sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzhai K. Paclmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O left sided hemiparesis 8-10 years back.
H/O giddiness with vomiting and fall with LOC for few minutes and forgetfulness 3 months back.
Now C/O tingling in the RUE and gait ataxia.
Known hypertensive.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

There are ill-defined, hyperintense areas on the T2 Weighted images in the right cerebellar hemisphere, inferiorly, (along the distribution of the right posterior inferior cerebellar artery), in the left cerebellar hemisphere, superiorly and inferiorly (along the distribution of the left superior cerebellar artery and left posterior inferior cerebellar artery). The cerebellar vermis is also involved. These lesions appear hypointense on the T1 Weighted images.

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







INTRACRANIAL MRA :

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

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized 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.

NECK MRA :

The left vertebral artery in the neck also appears hypoplastic as compared to the right.

The common carotid arteries and their bifurcations are unremarkable. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

1. Altered signal in the cerebellar hemispheres bilaterally represent old infarcts.

2. Hypoplastic left vertebral artery.

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

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Bhalmn / F / 38 yrs.
Referred by : Dr. Abc Xyzelwal / Dr. Abc Xyzsbekar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O positional giddiness since 4 days.
Audiogram s/o bilateral sensory - neural deafness.

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.

MR cisternogram was obtained in the coronal plane.

OBSERVATION :

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

The seventh and eighth cranial nerve complex are unremarkable on either side.

Both the lateral, third and the fourth ventricles are normal. There is slight prominence of the 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 :

No significant abnormality is detected on this study.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Jhalmn / F / 10 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

C/O pain in the left knee joint with swelling since 4 months.
H/O fall from a chair prior to this.

EXAMINATION :

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

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

4 mm thick T1 Weighted, proton and GRASS coronal images.

4 mm thick Fast Scan (T2 *) axial images.

OBSERVATION :

Menisci

The anterior and posterior horns of the lateral and medial menisci reveal normal configuration and signal characteristics.

Cruciate Ligaments :

The anterior and posterior cruciate ligaments show normal contour and signal characteristics.

Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.




Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

The articular cartilage overlying the patella, tibia and femur and epiphysis appear normal.

IMPRESSION :

Normal study of the Left Knee Joint.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyznmlmn / M / 25 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

H/O fever with chills on 00.00.00.
C/O retention of urine 2 days back.
Patient HIV +ve.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

10 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The dorsal spinal cord appears slightly increased in diameter and shows a patchy ill-defined, hyperintense signal on the T2 Weighted images, centrally, over the D2 to D11 vertebral levels (better appreciated on axial images). This signal appears isointense to the normal cord on the T1 Weighted images.

The intrathecal CSF in the visualized dorsal and lumbar regions appears more hyperintense than normal.

There is a small, collection, intradurally, along the posterior margin of the dorsal spinal cord over the D5 to D7 vertebral levels. This lesion is slightly hyperintense to CSF on all the pulse sequences and is best appreciated on the sagittal T2 Weighted images (scans 105.4, 103.5).







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

There is no cord compression.

Screening images of the cervical spine reveals patchy hyperintense signal on the T2 Weighted images in the cervical spinal cord. Screening images of the lumbar spine reveal a slightly hyperintense signal of the CSF on the T1 Weighted images as compared to normal.

IMPRESSION :

1. Altered signal of the intrathecal CSF in the dorsal and lumbar regions as described may suggest an infective/inflammatory meningeal pathology, with subsequent arachnoiditis.

2. Patchy altered signal in the dorsal spinal cord, centrally, over the D2 to D11 vertebral levels most likely represents infective/inflammatory myelitis.

3. Small, intradural collection along the posterior margin of the dorsal spinal cord over the D5 to D7 vertebral levels may represent a small effusion/granulation tissue, in the given clinical setting.

A contrast enhanced scan may be useful.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlal Nalmn / M / 55 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 1 month.

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 through the region of interest.

OBSERVATION :

There is seen a small, approximately 4.0 mms diameter sized well marginated, hypointense lesion on the T1 Weighted images in the subcortical white matter in the left frontal region (scans 105.12, 103.15, 102.15, 104.15, 106.7). This lesion appears hyperintense on the T2 Weighted images. There is no perilesional edema.

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 :

A small, approximately 4.0 mms diameter sized well marginated lesion in the subcortical white matter in the left frontal region represents a resolving granuloma, most likely a neurocysticercus cyst.

As compared to the previous CT Scan dated 00.00.00, there is reduction in the perilesional edema and the size of the lesion.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzj Bhlmn / M / 39 yrs.
Referred by : Dr. Abc Xyzorude.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE since February 0000.
H/O lumbar spine surgery in May 0000. (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.

OBSERVATION :

There is sacralization of the L5 vertebra and the L2 vertebral body is as marked on the film.

There is evidence of laminectomy at the L4 and L5 vertebral levels with post-operative changes in the soft tissues in the posterior lumbar region at these levels.

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

There is a fairly large, posteriorly extruded disc at the L4-L5 level with thecal sac compression and bilateral neural foraminal narrowing. There is also indentation on the traversing L5 nerve roots bilaterally. Ill-defined intermediate signal on the T1 Weighted images in the epidural space at the L4-L5 and L5 levels, which turns slightly hyperintense on the T2 Weighted images represents granulation tissue/scar tissue, the sequelae of previous surgery. There is encasement of the exiting L5 nerve roots bilaterally by granulation/scar tissue. Slight inferior migration of the disc fragment is also noted at the L4-L5 level.
..2/.




Small, right paracentral protruded disc is noted at the L3-L4 level.

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

Type II degenerative marrow changes are noted in the L5 vertebral body adjacent to the L4-L5 disc.

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 D12-L1 level and the thecal sac terminates at the S1 level.

Fat is noted in the filum terminale in the lumbar region.

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

16.0 mm at L1-L2
15.0 mm at L2-L3
14.0 mm at L3-L4

IMPRESSION :

1. Post-operative status.

2. Sacralization of the L5 vertebra.

3. A fairly large, posteriorly extruded disc at the L4-L5 level with bilateral neural foraminal narrowing and indentation on the traversing L5 nerve roots bilaterally.
..3/.








- 3 - Scan-00007



4. Scar/granulation tissue in the epidural space at the L4-L5 and L5 levels.

As compared to the previous MRI dated 00.00.00, the patient is now status post-operative.

There is however, no significant change in the degree of disc herniation at the L4-L5 level on the present study.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzDharmadhilmn / F / 43 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O tremors in the right hand with weakness of the RUE since 7-8 months.

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 :

There is loss of water content of the cervical intervertebral discs with loss of normal cervical curvature.

There are fairly large, posterior peridiscal osteophytes, more to the left of the midline at the C5-C6 level, with left neural foraminal narrowing and indentation of the spinal cord and the traversing left C6 nerve root. A small posterior disc bulge is also noted at this level.

Small postero-central protruded discs with peridiscal osteophytes are noted at the C4-C5 and C6-C7 levels.

Slight facetal hypertrophy is noted at the C4-C5 and C5-C6 levels bilaterally.

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 :

1. Fairly large, posterior peridiscal osteophytes, more to the left of the midline at the C5-C6 level, with left neural foraminal narrowing and indentation of the spinal cord and the traversing left C6 nerve root.

2. Small postero-central protruded discs with peridiscal osteophytes at the C4-C5 and C6-C7 levels.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzrd Coutlmn / M / 24 yrs.
Referred by : Dr. Abc Xyzhijwala.
Examination : M.R.I. of the Left Foot.

CLINICAL PROFILE :

C/O pain and swelling over both feet 1 year back.
Now similar complaints since 1 month.

EXAMINATION :

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

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

6 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and GRASS sagittal images.

OBSERVATION :

The visualized bones show normal alignment, configuration and signal intensity. No obvious bone destruction or erosion is evident.

The visualized tendons and ligament show normal signal intensity. No joint effusion is evident. The visualized soft tissues are unremarkable.

The visualized ankle joint is unremarkable.

IMPRESSION :

Normal study of the Left Foot.

sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzer Lulmn / F / 20 yrs.
Referred by : Dr. Abc Xyzmant.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

C/O pain in the left knee joint with swelling, locking and clicking since 00.00.00.
H/O trauma while dancing.
H/O similar complaints 3 years back. Recovered.

EXAMINATION :

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

4 mm thick T1 Weighted, proton and GRASS sagittal images.

4 mm thick T1 Weighted and STIR coronal images.

4 mm thick Fast Scan (T2 *) axial images.

OBSERVATION :

Menisci

The anterior and posterior horns of the lateral and medial menisci reveal normal configuration and signal characteristics.

Cruciate Ligaments :

The posterior cruciate ligament shows normal contour and signal characteristics. Ligament of Wisberg is visualized.

The anterior cruciate ligament is ill-defined, at its femoral attachment and its fibres appear slightly attenuated. This may suggest a chronic partial tear.




Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.

Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

The articular cartilage overlying the patella, tibia and femur appears normal.

There is a small left knee joint effusion.

IMPRESSION :

1. Ill-defined anterior cruciate ligament at its femoral attachment with slightly attenuated fibres may suggest a chronic partial tear.

2. Small left knee joint effusion.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzrd Coutlmn / M / 24 yrs.
Referred by : Dr. Abc Xyzhijwala.
Examination : M.R.I. of the Right Foot.

CLINICAL PROFILE :

C/O pain and swelling over both feet 1 year back.
Now similar complaints since 1 month.

EXAMINATION :

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

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

6 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and GRASS sagittal images.

OBSERVATION :

The visualized bones show normal alignment, configuration and signal intensity. No obvious bone destruction or erosion is evident.

The visualized tendons and ligament show normal signal intensity. No joint effusion is evident. The visualized soft tissues are unremarkable.

The visualized ankle joint is unremarkable.

IMPRESSION :

Normal study of the Right Foot.