sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzm Shinlmn / M / 55 yrs.
Referred by : Dr. Abc Xyzcha.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with tingling since 1 months.

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 lumbar intervertebral discs.

There is a left paracentral extruded disc at the L5-S1 level indenting the traversing left S1 nerve root.

A small posteriorly herniated disc is noted at the L4-L5 level with bilateral neural foraminal narrowing. Mild ligamentum flavum hypertrophy is also seen at this level.

A small, right postero-lateral disc bulge is noted at the L3-L4 level with slight right neural foraminal narrowing.
Schmorls nodes are seen in the lumbar region.

The pedicles of the lumbar vertebrae appear congenitally short in their antero-posterior dimensions. The facet joints in the lower lumbar region appear hypertrophied.

Type II degenerative marrow changes are noted adjacent to the L5-S1 intervertebral disc.
..2/.







The rest of the lumbar vertebral bodies 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.

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

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

IMPRESSION :

1. A left paracentral extruded disc at the L5-S1 level indenting the traversing left S1 nerve root.

2. A small posteriorly herniated disc at the L4-L5 level.

3. A small, right postero-lateral disc bulge at the L3-L4 level with slight right neural foraminal narrowing.

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

5. Facetal hypertrophy in the lower lumbar region.

6. Tight lumbar canal at the L4-L5 and L5-S1 levels.

sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzakant Cholmn / M / 67 yrs.
Referred by : Dr. Abc Xyzthwani.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache.

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 reduction in height of the L2-L3 and L3-L4 intervertebral discs and loss of water content of the lumbar intervertebral discs. There is mild retroplacement of the L3 over the L4, L4 over the L5 and L5 over the S1 vertebrae.

There is a posterior and left postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level with left neural foraminal narrowing and indentation of the foraminal segment of the left L5 nerve root. Slight facetal and ligamentum flavum hypertrophy is noted at this level, more so on the left side. A left far lateral (extraforaminal) disc herniation is also seen at this level.

A posterior and bilateral far lateral (extraforaminal) disc herniation with peridiscal osteophytes is noted at the L4-L5 level with bilateral neural foraminal narrowing. Facetal hypertrophy is noted at this level.

Bilateral postero-lateral and far lateral disc herniations with peridiscal osteophytes are noted at the L3-L4 level with bilateral neural foraminal narrowing.

..2/.




- 2 - Scan-00003

A left far lateral (extraforaminal) disc bulge with peridiscal osteophytes is noted at the L2-L3 level.

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

The L3 and L4 vertebral bodies adjacent to the L3-L4 intervertebral disc appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. There is slight irregularity of the adjacent cortical endplates.

The rest of 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 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
16.0 mm at L2-L3
12.0 mm at L3-L4
9.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

1. A posterior and left postero-lateral disc herniation with peridiscal osteophytes at the L5-S1 level with left neural foraminal narrowing and indentation of the foraminal segment of the left L5 nerve root. Slight facetal and ligamentum flavum hypertrophy is noted at this level, more so on the left side. Also seen is a left far lateral (extraforaminal) disc herniation at this level.

2. A posterior and bilateral far lateral disc herniations with peridiscal osteophytes at the L4-L5 level with bilateral neural foraminal narrowing.
..3/.



R>

3. Bilateral postero-lateral and far lateral (extraforaminal) disc herniations with peridiscal osteophytes at the L3-L4 level with bilateral neural foraminal narrowing.

4. A left far lateral (extraforaminal) disc bulge with peridiscal osteophytes at the L2-L3 level.

5. Altered signal in the L3 and L4 vertebral bodies adjacent to the L3-L4 intervertebral disc most likely represents Type I degenerative marrow changes (bone edema) rather than osteitis.


6. Facetal hypertrophy at the L4-L5 level.

7. A tight canal at the L4-L5 and L5-S1 levels.

hs/ke/nl/nl
/202 Date : 00.00.00

Name of the Patient : Abc Xyzha Plmn / F / 27 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical & Dorsal
Spines.

CLINICAL PROFILE :

C/O weakness of BLE (left more than right) since 1 month.
C/O bladder involvement since 1 day.

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 T2 Weighted axial images.

M.R.I. of the 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.

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

OBSERVATION :

There are hyperintense areas on the T2 Weighted and Fast Scan (T2 *) images within the spinal cord over the cervico-medullary junction to the C2 vertebral level, at the C3 and C4 vertebral levels and over the D8 to D12 vertebral levels. A few of these lesions are central and posterior whereas a few are located laterally.

- 2 - Scan-00000/2

A small hyperintense lesion on the T2 Weighted images is seen in the pons antero-lateral to the fourth ventricle on the left side. There is mild fullness of the fourth ventricle.

A postero-central disc herniation with peridiscal osteophytes is seen to indent the cord at the C4-C5 level. A left paracentral disc herniation is seen to indent the cord at the C5-C6 level.

There is a posterior disc bulge with small peridiscal osteophytes at the C6-C7 level.

The cervical intervertebral discs show loss of water content.

A focal hyperintensity on all the pulse sequences is seen within the D9 vertebral body and this may represent a hemangioma with high fat content.

The rest of the visualized cervical and dorsal vertebral bodies and the dorsal intervertebral discs show normal signal intensity. The joints of Luschka, facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The atlanto-axial region is unremarkable.

The conus medullaris terminates at the L2 level.

IMPRESSION :

The MRI features are suggestive of areas of altered signal intensity within the spinal cord over the cervico-medullary junction to the C2 vertebral level, at the C3 and C4 vertebral levels and over the D8 to D12 vertebral levels and in the pons antero-lateral to the fourth ventricle on the left side and these most likely represent plaques of demyelination.

The possibility of this being due to myelitis is considered less likely.

hs/ke/rg.
Date : 00.00.00
Name of the Patient : Abc Xyzrlal Adalmn / M / 74 yrs.
Referred by : Dr. Abc Xyznghal.
Examination : M.R.I. of the Chest.
CLINICAL PROFILE :
H/O inability to open both eyes and weakness of all four extremities.
To look for thymic remnant.
EXAMINATION :
M.R.I. of the chest was performed using the following parameters:
8 mm thick T1 Weighted axial images.7 mm thick STIR axial images.
5 mm thick T1 Weighted and T2 Weighted (with fat saturation) sagittal images.6 mm thick T1 Weighted coronal images.OBSERVATION :

No obvious lesion is seen in the region of the lung fields bilaterally.
The vascular structures in the mediastinum are normal. The hila bilaterally appear to be normal.No enlarged lymphnodes are identified.
The visualized cervico-dorsal vertebral bodies, the sternum and the costochondral joints do not reveal any area of altered signal intensity.
There is no obvious evidence of any thymic remnant/mass lesion on this scan.
IMPRESSION :No abnormality detected within the chest on this study.

hs/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzhlmn / F / 36 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches since 5-6 years.
C/O giddiness since 1 week.
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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is evidence of an area of hypointensity on the T1 Weighted images which turns hyperintense on the proton, T2 Weighted and FLAIR images within the left periatrial white matter.

There is mild prominence of the cerebellar folia bilaterally.

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 :

The MRI features are suggestive of an area of altered signal within the left periatrial white matter and this is not specific for a single diagnosis. This lesion may be ischemic in etiology or may represent a plaque of demyelination.

hs/ke/nl/nl.
Date : 00.00.00

Name of the Patient : Abc Xyzath Talmn / M / 52 yrs.
Referred by : Dr. Abc Xyzlankar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O left orbital mucormycosis for which the left eyeball was removed 6 weeks ago.
At present C/O headaches and giddiness with hearing loss and tinnitus on the left side.
H/O HT and DM.

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 :

The normal contents of the left orbit are not visualized, the result of the previous surgery.

Areas of intermediate signal intensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images are seen within the left optic canal, left superior orbital fissure, the sphenoid sinus, maxillary sinus and ethmoidal air cells on the left, left infratemporal fossa and the mastoid air cells on the right side.

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









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

IMPRESSION :

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

1. Post-operative status.

2. Inflammatory changes within the left optic canal, left superior orbital fissure, the sphenoid sinus, maxillary sinus and ethmoidal air cells on the left, left infratemporal fossa and the mastoid air cells on the right side.

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzh Mhalmn / M / 25 yrs.
Referred by : Dr. Abc Xyzrges.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O fever, headaches with neck stiffness (since 10-15 days) and inability to swallow liquids and solid since 7-8 days.

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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a fairly large approximately 3.5 x 3.5 x 3.0 cms sized, well-marginated hypointense lesion on the T1 Weighted images in the right cerebellar hemisphere with its broad base towards the petrous temporal bone. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images with a peripheral hypointense rim. There is perilesional edema with compression and displacement of the fourth ventricle to the left and effacement of the peripontine and right ambient cistern. There is herniation of the cerebellar tonsils through the foramen magnum.

There is moderate dilatation of both the lateral and the third ventricles with an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally suggesting a periventricular CSF ooze. Effacement of the cortical sulcal space is noted bilaterally.

No obvious vascular anomaly is identified on this study.


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

IMPRESSION :

An approximately 3.5 x 3.5 x 3.0 cms sized mass lesion in the right cerebellar hemisphere as described may represent a cerebellar abscess in the given clinical setting with surrounding mass effect. A cystic posterior fossa neoplasm however cannot be entirely excluded. There is resultant moderate obstructive hydrocephalus with periventricular CSF ooze.

A contrast enhanced scan may be worthwhile (patient refused contrast study).

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Chlmn / F / 61 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with numbness since 5-6 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.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is scoliosis of the lumbar spine with convexity to the right side and slight forward translation of the L4 over the L5 vertebral body.

A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level. A disc portion is seen to lie in the right lateral recess of the L5 vertebra with resultant impingement of the traversing right L5 nerve root.

Posterior disc herniations are seen to indent the thecal sac and narrow both neural foramina at the L2-L3 and L3-L4 levels. Bilateral far lateral (extraforaminal) disc herniations are noted at these levels.

The L4-L5 and L5-S1 facet joints on the right side and the L3-L4 facet joint on the left side show hypertrophic degenerative changes. The rest of the lumbar facet joints show mild degenerative changes.

- 2 - Scan-00004


There is ligamentum flavum hypertrophy at the L4-L5 and L5 levels. A mild posterior disc bulge is noted at the L5-S1 level.

Posterior peridiscal osteophytes are seen at the L2-L3, L3-L4 and L4-L5 levels. A small posterior disc bulge with small peridiscal osteophytes is noted at the L1-L2 level.

The lumbar intervertebral discs show loss of water content and the L3-L4 intervertebral disc is decreased in height.
The lumbar vertebral bodies show areas of fatty replacement of the normal marrow.

Anterior disc herniations with peridiscal osteophytes are noted at the L2-L3 and L3-L4 levels.

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 :

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

IMPRESSION :

1. A posterior disc herniation at the L4-L5 level with a disc portion lying in the right lateral recess of the L5 vertebra with resultant impingement of the traversing right L5 nerve root.
..3/.







- 3 - Scan-00004



2. Posterior disc herniations with bilateral far lateral (extraforaminal) disc herniations at the L2-L3 and L3-L4 levels.

3. Hypertrophic facetal arthropathy at the L4-L5 and L5-S1 levels on the right side and at the L3-L4 level on the left side and mild facetal arthropathy at the rest of the lumbar levels.

4. A tight canal at the L3-L4 and L4-L5 levels.

ke/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz S. Glmn / M / 15 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the left hip region and the LLE since 5 months.
Alleged H/O fall from steps 5 years back.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

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

5 mm thick Proton density sagittal images.

5 mm thick T1 Weighted axial images.

8 mm thick T1 Weighted coronal images.

OBSERVATION :

There is evidence of a well-circumscribed lesion having a diameter of approximately 9.0 mms within the medial cortex of the neck of the left femur. This is of intermediate signal intensity on the T1 Weighted images.

There is a hyperintense signal on the T2 Weighted and STIR images in the neck and the upper shaft of the left femur. This is mildly hypointense to marrow on the T1 Weighted images.

The femoral head and the acetabulum reveal normal signal intensity bilaterally. The articular cartilages are unremarkable. There is no effusion within both the hip joints.


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

IMPRESSION :

A 9.00 mms diameter sized lesion within the medial cortex of the left femoral neck. An osteoid osteoma should be ruled out.

Altered signal in the left femoral neck may represent bone edema.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzue Anlmn / M / 32 yrs.
Referred by : Dr. Abc Xyzddiqui.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O low back pain since 4 years with paresthesias in BLE.

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 and L5-S1 intervertebral discs.

There is a postero-central disc herniation with a peridiscal osteophyte at the L5-S1 level.

A posteriorly extruded disc is noted at the L4-L5 level with a sequestered disc fragment in the anterior epidural space at the L5 vertebral level, more to the right of the midline, and indenting the traversing right L5 nerve root. Small posterior peridiscal osteophytes are noted at this level.

A postero-central protruded disc is noted at the L3-L4 level.

A hemangioma with fat content (hyperintense on all the pulse sequences) is noted in the L4 vertebral body.
Scan-00002



The rest of 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 D12-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 :

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

IMPRESSION :

1. A postero-central disc herniation with a peridiscal osteophyte at the L5-S1 level.

2. A posteriorly extruded disc at the L4-L5 level with a sequestered disc fragment in the anterior epidural space at the L5 vertebral level, more to the right of the midline and indenting the traversing right L5 nerve root.