sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzShlmn / M / 14 yrs.
Referred by : Dr. Abc Xyzah.
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, T2 Weighted and STIR coronal images.

OBSERVATION :

There is a small, CSF signal intensity lesion on all the pulse sequences along the lateral aspect of the roof of the left orbit (scans 102.7 and 104.7). This most likely is partial volume averaging with the CSF space in that region (best appreciated on the STIR coronal images).

There is seen a very small, extra-axial, CSF intensity lesion on all the pulse sequences in the right anterior temporal region. This may represent a prominent sulcal space/arachnoid cyst.

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

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.
Scan-00009



Note is made of an empty sella.

IMPRESSION :

Small, extra-axial, CSF intensity lesion in the right anterior temporal region may represent a prominent sulcal space/arachnoid cyst.

No other significant abnormality is detected on this study.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi R. Dhlmn / F / 15 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches since 6-7 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.

5 mm thick T1 Weighted sagittal images.

MR cisternogram was obtained in the sagittal plane.

OBSERVATION :

There is seen a fairly large, approximately 5.8 x 4.2 x 3.8 cms sized well-defined mass lesion in the right cerebellar hemisphere. This lesion follows CSF signal on all the pulse sequences. This lesion is not in communication with the fourth ventricle or the cerebellar cisterns. There is resultant compression of the fourth ventricle, aqueduct and brainstem which is displaced slightly to the left. There is also cerebellar tonsillar herniation through the foramen magnum. There is mild to moderate dilatation of both the lateral and third ventricles with slight periventricular white matter hyperintense signal on the T2 Weighted images suggesting periventricular CSF ooze. Effacement of the cortical sulcal spaces in the cerebral hemispheres, bilaterally, is noted.






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

Inflammatory changes are noted in the ethmoidal air cells bilaterally.

IMPRESSION :

A fairly large, approximately 5.8 x 4.2 x 3.8 cms sized mass lesion in the right cerebellar hemisphere as described, is not specific for a single etiology. A cystic astrocytoma or a hemangioblastoma should be considered in the differential diagnosis. There is mild to moderate obstructive hydrocephalus.

A contrast enhanced scan may be worthwhile.

sb/bv/rg.
Date : 00.00.00

Name of the Patient : Abc XyzShafi Merclmn / M / 43 yrs.
Referred by : Dr. Abc Xyzoshipura.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE (right more than left) with numbness since 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 sacralization of the L5 vertebra and the L2 vertebral body is as marked on the film.

There is scoliosis of the spine with convexity to the left side.

There is loss of water content of the L4-L5 intervertebral disc.

There is Grade I spondylolisthesis of the L4 over the L5 vertebra with spondylolysis at L4, bilaterally. A pseudo-posterior disc herniation is noted at the L4-L5 level with bilateral neural foraminal narrowing and probable indentation upon the foraminal L4 nerve roots. Slight superior migration of the disc fragment is noted, more to the right of the midline.

A minimal posterior disc bulge is noted at the L3-L4 level.

Facetal hypertrophy is noted at the L3-L4, L4-L5 and L5-S1 levels.
..2/.






Schmorls nodes are noted in the lumbar region.

A hemangioma with fat content is noted at the D10 and D12 vertebral levels.

Slight anterior wedging of the D12 vertebral body is noted.

Fat is noted in the filum terminale at the L3 and L4 vertebral levels.

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 L2 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
20.0 mm at L2-L3
20.0 mm at L3-L4
18.0 mm at L4-L5
12.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. Grade I spondylolisthesis of the L4 over the L5 vertebra with spondylolysis at L4, bilaterally.

3. A pseudo-posterior disc herniation at the L4-L5 level with slight superior migration of the disc fragment and bilateral neural foraminal narrowing.

4. Facetal hypertrophy at the L3-L4, L4-L5 and L5-S1 levels.

sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzvati Galmn / F / 65 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Lumbo-sacral Spine
with Myelogram.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE 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.

MR Myelogram was also obtained.

OBSERVATION :

There is probable sacralization of the L5 vertebra which is as marked on the film (Kindly correlate with plain radiographs).

There is loss of water content of all the lumbar intervertebral discs except the L5-S1 disc.

There are posteriorly herniated discs with peridiscal osteophytes at the L3-L4 and L4-L5 levels with thecal sac compression and bilateral neural foraminal narrowing. Facetal hypertrophy is also noted at these levels with canal stenosis.

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

The pedicles of the lower lumbar vertebrae appears congenitally short in their antero-posterior dimensions.

..2/.





Bilateral far lateral (extraforaminal) disc herniations are seen at the L3-L4 and L4-L5 levels. Bilateral far lateral (extraforaminal) disc bulges are noted at the L1-L2 and L2-L3 levels.

Schmorls nodes are noted in the D11 and D12 vertebral bodies with Type II degenerative marrow changes in the vertebral bodies adjacent to the Schmorls nodes.

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-L2 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 :

12.0 mm at L1-L2
10.0 mm at L2-L3
7.0 mm at L3-L4
7.0 mm at L4-L5
19.0 mm at L5-S1.

IMPRESSION :

1. Probable sacralization of the L5 vertebra.

2. Posteriorly herniated discs with peridiscal osteophytes at the L3-L4 and L4-L5 levels with facetal hypertrophy and canal stenosis at these levels.

3. Small posterior disc bulges with peridiscal osteophytes at the L1-L2 and L3-L4 levels.

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

5. Bilateral far lateral (extraforaminal) disc herniations at the L3-L4 and L4-L5 levels.

sb/bv/nl/rg.
s Date : 00.00.00

Name of the Patient : Abc Xyzr Chlmn / M / 43 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures in childhood and since the last 15 years. On anti-epileptics.

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 seen a CSF intensity lesion on all the pulse sequences in the right temporo-parietal region. This lesion represents an area of cystic encephalomalacia. Resultant volume loss is noted in this region.

An ill-defined hyperintense signal on the proton, T2 Weighted and FLAIR images in the periventricular white matter in the right posterior parietal region (scans 105.4-7).

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is slight 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.







IMPRESSION :

1. An area of cystic encephalomalacia in the right temporo-parietal region, most likely the sequelae of a previous vascular insult.

2. Altered signal in the periventricular white matter in the right posterior parietal region most likely represents a gliotic/ischemic lesion.

3. Mild cerebral and cerebellar atrophy.

sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Karlmn / F / 46 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of numbness on the left side of the face on 00.00.00 with slight speech disturbances, difficulty in eating and watering from the left eye.

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 T1 Weighted coronal images through the seventh and eighth cranial nerve complex.

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 is 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.

A polyp is noted in the right maxilllary antrum.

IMPRESSION :

Normal study of the Brain.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz. Vallmn / M / 58 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE since 00.00.00.

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 lumbar intervertebral discs.

A small posterior disc herniation is noted at the L4-L5 level with bilateral neural foraminal narrowing. A small right far lateral (extraforaminal) disc herniation is seen at the L4-L5 level with indentation upon the extraforaminal portion of the exiting right L4 nerve root.

Small left and right postero-lateral disc herniations are noted at the L3-L4 level, with slight bilateral neural foraminal narrowing.

Facetal hypertrophy is noted at the L2-L3, L3-L4 and L4-L5 levels.

Far lateral (extraforaminal) disc bulges are noted bilaterally at the L1-L2, L2-L3 and L3-L4 levels and on the left side at the L4-L5 level.


Mild ligamentum flavum hypertrophy is seen at the L4-L5 and L5 levels.

Type II degenerative marrow changes are noted in the L1 vertebral body adjacent to the L1-L2 intervertebral disc.

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

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 D12-L1 level and the thecal sac terminates at the L5 level.

Fat is noted in the filum terminale over the L2 to L5 vertebral levels.

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
17.0 mm at L3-L4
13.0 mm at L4-L5
11.0 mm at L5-S1.

IMPRESSION :

1. A small posterior disc herniation at the L4-L5 level with bilateral neural foraminal narrowing.

2. Small left and right postero-lateral disc herniations at the L3-L4 level, with slight bilateral neural foraminal narrowing.

3. Facetal hypertrophy at the L2-L3, L3-L4 and L4-L5 levels.
..3/.



- 3 - Scan-00003


4. A small right far lateral (extraforaminal) disc herniation indenting the extraforaminal portion of the exiting right L4 nerve root at the L4-L5 level.

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

6. Mild ligamentum flavum hypertrophy at the L4-L5 and L5 levels.

sb/bv/nl/rg.
s Date : 00.00.00

Name of the Patient : Abc Xyzandlmn / M / 71 yrs.
Referred by : Dr. Abc Xyznshah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE since 3 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.

The hip joints and sacro-iliac joints were screened with 6 mm thick T1 Weighted coronal and axial images.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is loss of water content of all the lumbar intervertebral discs except the L2-L3 disc.

There is an ill-defined, hypointense signal on the T1 Weighted images in the L2 and L3 vertebral bodies, which appears heterogeneously hyperintense on the T2 Weighted images. There is erosion of the cortical endplates adjacent to the L2-L3 disc with involvement of the L2-L3 disc. There is right paravertebral and anterior epidural soft tissue lesion at the L2 and L3 vertebral levels which are of intermediate signal on the T1 Weighted images and hyperintense on the T2 Weighted images. Encasement of the L2 nerve roots in the neural foramina at the L2-L3 level is noted bilaterally. There is resultant thecal sac compression by the anterior epidural soft tissue lesion.


There is minimal forward translation of the L4 over the L5 vertebra without obvious lysis. A pseudoposterior and left postero-lateral disc herniation is noted at the L4-L5 level. There is also facetal hypertrophy and canal stenosis at that level.

A small posterior disc bulge is noted at the L3-L4 level.

A small left postero-lateral disc bulge is noted at the L1-L2 level.

The facet joints at the L2-L3 level also appear slightly hypertrophied.

The rest of the lumbar vertebral bodies reveal spotty fatty changes suggesting osteoporosis. The visualized prevertebral 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 :

14.0 mm at L1-L2
6.0 mm at L2-L3
12.0 mm at L3-L4
9.0 mm at L4-L5
12.0 mm at L5-S1.

Screening images of the S. I. joints and hip joints do not reveal any significant feature of note.
..3/.











- 3 - Scan-00002


IMPRESSION :

1. Altered signal of the L2 and L3 vertebral bodies and the L2-L3 disc as described, most likely represents osteitis with discitis, probably tuberculous in etiology. Right paravertebral and anterior epidural soft tissue lesion may represent granulation tissue/abscess.

The possibility of a neoplasm cannot be entirely excluded, though less likely.

2. Minimal forward translation of the L4 over the L5 vertebra without obvious lysis.

3. A pseudoposterior and left postero-lateral disc herniation at the L4-L5 level with facetal hypertrophy and canal stenosis at that level.

sb/hs/nl/rg.
s Date : 00.00.00

Name of the Patient : Abc Xyzit lmn / F / 47 yrs.
Referred by : Dr. Abc Xyznghal.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE since 6 months.
Alleged H/O fall.

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 L2-L3, L4-L5 and L5-S1 intervertebral discs.

The L4-L5 intervertebral disc is reduced in height.

Type II degenerative marrow changes are noted adjacent to the L4-L5 intervertebral disc.

There is a small, left paracentral disc herniation at the L5-S1 level with minimal indentation on the traversing left S1 nerve root.

There is a left paracentral and left postero-lateral disc herniation with peridiscal osteophytes at the L4-L5 level with left neural foraminal narrowing and indentation on the traversing left L5 nerve root. Slight facetal hypertrophy is noted at the L4-L5 level.

Far lateral (extraforaminal) disc bulges are seen bilaterally at the L4-L5 level and on the left side at the L2-L3 and L3-L4 levels.
..2/.






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-L2 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 :

15.0 mm at L1-L2
15.0 mm at L2-L3
15.0 mm at L3-L4
12.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. A small, left paracentral disc herniation at the L5-S1 level with minimal indentation on the traversing left S1 nerve root.

2. A left paracentral and left postero-lateral disc herniation with peridiscal osteophytes at the L4-L5 level with indentation on the traversing left L5 nerve root.

ke/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzi Kolmn / F / 72 yrs.
Referred by : Dr. Abc Xyz Mehta.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O drowsiness since 4-5 days.
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 and Fast Scan (T2 *) coronal images.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the right lentiform nucleus, left thalamus and the frontal periventricular deep white matter. These are isointense to white matter on the T1 Weighted images and are suggestive of areas of ischemia/infarction.

Lacunar infarct is noted in the right corona radiata (scan 102.14, 103.14, 104.14) .

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. Slight prominence of the cerebral cortical sulci is noted. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.







Metallic susceptibility artifacts are noted as a result of dentures.

IMPRESSION :

1. Altered signal in the right lentiform nucleus, left thalamus and the frontal periventricular deep white matter is suggestive of areas of ischemia/infarction.

2. Lacunar infarct in the right corona radiata.

3. Mild cerebral atrophy.