sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzed Almn / M / 27 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 0000.
H/O Pulmonary Kochs in 0000. Received AKT.

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 a CSF intensity lesion on all the pulse sequences in the right medial temporal, subcortical white matter. Perilesional diffuse white matter hyperintense signal is also noted in that region. This lesion appears separate from the right temporal horn (scans 107.9-10, 106.9-10, 103.6-7, 102.6-7).

The hippocampal complexes on either side are unremarkable.

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 :

Altered signal in the subcortical white matter in the right medial temporal region as described, represents an area of gliosis/encephalomalacia.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 30 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O paresthesias in BLE (left more than right) since 6 months.
H/O lifting heavy weight.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

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

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

OBSERVATION :

The spinal cord over the D3 to the D6 vertebral levels is swollen. The cord over these levels is hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted images.
There is effacement of the surrounding CSF space.

A small left paracentral disc herniation is seen to indent the cord at the D8-D9 level.

Posterior disc bulges are noted at the D6-D7 and D7-D8 levels.

The upper and mid-dorsal intervertebral discs show loss of water content.

R>
The visualized dorsal 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.

IMPRESSION :

The MRI features are suggestive of swelling of the dorsal spinal cord over the D3 to the D6 vertebral levels with altered signal as described. This is not specific for a single etiology. The differential diagnosis would include,

1. Cord tumors.

2. Myelitis/demyelination.

A contrast enhanced study would be worthwhile.

hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 58 yrs.
Referred by : Dr. Abc Xyzdha.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to the LUE with paresthesias, giddiness and gait imbalance.

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 curvature and loss of water content of the cervical intervertebral discs.

There is evidence of a large postero-central disc extrusion with peridiscal osteophytes, more to the left of the midline at the C5-C6 level. It is seen to compress upon the spinal cord and narrow the left neural foramen at this level. The cord at the C5-C6 level shows a subtle hyperintense signal on the Fast Scan (T2 *) images and this represent cord edema/ischemia. The disc appears reduced in height.

A postero-central disc herniation with peridiscal osteophytes is seen to indent the cord at the C4-C5 level. The joints of Luschka at this level show mild degenerative changes with slight bilateral neural foraminal narrowing, right more than left.
Scan-00008


There is a small left postero-lateral disc herniation with peridiscal osteophytes narrowing the left neural foramen at the C6-C7 level. Postero-central disc protrusions are seen at the C2-C3 and C3-C4 levels.

The facet joints show degenerative changes bilaterally at the C5-C6 level and on the right side at the C6-C7 level.

Anterior disc herniations with peridiscal osteophytes are noted at the C4-C5, C5-C6 and C6-C7 levels.

The cervical vertebral bodies show areas of fatty replacement of normal marrow. The cervical intervertebral discs show loss of water content.

The rest of the joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

Small lymph nodes are seen adjacent to the carotid sheaths bilaterally.

IMPRESSION :

The MRI features are suggestive of :

1. A large postero-central disc extrusion with peridiscal osteophytes, more to the left of the midline at the C5-C6 level with canal stenosis and cord compression with cord signal alteration at this level representing cord edema/ischemia.

2. A postero-central disc herniation with peridiscal osteophytes at the C4-C5 level.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzar Mlmn / M / 57 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc XyzR> Examination : M.R.I. - Brain (Post-contrast Study).

CLINICAL PROFILE :

Known C/O intracranial tuberculomas, detected in May 0000. On AKT.

EXAMINATION :

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

After administration of contrast, there are multiple rim-enhancing lesions scattered in the cerebellar and cerebral hemispheres bilaterally, predominantly in the subcortical white matter. Most of these lesions are a conglomeration of multiple lesions. They vary in size from a few mms to about 1.5 cms in maximum transverse dimensions.

There is no abnormal meningeal enhancement noted on this study.

hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyznd lmn / M / 10 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Known C/O Non-Hodgkins lymphoma detected 1 1/2 years back. Received radiotherapy and Chemotherapy.
C/O seizures since the age of 4 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.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of an extra-axial mass lesion in the left fronto-parietal region, parafalcine region with its broad base towards the falx and measuring approximately 3.2 x 2.2 x 2.8 cms. This lesion is iso to hyperintense to gray matter on the T1 Weighted images and is hypointense on the proton and T2 Weighted images. It has a hypointense rim on the proton and T2 Weighted images and which is hyperintense on the T1 Weighted images (? calcified lesion). After contrast administration, there is slight peripheral enhancement of this lesion.
Scan-00006


Areas which are isointense to CSF on all the pulse sequences are seen within the left fronto-parietal lobes adjacent to the aforementioned lesion. These are surrounded by areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images and would represent gliotic changes. These would represent areas of cystic encephalomalacia. Small areas with similar signal characterstics are seen within both frontal lobes and right cerebellar hemisphere (may be ischemic in etiology).

There is mild fullness of the third and both the lateral ventricles. There is mild prominence of the cerebellar folia bilaterally.

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.

IMPRESSION :

The MRI features are suggestive of :

1. An extra-axial mass lesion in the left fronto-parietal region measuring approximately 3.2 x 2.2 x 2.8 cms with signal characteristics as described. This most likely represents a meningioma, probably a calcified meningioma. The possibility of a lymphoma seems less likely.

2. Areas of cystic encephalomalacia within the left fronto-parietal lobes, both frontal lobes and in the right cerebellar hemisphere.

hs/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzdra Klmn / M / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 2 years.
Also C/O gait imbalance and vomiting.

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.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are irregularly defined areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images within the left periatrial white matter and right frontal white matter. These most likely represent gliotic/encephalomalacic changes. A focal area with similar signal characteristics is seen within the right paraatrial white matter.

The left hippocampus appears smaller as compared to the right side and shows a hyperintense signal on the T2 Weighted images.


There is prominence of the cerebellar folia bilaterally with fullness of the fourth ventricle. Also seen is mild prominence of the cerebral cortical sulci bilaterally.

Both the lateral and the third 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.

A focal lesion which is hypointense on all the pulse sequences is seen in the region of the right eyelid laterally and is not specific for a single etiology (? fibroma).

After administration of contrast, there is no area of abnormal enhancement within the brain parenchyma or along the meninges.

IMPRESSION :

The MRI features are suggestive of :

1. Areas of altered signal within the left periatrial white matter, right frontal white matter and in the right paraatrial white matter and these most likely represent gliotic/encephalomalacic changes.

2. Left hippocampal sclerosis.

3. Mild cerebellar atrophy.

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Plmn / M / 65 yrs.
Referred by : Dr. Abc Xyze / Dr. Abc Xyzzare.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain radiating to BUE and BLE with paresthesias since 15 days.

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 and loss of normal cervical lordosis. Slight retroplacement of the C4 over the C5 and C5 over the C6 vertebrae are noted.

There is continuous ossification of the posterior longitudinal ligament extending over the C3 to C6 vertebral levels.

Postero-central disc herniations with posterior peridiscal osteophytes are noted at the C3-C4, C4-C5, C5-C6 and C6-C7 levels. Cord compression is noted at the C3-C4, C4-C5 and C5-C6 levels, with the spinal cord appearing triangular in shape.

The cervical spinal cord at C1-C2 level appears atrophied and shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images, centrally.
- 2 -

Suspicious hyperintense signal is also visualized within the spinal cord at the C3-C4, C4-C5 and C5-C6 levels (better appreciated on the axial images).

Slight ligamentum flavum prominence is noted in the cervical region at all the disc levels. There is facetal hypertrophy at the C4-C5 and C5-C6 levels.

Anterior peridiscal osteophytes are seen in the upper cervical region.

Diffuse fatty marrow changes are noted in the cervical vertebrae.

The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The atlanto-axial region is unremarkable.

IMPRESSION :

1. Continuous ossification of the posterior longitudinal ligament extending over the C3 to the C6 vertebral levels.

2. Postero-central disc herniations with posterior peridiscal osteophytes at the C3-C4, C4-C5, C5-C6 and C6-C7 levels with cord compression at the C3-C4, C4-C5 and C5-C6 levels.

3. Atrophy of the cervical spinal cord at the C1-C2 level with altered signal is of ? etiology ?? due to previous trauma.

4. Slight ligamentum flavum prominence in the cervical region at all the disc levels and facetal hypertrophy at the C4-C5 and C5-C6 levels.

5. Cervical canal stenosis at the C3-C4, C4-C5 and C5-C6 levels.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / F / 16 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Hippocampal Region.

CLINICAL PROFILE :

C/O seizures since June 0000.

EXAMINATION :

M.R.I of the hippocampal region was performed, as requested using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick T2 Weighted axial images through the brain.

OBSERVATION :

There is no area of focal altered signal intensity on the T2 Weighted axial images of the brain.

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.

Inflammatory changes are noted in the ethmoidal air cells and maxillary sinus on the right.

IMPRESSION :

Normal study of the Hippocampal Region.

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzAnlmn / M / 42 yrs.
Referred by : Dr. Abc Xyzwant.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O right sided trigeminal neuralgia.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

MR Cisternogram was obtained in the coronal plane.

A limited MRA (source images) was obtained through the region of interest.

OBSERVATION :

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

Small vascular loops are seen adjacent to the cisternal component of both the trigeminal nerves. However they are not seen to deform the same.

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

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








Inflammatory changes are seen within the frontal sinus and right ethmoidal air cells. The nasal septum is deviated to the left side.

The left intraocular lens is not seen, probably a result of previous surgery.

IMPRESSION :

The MRI features are suggestive of small vascular loops adjacent to the cisternal component of both trigeminal nerves.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzti Kanlmn / F / 47 yrs.
Referred by : Dr. Abc Xyzkia.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE since 3-4 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 loss of water content of all the lumbar intervertebral discs except the L4-L5 disc.

There is Grade I spondylolisthesis of the L4 over the L5 vertebra and the L5 over the S1 vertebra without obvious spondylolysis.

There is a postero-central and right postero-lateral disc herniation at the L5-S1 level with right neural foraminal narrowing and indentation on the traversing right S1 nerve root. Hypertrophic facetal arthropathy and canal stenosis is also noted at this level.

A small postero-central protruded disc is noted at the L4-L5 level. Hypertrophic facetal arthropathy and ligamentum flavum hypertrophy is also noted at this level, with a tight lumbar canal at that level.

Type II degenerative marrow changes are seen in the L3, L4 and L5 vertebrae adjacent to the intervertebral discs.



The rest of the lumbar vertebral bodies 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 :

17.0 mm at L1-L2
15.0 mm at L2-L3
14.0 mm at L3-L4
9.0 mm at L4-L5
5.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L4 over the L5 vertebra and the L5 over the S1 vertebra without obvious spondylolysis.

2. A postero-central and right postero-lateral disc herniation at the L5-S1 level with right neural foraminal narrowing and indentation on the traversing right S1 nerve root. Hypertrophic facetal arthropathy and canal stenosis is also noted at this level.

3. A small postero-central protruded disc at the L4-L5 level with hypertrophic facetal arthropathy and ligamentum flavum hypertrophy and a tight lumbar canal at that level.