hs/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzMilmn / M / 22 yrs.
Referred by : Dr. Abc Xyzchale
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O backache with paraplegia since 00.00.00.
H/O fever prior to this.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

9 mm thick T1 Weighted and T2 Weighted axial images.

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of a space occupying lesion within the posterior epidural space over the C6-C7 to the D12-L1 level. This lesion is hyperintense to CSF but hypointense to fat on the T1 Weighted images and turns hyperintense to both on the T2 Weighted and Fast Scan (T2 *) images. There is resultant compression and anterior displacement of the cord over these levels. The cord over these levels shows a hyperintense signal on the T2 Weighted images and would represent cord edema/ischemia/involvement by the pathologic process per se.

The spinal cord over the C5 to the C6 vertebral levels is swollen and shows a hyperintense signal on the T2 Weighted images.

Subtle areas of hyperintensity on the Fast Scan (T2 *) and T2 Weighted images are seen within the paraspinal soft tissues over the D1 to the D6 vertebral level.
..2/.






The visualized cervico-dorso-lumbar vertebral bodies are more hypointense as compared to the normal marrow on the T1 Weighted images and these may represent a preponderance of hematopoietic marrow/?? myeloproliferative disorder.

The conus medullaris terminates at the L1 level.

IMPRESSION :

The MRI features are suggestive of a space occupying lesion within the posterior epidural space over the C6-C7 to the D12-L1 level with cord compression and altered cord signal as described. This may represent an infective process like tuberculosis or neoplastic process like a small cell tumor.

Altered signal of the cervico-dorso-lumbar vertebral bodies may represent a preponderance of hematopoietic marrow/?? myeloproliferative disorder.

Date : 00.00.00

Name of the Patient : Abc Xyzam D. Gailmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias 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 :

There is evidence of a large postero-central disc extrusion compressing the thecal sac at the L4-L5 level. A disc portion is seen to lie within the anterior epidural space at the L5 vertebral level.

A postero-central disc herniation is seen to indent the thecal sac at the L3-L4 level. Also seen a postero-central disc herniation with peridiscal osteophytes indenting the thecal sac at the L1-L2 level.

There are posterior disc bulges at the L2-L3 and L5-S1 levels.

The L2-L3, L3-L4, L4-L5 and L5-S1 facet joints show hypertrophic degenerative changes.

The lumbar intervertebral discs show loss of water content.

The lumbar vertebral bodies reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
..2/.




R>
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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. A large postero-central disc extrusion at the L4-L5 level with severe canal stenosis. A disc portion is seen to lie within the anterior epidural space at the L5 vertebral level.

2. A postero-central disc herniation at the L3-L4 level with a tight canal.

3. A postero-central disc herniation with peridiscal osteophytes at the L1-L2 level.

4. Hypertrophic facetal arthropathy at the L2-L3, L3-L4, L4-L5 and L5-S1 levels.

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 27 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches, giddiness and neck pain radiating to the LUE since 2-3 months.

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 FLAIR coronal images.

5 mm thick T1 Weighted sagittal images. An MR cisternogram was obtained in the coronal plane.

OBSERVATION :

There is seen a fairly large, approximately 6.0 x 3.8 x 3.1 cms sized well-defined, cystic mass lesion in the right cerebellar hemisphere. This lesion is slightly hyperintense to CSF on all pulse sequences. There is an approximately 1.8 x 1.1 cms solid mural nodule along the infero-lateral wall of the lesion on the right. There is no significant perilesional edema. There is resultant compression of the fourth ventricle which is displaced slightly to the left of the midline. The right paramedullary and the right quadrigeminal cisterns are also effaced.

There is cerebellar tonsillar herniation through the foramen magnum. Mild dilatation of both the lateral and the third ventricles is noted.

There is a hyperintense signal on the proton, T2 Weighted and FLAIR images in the left cerebellar hemisphere which is hypointense on the T1 Weighted images which needs to be evaluated further.
..2/.







No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the left maxillary antrum.

IMPRESSION :

An approximately 6.0 x 3.8 x 3.1 cms sized well-defined, cystic mass lesion with a solid nodule in the right cerebellar hemisphere as described, most likely represents a hemangioblastoma. The possibility of a cystic astrocytoma seems less likely (in view of the solid nodule described above).

A contrast enhanced scan would be worthwhile.

von Hippel-Lindau syndrome should be ruled out.

sb/bv/nl/rg.
/298 Date : 24/00.00.00

Name of the Patient : Abc Xyzkash Arullmn / M / 46 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided weakness with speech disturbances since 5.00 pm of 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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is seen an approximately 2.8 x 3.8 x 4.0 cms sized well-marginated, iso to hypointense mass lesion on the T1 Weighted images in the right thalamus. This lesion appears heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images with hypointense areas within. The lesion blooms partially, on the Fast Scan (T2 *) images. There is mild perilesional edema with indentation of the right lateral and third ventricles and mild bulge of the midline to the left. Extension into the right lateral ventricle is noted. There is also extension into the right corona radiata, superiorly and right cerebral peduncle, inferiorly.

A small bright focus on the proton, T2 Weighted and FLAIR images is noted in the subcortical white matter in the left fronto-temporal region.






There is mild fullness of the left lateral ventricle. The fourth ventricle is normal. The CSF in the fourth ventricle and the cisterna magna appears hyperintense when compared to the normal CSF signal on the T1 Weighted and FLAIR images. This may be due to leak of the right thalamic hematoma into the fourth ventricle/basal cisterns. No obvious vascular anomaly is identified on this study.

IMPRESSION :

An approximately 2.8 x 3.8 x 4.0 cms sized mass lesion in the right thalamus with extensions as described follows the signal characteristics of a hyperacute to acute intracerebral hematoma. There is intraventricular extension of this lesion.

Repeat, limited, T2 Weighted axial images of the brain were obtained on 00.00.00. There is a definite increase in the size of the right thalamic lesion which now measures 4.2 x 5.8 x 4.9 cms. There is also increase in the size of the lateral ventricles and increase in the overall mass effect. The intraventricular extension of the hematoma is more pronounced.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzidevi Bhanlmn / F / 35 yrs.
Referred by : Dr. Abc Xyz Mehta.
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 hippocampal complex 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.

IMPRESSION :

Normal study of the Brain.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzchandra lmn / M / 60 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the RUE and RLE with slurred speech since 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.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the pons, in the periventricular white matter bilaterally, subcortical white matter in the frontal and parietal regions bilaterally and in the region of the genu of the corpus callosum. These lesions appear hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic lesions.

Lacunar infarcts are noted in the right lentiform nucleus.

Dilated perivascular spaces are seen in the centrum semiovale bilaterally.

There is mild fullness of both the lateral and third 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.

Incidentally noted is an empty sella.


IMPRESSION :

1. Altered signal in the pons, in the periventricular white matter bilaterally, subcortical white matter in the frontal and parietal regions bilaterally and in the region of the genu of the corpus callosum most likely represent ischemic changes.

2. Lacunar infarcts in the right lentiform nucleus.

Date : 00.00.00

Name of the Patient : Abc Xyzta Prlmn / F / 83 yrs.
Referred by : Dr. Abc Xyz Shah
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O breathlessness with seizures.
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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally, pons, right lentiform nucleus, bilateral thalami and in the corona radiata and centrum semiovale bilaterally. These lesions appear hypointense to normal white matter on the T1 weighted images.

Lacunar infarcts are noted in the pons and left corona radiata.

There is mild dilatation of both the lateral and the third ventricles. The fourth ventricle is normal. There is prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures. There is ectasia of the left vertebral artery with indentation upon the left lateral aspect of the medulla.




There is no evidence of haemorrhage on this study.

IMPRESSION :

1. Altered signal in the periventricular white matter bilaterally, pons, right lentiform nucleus, bilateral thalami and in the corona radiata and centrum semiovale bilaterally most likely represent ischemic changes.

2. Lacunar infarcts in the pons and in the left corona radiata.

3. Age related cerebral and cerebellar atrophy.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzPlmn / F / 55 yrs.
Referred by : Dr. Abc Xyzsani / Dr. Abc Xyzhatt.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE (left more than right) with numbness.

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 normal cervical lordosis and loss of water content of the cervical intervertebral discs.

There is a fairly large, left paracentral disc herniation with peridiscal osteophytes at the C5-C6 level with resultant indentation on the cervical spinal cord anteriorly.

Postero-central protruded discs are noted at the C3-C4 and C4-C5 levels. Small posterior disc bulges are noted at the C2-C3 and C6-C7 levels.

The cervical vertebral bodies show spotty fatty marrow changes. 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. A fairly large, left paracentral disc herniation with peridiscal osteophytes at the C5-C6 level with resultant indentation on the cervical spinal cord anteriorly.

2. Postero-central protruded discs at the C3-C4 and C4-C5 levels.

hs/sb/nl/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O radicular pain to the RLE since 2 weeks.

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 appears to be as marked on the film. Please correlate with plain radiographs. There is mild forward listhesis of the L4 vertebra over the L5 vertebra.

A right postero-lateral disc herniation with peridiscal osteophytes is seen to narrow the right neural foramen at the L4-L5 level. A sequestered disc fragment is seen to lie within the right lateral recess of the L4 vertebra with indentation upon the thecal sac. A small postero-central disc herniation is seen at the L4-L5 level.

Postero-central and right postero-lateral disc herniations with peridiscal osteophytes are seen to indent the thecal sac and narrow the right neural foramen, respectively at the L5-S1 level.

Far lateral (extraforaminal) disc herniations are seen bilaterally at the L4-L5 and L5-S1 levels and on the right side at the L2-L3 level. A small right postero-lateral disc herniation is seen to narrow the right neural foramen at the L2-L3 level.


The L4-L5 facet joints show hypertrophic degenerative changes.

The L2-L3 to the L5-S1 intervertebral discs show loss of water content.

The lumbar vertebral bodies and the L1-L2 intervertebral disc reveal normal signal intensity. The remaining 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 :

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

IMPRESSION :

The MRI features are suggestive of :

1. A right postero-lateral disc herniation and a small postero-central disc herniation with peridiscal osteophytes at the L4-L5 level with a sequestered disc fragment lying within the right lateral recess of the L4 vertebra.

2. Hypertrophic facetal arthropathy at the L4-L5 level.
..3/.









- 3 - Scan-00002




3. Postero-central and right postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level.

4. A small right postero-lateral disc herniation at the L2-L3 level.

5. Far lateral (extraforaminal) disc herniations bilaterally at the L4-L5 and L5-S1 levels and on the right side at the L2-L3 level.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzPlmn / F / 55 yrs.
Referred by : Dr. Abc Xyzsani / Dr. Abc Xyzhatt.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (left more than right) with numbness.

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 nearly all the lumbar intervertebral discs except the L1-L2 disc.

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

Congenital anomaly of the D12 and L1 vertebral bodies is noted. The waist appears narrow and the D12-L1 disc appears reduced in height.

A small postero-central protruded disc is noted at the L4-L5 level. The facet joints at this level appear hypertrophied bilaterally. Mild ligamentum flavum hypertrophy is also identified at the L4-L5 and L5 vertebral levels.

The lumbar vertebral bodies reveal normal signal intensity. The remaining 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.
..2/.







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

15.0 mm at L1-L2
18.0 mm at L2-L3
16.0 mm at L3-L4
14.0 mm at L4-L5
15.0 mm at L5-S1.

IMPRESSION :

1. Probable sacralization of the L5 vertebra.

2. A small postero-central protruded disc at the L4-L5 level.