sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz J. Trilmn / F / 40 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches (since 8-9 years) with giddiness 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.

5 mm thick FLAIR coronal images.

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.

Inflammatory changes are noted in the ethmoidal aircells bilaterally. The nasal septum is deviated to the left with hypertrophied middle and inferior nasal turbinates on the right.

IMPRESSION :

Normal study of the Brain.

sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc XyzKhalifa Slmn / M / 60 yrs.
Referred by : Dr. Abc Xyzlpani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O left sided hemiparesis with slurred speech and LOC for 8 days, 3 months ago.
Alleged H/O fall with injury to forehead 1 month back.
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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There are CSF intensity lesions on all the pulse sequences in the right fronto-temporo-parietal region (along the watershed zone of the right middle cerebral artery with the right anterior cerebral and right posterior cerebral arteries). Perilesional white matter hyperintense signal on the proton, T2 Weighted and FLAIR images would represent gliotic changes. These lesions represent areas of cystic encephalomalacia, most likely the sequelae of a previous vascular insult. Involvement of the right sided caudate and lentiform nuclei is also noted.

There are ill-defined, hyperintense areas on the T2 Weighted and FLAIR images in the left cerebellar hemisphere, pons, periventricular white matter on the left and in the left centrum semiovale. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images and most likely represent ischemic changes. There is mild dilatation of both the lateral (right more than left) and the fourth ventricles. There is mild fullness of the third ventricle.


There is prominence of the cerebral cortical sulci, cerebellar folia and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the paranasal sinuses.

IMPRESSION :

The MRI features are suggestive of :

1. Areas of cystic encephalomalacia in the right fronto-temporo-parietal region (along the watershed zone of the right middle cerebral artery with the right anterior cerebral and posterior cerebral arteries) are most likely the sequelae of a previous vascular insult.

2. Altered signal in the left cerebellar hemisphere, pons, periventricular white matter on the left and in the left centrum semiovale most likely represent ischemic changes.
3. Mild cerebral cortical and cerebellar atrophy.

ke/sb/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Ralmn / F / 77 yrs.
Referred by : Dr. Abc Xyzhauhan.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating 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.

OBSERVATION :

There is a diffuse posterior disc herniation at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. Gross ligamentum flavum hypertrophy is noted at this level with resultant severe canal stenosis.

A small posterior disc herniation with left far lateral disc herniation is seen at the L3-L4 level with anterior indentation of the thecal sac and left neural foraminal narrowing. Ligamentum flavum hypertrophy is also seen at this level.

Small posterior disc bulges are noted at the L1-L2, L2-L3 and L5-S1 levels.

Ligamentum flavum hypertrophy is seen at the L5 and L5-S1 levels.

Posterior peridiscal osteophytes are noted in the lumbar region.


Anterior disc herniations are seen in the lumbar region with anterior peridiscal osteophytes. The lumbar intervertebral discs show loss of water content. Hypointense areas are seen within the L3-L4, L4-L5 and L5-S1 intervertebral discs on all the pulse sequences suggestive of calcification/vacuum phenomenon.

Focal fatty changes are noted in the lumbar region.

The facet joints in the lower lumbar region appear hypertrophied. 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 :

11.0 mm at L1-L2
13.0 mm at L2-L3
11.0 mm at L3-L4
6.0 mm at L4-L5
10.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. A diffuse posterior disc herniation at the L4-L5 level with gross ligamentum flavum hypertrophy.

2. A small posterior disc herniation with left far lateral disc herniation at the L3-L4 level
..3/.










- 3 - Scan-00006


3. Small posterior disc bulges at the L1-L2, L2-L3 and L5-S1 levels.

4. Ligamentum flavum hypertrophy at the L3-L4, L5 and L5-S1 levels and facetal hypertrophy in the lumbar region.

5. Posterior peridiscal osteophytes in the lumbar region.

6. Canal stenosis at the L3-L4, L4-L5 and L5-S1 levels (maximum at the L4-L5 level).

sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc XyzDlmn / M / 31 yrs.
Referred by : Dr. Abc Xyznna / Dr. Abc Xyzsrani.
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 :

The L2 vertebral body appears to be as marked on the film. Please correlate with plain radiographs.

There is loss of water content of the L1-L2 and L4-L5 intervertebral discs.

A postero-central protruded disc with peridiscal osteophytes is noted at the L4-L5 level indenting the dural theca anteriorly.

Small posterior peridiscal osteophytes are noted at the L1-L2 and L3-L4 levels.

Slight facetal hypertrophy is noted at the L4-L5 and L5-S1 levels. Also seen is mild ligamentum flavum hypertrophy at these levels.

There is slight anterior wedging of the L1 vertebral body without change in its signal intensity.

Schmorls nodes are noted in the dorso-lumbar region.

..2/.






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 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
18.0 mm at L3-L4
14.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. A postero-central protruded disc with peridiscal osteophytes at the L4-L5 level.

2. Slight facetal and ligamentum flavum hypertrophy at the L4-L5 and L5-S1 levels.

3. Slight anterior wedging of the L1 vertebral body without change in its signal intensity may be the sequelae of previous trauma.

ke/bv/rg.
Date : 00.00.00

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

CLINICAL PROFILE :

H/O sudden onset of catch in back with radicular pain in BLE, paresthesias and bladder/bowel involvement 20 days back.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.
8 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

Few upper dorsal and cervical intervertebral discs show loss of water content.

The facet joints at the D9-D10 and D10-D11 levels show hypertrophic changes.

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

The visualized dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the D12-L1 level.

The cervico-dorsal spine was screened with the help of 4 mm thick T2 Weighted sagittal images which shows mild degenerative changes.

IMPRESSION :

No significant abnormality is detected on this study.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzen V. Plmn / F / 39 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches and giddiness.

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 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.

Incidental note is made of retrocerebellar arachnoid pouch on the right side.

IMPRESSION :

Normal study of the Brain.

sb/ke/nl/nl
/64 Date : 16/00.00.00

Name of the Patient : Abc Xyzaben lmn / F / 59 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O 2 episodes of seizures since 1 1/2 months.
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.

4 mm thick FLAIR coronal images.

5 mm thick T1 Weighted sagittal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial and 4 mm thick T1 Weighted coronal images with magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a fairly large, approximately 4.0 x 4.5 x 3.7 cms sized well-marginated extra-axial mass lesion overlying the right high frontal convexity, with its broad base towards the meninges. This lesion is iso to slightly hyperintense to normal white matter on the T1 Weighted images and appears heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images. There is perilesional edema in the underlying brain parenchyma. A cystic/necrotic focus is noted along the posterior margin of the lesion. A CSF cleft is also noted around the lesion. Flow void signal at the periphery of the lesion on all the pulse sequences would represent blood vessels.
..2/.





- 2 - Scan-00001/64



There is mild indentation and inferior displacement of the frontal horn and body of the right lateral ventricle. Sulcal space effacement is noted in the right frontal region with mild bulge of the anterior falx to the left.

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable.

After administration of contrast there is intense enhancement of the lesion in the right frontal region (the cystic/necrotic area does not enhance). Enhancement of the meninges overlying the mass lesion is also noted.

IMPRESSION :

An approximately 4.0 x 4.5 x 3.7 cms sized well-marginated, uniformly enhancing (except for the cystic area) extra-axial mass lesion overlying the right high frontal convexity follows the signal characteristics of a meningioma.

ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzP. Sallmn / F / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O single episode of seizure 8 days back with headaches since then.

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.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the posterior parietal deep white matter bilaterally. These are hypointense to normal white matter on the T1 Weighted images and may be ischemic in etiology.

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 slight prominence of the cerebellar folia bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.






Incidental note is made of mild inflammatory changes in the right maxillary sinus and ethmoidal air cells.

IMPRESSION :

1. Altered signal in the posterior parietal, deep white matter, most likely represents ischemic changes.

2. Mild cerebellar atrophy.

sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzm Jaffer Walmn / M / 54 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O gait ataxia since 10 years.
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 coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a small, hyperintense signal best appreciated on the FLAIR images in the subcortical white matter in the right fronto-temporal region and in the right inferior frontal region (scans 105.10, 16). These lesions appear nearly isointense to normal white matter on the T1 Weighted images.

There is prominence of the cerebellar folia bilaterally without change in signal intensity with mild dilatation of the fourth ventricle.

There is also mild dilatation of both the lateral ventricles. The third ventricle is normal. There is slight prominence of the cerebral cortical sulci and the basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.





Screening, T2 Weighted sagittal images of the cervical spine reveal small posterior disc herniations with peridiscal osteophytes over the C3-C4 to C6-C7 levels.

IMPRESSION :

1. Altered signal in the subcortical white matter in the right fronto-temporal region and in the right inferior frontal region most likely represent ischemic changes.

2. Mild to moderate cerebellar atrophy.

hs/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzkumar lmn / M / 45 yrs.
Referred by : Dr. Abc Xyznna.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O accident 4 months back.
C/O left sided hemiparesis and left UMN facial palsy.

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.
FEW IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

There are diffuse areas of hypointensity on the T1 Weighted images involving the cortex and subcortical white matter in the right fronto-temporal lobes and left temporal lobe. In the given clinical setting of trauma, these most likely represent contusions.

A sliver of hyperintensity on the proton and T2 Weighted images is seen to overlie the right cerebral hemisphere and may represent a very small collection of fluid/blood.

A lacunar infarct (iso to hyperintense to CSF) is seen within the right lentiform nucleus.

There is mild fullness of the ventricular system.

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 seen within the maxillary sinuses bilaterally and ethmoidal air cells.

The cervical and dorsal spines were screened with 4 mm thick T2 Weighted sagittal images and the lumbar spine was screened with 5 mm thick T1 Weighted sagittal images. A mild posterior disc bulge with small peridiscal osteophytes is seen at the D8-D9 level.

IMPRESSION :

In the given clinical setting of trauma, the MRI features are suggestive of :

1. Contusions in the cortex and subcortical white matter in the right fronto-temporal lobes and left temporal lobe.

2. A very small collection of fluid/blood overlying the right cerebral hemisphere.

3. A lacunar infarct within the right lentiform nucleus.