hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz. Sallmn / F / 20 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O drowsiness since 1 day and high grade fever since 7 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.

The cervical spine was screened with 3 mm thick T2 Weighted sagittal images.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

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

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.

The screening images of the cervical spine do not show any significant feature of note.

IMPRESSION :

No abnormality is detected within the brain on this study.

ke/sb/nl/rg.
/195 Date : 17/00.00.00

Name of the Patient : Abc Xyzti Almn / F / 66 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O left sided weakness with slurred speech since 4 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 and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images and 3 mm thick T1 Weighted coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined, hypointense areas on the T1 Weighted images in the right lentiform nucleus extending into the right corona radiata. These lesions are seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images with a small lesion posteriorly turning homogeneously hyperintense. There is surrounding edema with mass effect and compression upon the body of the right lateral ventricle and third ventricle with slight shift of the midline structures to the left. On administration of contrast, there is fairly thick peripheral enhancement of the lesion with multiple smaller lesions of varying sizes around. The largest lesion measures approximately 1.8 x 1.5 x 1.7 cms.
..2/.








There is no area of abnormal enhancement along the meninges.

The left lateral and the fourth ventricles are normal.

The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.

IMPRESSION :

The MRI features are suggestive of altered signal intensity, rim-enhancing lesions in the right lentiform nucleus extending into the right corona radiata. These are not specific for a single etiology.

The differentials to be considered are :

1. Metastasis.

2. Infective granuloma.

3. Lymphoma.

4. Less likely to represent an ischemic lesion.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzkolmn / F / 41 yrs.
Referred by : Dr. Abc Xyzrtane.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O giddiness and right sided earache since 2 months.
To r/o acoustic neuroma.

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 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 on either side are unremarkable.

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 :

1. Mild cerebellar atrophy.

2. Normal nonenhanced study of the seventh and eighth cranial nerve complex on either side.

If clinically indicated a contrast enhanced study may be performed (patient refused contrast administration).

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzta Yenclmn / F / 22 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in BLE with associated weakness.

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 through the region of interest.

The brain was screened with 5 mm thick T2 Weighted axial images and the optic nerves were screened with 3 mm thick STIR coronal images.

OBSERVATION :

There is evidence of a fairly well-defined area which is near isointense to CSF on all the pulse sequences within the cord at the D7 and D8 vertebral levels. This may represent an area of myelomalacia.

A few of the visualized dorsal intervertebral discs show loss of water content.

The visualized dorsal vertebral bodies and the pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12 level.





On screening the brain there is evidence of a hyperintense focus on the T2 Weighted images within the pons, centrally. Also seen is mild fullness of the fourth and both the lateral ventricles. There is slight prominence of the cerebellar folia and cerebral cortical sulci bilaterally.

The visualized optic nerves show normal signal intensity bilaterally on the STIR images.

IMPRESSION :

The MRI features are suggestive of :

1. An area of altered signal intensity within the cord at the D7 and D8 vertebral levels most likely represents an area of myelomalacia.

2. An area of altered signal intensity within the pons is not specific for a single etiology (? demyelination, ?? ischemia).

3. Mild cerebral and cerebellar atrophy.

As compared to the previous MRI dated 00.00.00 (Study No.00001). the previously identified lesion in the cord has now become myelomalacic. On review of the previous films and correlating with the MRI brain findings, the diagnosis of a demyelinating/ischemic lesion should be considered.

sb/bv/rg/nl
Date : 00.00.00

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

CLINICAL PROFILE :

C/O paresthesias in the RUE since 00.00.00 and slightly in the RLE.

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 T1 Weighted and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a small, approximately 9.0 mms diameter sized, well-marginated hyperintense lesion on the T1 Weighted images in the left precentral cortex. This lesion turns slightly more hyperintense on the proton, T2 Weighted and FLAIR images. There is mild perilesional edema with slight effacement of the left central sulcus.

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

Altered signal in the left precentral sulcus, most likely represents a late, subacute hematoma (extracellular methaemoglobin).

An occult cerebrovascular malformation may be considered as a likely possibility.

A follow-up MRI would be worthwhile.

hs/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzChlmn / M / 27 yrs.
Referred by : Dr. Abc Xyzhari.
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 appears to be sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.

There are mild posterior disc bulges at the L3-L4 and L4-L5 levels. The L4-L5 facet joints show mild degenerative changes.

Mild right far lateral (extraforaminal) disc bulges are noted at the L2-L3 and L3-L4 levels.

The lumbar vertebral bodies and the intervertebral discs 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 S2 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
16.0 mm at L2-L3
18.0 mm at L3-L4
17.0 mm at L4-L5
15.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Sacralization of the L5 vertebra. Please correlate with plain radiographs.

2. Small posterior disc bulges at the L3-L4 and L4-L5 levels.

3. Mild facetal arthropathy at the L4-L5 level.

hs/bv/nl/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

C/O radicular pain in the RUE.

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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is scoliosis of the cervical spine with convexity to the left with clockwise rotation of the midcervical vertebrae.

There is fusion of the C4 and C5 vertebral bodies with partial obliteration of the C4-C5 intervertebral disc. Also seen is partial fusion of the C5 and C6 vertebral bodies with partial obliteration of the C5-C6 intervertebral disc. The antero-posterior dimension of these vertebral bodies is reduced and there appears to be fusion of their posterior elements suggesting a congenital origin.

Posterior disc herniations with peridiscal osteophytes are seen to indent the cord and narrow the neural foramina bilaterally at the C3-C4 and C6-C7 levels.

Mild posterior disc bulges with small peridiscal osteophytes are noted at the C7-D1 and D1-D2 levels.


Anterior disc herniations with peridiscal osteophytes are noted at the C3-C4 and C6-C7 levels.

The rest of the cervical intervertebral discs show loss of water content.

The cervical vertebral bodies show areas of fatty replacement of the normal marrow.

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 :

1. Congenital fusion of the C4, C5 and C6 vertebrae.

2. Scoliosis of the cervical spine.

3. Posterior disc herniations with peridiscal osteophytes at the C3-C4 and C6-C7 levels.

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzkar Manlmn / M / 57 yrs.
Referred by : Dr. Abc Xyzosle / Dr. Abc Xyzkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain to 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 appears to be sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.

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

Posterior disc herniations are seen to indent the thecal sac and narrow both neural foramina at the L3-L4 and L4-L5 levels.

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

Far lateral (extraforaminal) disc bulges are seen bilaterally at the L3-L4 and L4-L5 levels and on the right side at the L1-L2 and L2-L3 levels.

The pedicles of the lumbar vertebrae appear to be congenitally short in their antero-posterior dimensions.


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.

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

IMPRESSION :

The MRI features are suggestive of :

1. Sacralization of the L5 vertebra. Please correlate with plain radiographs.

2. Posterior disc herniations with canal stenosis at the L3-L4 and L4-L5 levels.

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

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

5. Far lateral (extraforaminal) disc bulges at the L3-L4 and L4-L5 levels bilaterally and on the right side at the L1-L2 and L2-L3 levels.

hs/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzJalmn / M / 42 yrs.
Referred by : Dr. Abc XyzBhojraj.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache (occasional) with pain radiating to BLE since 2 1/2 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 Grade I spondylolisthesis of the L5 vertebra over the S1 vertebra. There is a break of the pars interarticularis of the L5 vertebra bilaterally.

There is mild retroplacement of the L4 vertebra over the L5 vertebra.

A postero-central disc protrusion is seen to indent the thecal sac at the L4-L5 level.

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

There is anterior wedging of the D11 vertebral body without change in its signal intensity.

Anterior disc herniations with peridiscal osteophytes are noted at the D11-D12, D12-L1, L4-L5 and L5-S1 levels. The D10-D11, D11-D12, D12-L1, L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.
..2/.







Type II degenerative changes are seen within the inferior aspect of the D12 and L5 vertebral bodies.

A well-circumscribed area of hyperintensity on all the pulse sequences is seen within the L1 vertebral body and this may represent a hemangioma with high fat content.

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 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
17.0 mm at L2-L3
17.0 mm at L3-L4
16.0 mm at L4-L5
16.0 mm at L5-S1.

IMPRESSION :

1. Grade I spondylolisthesis of the L5 vertebra over the S1 vertebra with spondylolysis of the L5 vertebra bilaterally.

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

3. Mild posterior disc bulges at the L3-L4 and L5-S1 levels.

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzli Slmn / M / 63 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with radiation of pain 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.

The dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and 5 mm thick T2 Weighted axial images through the region of interest.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There appears to be partial sacralization of the L5 vertebra on the right side and the L1 vertebra is as marked on the film.

There is Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra. The L4-L5 facet joints show severe hypertrophic degenerative changes.

A large postero-central disc extrusion with peridiscal osteophytes is seen to indent the cord at the D10-D11 level. The cord at the D10-D11 and D11 levels show a hyperintense signal on the T2 Weighted images suggestive of cord edema/contusion/ischemia. The D10-D11 facet joints show degenerative changes with a resultant tight canal at this level.
..2/.







A posterior disc herniation is seen to indent the thecal sac at the L4-L5 level with resultant bilateral neural foraminal narrowing.

A small posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L3-L4 level.

There are small right postero-lateral (foraminal) disc herniations narrowing the right neural foramina at the L1-L2 and L2-L3 levels.

Far lateral disc herniations are seen bilaterally at the L3-L4 and L4-L5 levels and on the right side at the L1-L2 and L2-L3 levels.

The L1-L2, L2-L3 and L3-L4 facet joints show degenerative changes.

The lumbar intervertebral discs show loss of water content. The lumbar vertebral bodies show spotty fatty marrow changes.

The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D11-D12 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
16.0 mm at L2-L3
16.0 mm at L3-L4
11.0 mm at L4-L5
11.0 mm at L5-S1.
..3/.







- 3 - Scan-00009


IMPRESSION :

The MRI features are suggestive of :

1. Partial sacralization of the L5 vertebra on the right side.

2. Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra with hypertrophic facetal arthropathy and a tight canal at the L4-L5 level.

3. A posterior disc herniation at the L4-L5 level.

4. A small posterior herniation at the L3-L4 level.

5. A large postero-central disc extrusion with peridiscal osteophytes and a tight canal at the D10-D11 level.

6. Altered cord signal at the D10-D11 and D11 levels may represent cord edema/contusion/ischemia.