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Sunday, 27 December 2015 16:48

14070

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz Ylmn / M / 16 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O neckpain radiating to the RUE with weakness and numbness, gradually progressing over the last 2 years.
Now similar complaints in the LUE.
Alleged H/O fall from a tree 4 years back.

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.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is loss of normal ventral bulge of the cervical spinal cord over the C5 vertebral level to the C7-D1 disc level, centrally and more to the right of the midline. There is however, no signal change in the visualized cervico-dorsal spinal cord.

The visualized cervico-dorsal vertebral bodies and the intervertebral discs show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

There is no extrinsic cord compression.








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

IMPRESSION :

Loss of normal ventral bulge of the cervical spinal cord over the C5 vertebral level to the C7-D1 disc level, centrally and more to the right of the midline may be seen with motor neuron disease.


Sunday, 27 December 2015 16:48

14068

sb/hs/rg.
s Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / M / 62 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

H/O single episode of unresponsiveness for 15 minutes on 00.00.00.

EXAMINATION :

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

Intracranial and neck MRA were performed with 3D TOF and 2D TOF sequences, respectively.

OBSERVATION :

There are small bright foci on the T2 Weighted and FLAIR images in the subcortical and deep white matter in the frontal and parietal regions bilaterally. These lesions most likely represent ischemic changes.

Mild fullness of both the lateral ventricles is noted. The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

INTRACRANIAL MRA :

The right vertebral artery is hypoplastic.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, left vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The right vertebral artery in the neck also appears hypoplastic.

The common carotid arteries and their extracranial branches appear normal bilaterally. There are no vessel wall irregularities or stenosis of the vessels noted.

IMPRESSION :

Altered signal in the subcortical and deep white matter in the frontal and parietal regions bilaterally most likely represent ischemic changes.

No significant abnormality is detected on the intracranial and neck MRA on this study.

Sunday, 27 December 2015 16:48

14067

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzvi Ylmn / F / 55 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O weakness with wasting of BLE since 1 1/2 months.

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.

5 mm thick T1 Weighted and T2 Weighted axial images.

The lumbar spine was screened with 5 mm thick T2 Weighted sagittal images.

OBSERVATION :

There is near complete collapse of the D4 vertebral body and anterior wedging of the D3 vertebral body with a kyphus at that level. The D3-D4 intervertebral disc is not well identified.

The D3, D4 and D5 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. There is prevertebral, paravertebral and anterior epidural soft tissue lesion extending over the D3 to D5 vertebral levels. This lesion is of intermediate signal on the T1 Weighted images and appears hyperintense on the T2 Weighted images. There is resultant cord compression over these levels. The dorsal spinal cord at these levels shows a hyperintense signal on the T2 Weighted images which suggest cord edema/ischemia.
Scan-00007


The rest of the visualized cervico-dorsal vertebral bodies reveal normal signal intensity. The remaining cervico-dorsal intervertebral discs show loss of water content. The facet joints are unremarkable.

The T2 Weighted sagittal images of the lumbar spine shows a suspicious signal change in the S1 vertebral body. Small posterior disc herniations are noted in the lumbar region. Facetal hypertrophy is noted at the D11-D12 level on the right.

Nodular lesions are noted in the lung field on either side.

IMPRESSION :

1. Near complete collapse of the D4 vertebral body, anterior wedging of the D3 vertebral body and altered signal of the D3, D4 and D5 vertebral bodies and the D3-D4 intervertebral disc as described most likely represents osteitis with discitis most likely tuberculous in etiology. Prevertebral, paravertebral and anterior epidural soft tissue lesion at D3 to D5 vertebral levels represents granulation tissue/abscess. There is resultant cord compression and cord signal alteration suggesting cord edema/ischemia.

Nodular lesions in both the lung fields also appear to be tuberculous in etiology.

The possibility of a neoplasm seems less likely.

2. Degenerative changes of the lumbar spine as described.




Sunday, 27 December 2015 16:48

14066

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzSalam Anlmn / M / 33 yrs.
Referred by : Dr. Abc Xyzhalani.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O occasional headaches.
S/S s/o acromegaly since 1 1/2 years.

EXAMINATION :

M.R.I of the sella and perisellar region was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted coronal images.

3 mm thick T1 Weighted and T2 Weighted sagittal images.

The brain was screened with 5 mm thick T2 Weighted axial images and 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen an approximately 1.2 x 1.2 x 1.0 cms sized, well-marginated, hypointense mass lesion on the T2 Weighted images in the anterior pituitary gland, more to the left of the midline. This lesion appears iso to slightly hypointense to normal pituitary gland on the T1 Weighted images. Slight convexity of the superior margin of the pituitary gland with mild displacement of the pituitary stalk to the right is noted.

The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. The hypothalamus, cavernous sinuses and suprasellar cistern are unremarkable.






The T2 Weighted axial images of the brain do not reveal any significant feature of note.

IMPRESSION :

An approximately 1.2 x 1.2 x 1.0 cms sized, well-marginated, mass lesion in the anterior pituitary gland, more to the left of the midline with signal characteristics as described, most likely represents a pituitary macroadenoma.

A contrast enhanced scan is essential.




Sunday, 27 December 2015 16:48

14065

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Shlmn / F / 31 yrs.
Referred by : Dr. Abc Xyzhtekar.
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.

5 mm thick T1 Weighted sagittal 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.
Sunday, 27 December 2015 16:48

14064

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyze Karkhanalmn / F / 43 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

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 slight loss of water content of the L3-L4 and L4-L5 intervertebral discs.

Minimal posterior disc bulges with peridiscal osteophytes are noted at the L3-L4, L4-L5 and L5-S1 levels.

Facetal hypertrophy is noted at the L4-L5 and L5-S1 levels bilaterally (more pronounced at the L4-L5 level on the right).

A hemangioma with fat content is noted in the L3 vertebral body.

The rest of 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
18.0 mm at L2-L3
16.0 mm at L3-L4
15.0 mm at L4-L5
14.0 mm at L5-S1.

Note is made of osteitis condensans ili bilaterally.

IMPRESSION :

1. Minimal posterior disc bulges with peridiscal osteophytes at the L3-L4, L4-L5 and L5-S1 levels.

2. Facetal hypertrophy at the L4-L5 and L5-S1 levels bilaterally (more pronounced at the L4-L5 level on the right).


Sunday, 27 December 2015 16:48

14063

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzur Ralmn / M / 11 mnths.
Referred by : Dr. Abc Xyzankhla.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O swelling in the lumbar region since birth.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

3 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is seen a discontinuity in the subcutaneous fat at the lumbo-sacral junction.

There is seen an open lumbo-sacral canal extending from the L5 vertebral level distally. There is seen a CSF signal intensity lesion on all the pulse sequences in the posterior soft tissues in the lumbo-sacral junction extending from the L5 to the S4 vertebral levels. This lesion is in continuity with the thecal sac and represents a meningocele sac. The tip of the spinal cord is seen to extend into this meningocele sac and is probably tethered to it. There is no evidence of an intradural lipoma on this study. The tip of the spinal cord is seen at the S1-S2 level.

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

IMPRESSION :

The MRI features suggest a meningomyelocele in the lumbo-sacral region with the tip of the spinal cord probably tethered to the meningocele sac at the S1-S2 level.

Sunday, 27 December 2015 16:48

14062

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Klmn / M / 45 yrs.
Referred by : Dr. Abc Xyzisheri.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O gradually progressive weakness of BLE with retention of urine since 7 days.
H/O headaches and vomiting with fever since 10 days.

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.

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

OBSERVATION :

There is slight loss of water content of the cervical intervertebral discs.

The cervico-dorsal spinal cord appears slightly larger in diameter. There is a hyperintense signal on the T2 Weighted images in the cervico-dorsal spinal cord, centrally, extending over the C2 vertebral level upto the conus medullaris. This signal appears relatively hypointense to the normal cord on the T1 Weighted images. Resultant slight effacement of the CSF space is noted.

The visualized cervico-dorsal vertebral bodies show normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

There is no cord compression.



IMPRESSION :

Altered signal in the cervico-dorsal spinal cord, centrally, extending from the C2 vertebral level upto the conus medullaris as described, most likely represents myelitis, in the given clinical setting.

The possibility of a demyelinating lesion seems less likely.
Sunday, 27 December 2015 16:48

14061

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzIqrarullmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the fingers of the right hand since 1 year and of the fingers of the left hand since 6 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.

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.

IMPRESSION :

Normal study of the Brain.
Sunday, 27 December 2015 16:48

14060

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Salmn / M / 46 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 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 the L3-L4 and L4-L5 intervertebral discs.

There is inequality in the size of the laminae of the S1 vertebra. The left lamina being smaller than the right and is congenital in origin.

There is Grade I spondylolisthesis of the L5 vertebra over the S1 vertebra.

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

Slight facetal arthropathy is noted at the L5-S1 level, on the left.

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 D12-L1 level and the thecal sac terminates at the S2 level.
..2/.





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

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

IMPRESSION :

1. Congenital anomaly of the left lamina of the S1.

2. Slight facetal arthropathy at the L5-S1 level, on the left.

3. Grade I spondylolisthesis of the L5 over the S1 vertebra without spondylolysis.

4. Small posterior disc bulges at the L4-L5 and L5-S1 levels.