of the sphenoid sinus with probable extension of the lesion in the nasopharyngeal region.

The optic chiasma and the proximal optic nerves are pulled inferiorly by this lesion. Hyperintense signal on the T1 Weighted images of the posterior pituitary gland is not well-identified on this study. The pituitary stalk is also not well identified. The sphenoid sinus seems to be occupied by the cystic tumor.

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

Mucosal thickening is noted in the maxillary sinuses bilaterally.
IMPRESSION :In a known C/O an invasive pituitary adenoma, the MRI features now show a predominantly cystic lesion in the sella and perisellar region as described which is the sequelae of resolution of the previous pituitary adenoma.

As compared to the previous MRI dated 00.00.00 (Study No. 0000), there is further cystic degeneration of the lesion. The extent of the lesion is however unchanged.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzTlmn / M / 53 yrs.
Referred by : Dr. Abc Xyzosle.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since February 0000.

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 intervertebral disc.

There is a postero-central disc herniation with peridiscal osteophytes, slightly more to the right of the midline at the L4-L5 level indenting the dural theca and the traversing right L5 nerve root. A left far lateral disc herniation is also noted at this level.

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

The lumbar vertebral bodies and the remaining 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 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 :

19.0 mm at L1-L2
18.0 mm at L2-L3
17.0 mm at L3-L4
12.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

A postero-central disc herniation, slightly more to the right of the midline at the L4-L5 level indenting the traversing right L5 nerve root.