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Sunday, 27 December 2015 16:48

14038

ke/bv/nl/rg.
/41 Date : 00.00.00

Name of the Patient : Abc Xyzeen A. Plmn / M / 6 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O abnormal behaviour since 2 years.
C/O ? partial seizures.
H/O delayed milestones.
H/O FTND (cried after 2 minutes).

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 FLAIR coronal images.

After administration of contrast the following parameters were used :

5 mm thick T1 Weighted axial images with magnetization transfer.

5 mm thick T1 Weighted coronal and sagittal images.

OBSERVATION :

There is a small, fairly well-defined lesion in the region of the tuber cinerium which measures approximately 1.0 x 0.8 x 1.2 cms. This lesion is isointense to grey matter on all the pulse sequences. It is seen to indent upon the inferior aspect of the third ventricle to the right of the midline. The lesion is seen to occupy the interpeduncular cistern. Scan-00008/41


On administration of contrast, there is no appreciable enhancement of this lesion.

The hippocampal complex on either side is unremarkable.

Both the lateral and the fourth ventricles are normal. The rest of 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 enlarged adenoids.

IMPRESSION :

The MRI features are suggestive of a mass lesion measuring approximately 1.0 x 0.8 x 1.2 cms in the region of the tuber cinerium and most probably represents a hamartoma of the tuber cinerium.

Sunday, 27 December 2015 16:48

14037

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 17 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (right more than left) with paresthesias since 2 years
H/O fall from a height at the age of 5-6 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 a defect in the sacral vertebra with scoliosis and convexity to the right with a pseudo joint formation (?? traumatic ? congenital). The L5 vertebral body is sacralized and the L4 vertebra is as marked on the film. The right ala appears smaller as compared to the left side with a pelvic tilt to the right side. The right lamina of L5 also appears smaller.

Right far lateral disc herniations are seen at the L3-L4 and L4-L5 levels with indentation upon the right L3 and L5 nerve roots, respectively.

There is narrowing of the neural foramen at the L3-L4 level with probable indentation upon the left L3 nerve root.

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.
..2/.







The facet joints on the left side at the L4-L5 and L3-L4 levels and bilaterally at the L2-L3 and L1-L2 levels show hypertrophic changes.

The conus medullaris terminates at the D11 level and the thecal sac terminates at the L5 level.

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

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

IMPRESSION :

1. Defect in the sacral vertebra with scoliosis and convexity to the right (? congenital ?? traumatic).

2. Sacralized L5 vertebral body and the L4 vertebra is as marked on the film.

3. Right far lateral disc herniations at the L3-L4 and L4-L5 levels with indentation upon the right L3 and L5 nerve roots respectively with narrowing of the left neural foramen at the L3-L4 level.

4. Hypertrophy of the left facet joints at the L4-L5 and L3-L4 levels and bilaterally at the L1-L2 and L2-L3 levels.

Sunday, 27 December 2015 16:48

14036

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza Anlmn / F / 6 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall from a bed 8-9 months back with weakness of BUE and BLE and speech impairment 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.

4 mm thick FLAIR and Fast Scan (T2 *) coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are hypointense areas on the T1 Weighted images within the head of the caudate nucleus and the putamen bilaterally. These are seen to turn hyperintense on the proton, T2 Weighted, FLAIR and Fast Scan (T2 *) images. There is indentation on the frontal horns of the lateral ventricles.

Hyperintense areas are seen on the proton, T2 Weighted and FLAIR images in the left temporo-parietal and right parietal white matter. These are iso to hypointense on the T1 Weighted images.

The 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 altered signal intensity in the head of the caudate nucleus and putamen bilaterally, left temporo-parietal and right parietal deep white matter and is not specific for a single etiology. Metabolic brain disorders like mitochondrial encephalopathies and Wilsons disease should be ruled out.

Hypoxic-ischemic insult should also be considered as a differential diagnosis, though less likely (in view of the long standing history)

Sunday, 27 December 2015 16:48

14035

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyza S. Ibrlmn / M / 10 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache since 1 month.

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.

OBSERVATION :

The visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The 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 level.

The lumbar spine was screened with 4 mm thick T1 Weighted sagittal images and does not reveal any diagnostic feature of note.

IMPRESSION :

Normal study of the Dorsal Spine.



Sunday, 27 December 2015 16:48

14034

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzati Kollmn / F / 45 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O radicular pain to the LLE.

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 left.

There is a left postero-lateral disc herniation at the L3-L4 level.

Small posterior disc bulges are seen at the L2-L3 and L5-S1 levels and a left far lateral disc bulge at the L4-L5 level. The lumbar intervertebral disc except the L1-L2 and L5-S1 discs show loss of water content.

The lumbar vertebral bodies 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 S1 level.





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

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

The visualized pelvis and hip joints does not reveal any diagnostic feature of note.

IMPRESSION :

1. Scoliosis of the lumbar spine with convexity to the left.

2. A left postero-lateral disc herniation at the L3-L4 level.

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

4. A left far lateral disc bulge at the L4-L5 level.

Compared to the previous MRI dated 00.00.00, there is no significant change noted.
Sunday, 27 December 2015 16:48

14033

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Khalmn / F / 58 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 15-20 days.
Alleged H/O vehicular accident 4 years back with fracture of the left hip region.

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.

FEW IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is sacralization of the L5 vertebral body and the L3 vertebral body is as marked on the film.

There is a left paracentral disc herniation at the L4-L5 level with antero-lateral indentation of the thecal sac and left neural foraminal narrowing. Slight inferior migration of the disc is noted posterior to the L5 vertebral body in the left lateral recess with impingement of the traversing left L5 nerve root. A small left far lateral disc bulge is also noted at the L4-L5 level with indentation upon the extraforaminal portion of the left L4 nerve root. The L4-L5 facet joints show degenerative changes (scans 104.5, 104.6, 104.7).



Small posterior disc herniations are seen at the L1-L2, L2-L3 and L3-L4 levels with anterior indentation of the thecal sac. The lumbar intervertebral discs show loss of water content.

The lumbar vertebral bodies show diffuse fatty changes. The remaining facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the D12 level and the thecal sac terminates at the L5 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
15.0 mm at L3-L4
12.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. Sacralization of the L5 vertebra.

2. A left paracentral disc herniation at the L4-L5 level with impingement of the traversing left L5 nerve root.

3. A small left far lateral disc bulge at the L4-L5 level with indentation upon the extraforaminal portion of the left L4 nerve root.

4. L4-L5 facetal arthropathy.

Sunday, 27 December 2015 16:48

14032

ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz. Jagaslmn / F / 34 yrs.
Referred by : Dr. Abc Xyzsai.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

C/O lump since 2 years.

EXAMINATION :

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

8 mm thick T1 Weighted and T2 Weighted axial images.

6 mm thick T1 Weighted and STIR coronal images.

6 mm thick T1 Weighted and T2 Weighted sagittal images.

OBSERVATION :

There is a large mass lesion within the pelvis which measures approximately 15.7 x 11.0 x 12.0 cms. This lesion appears along the right lateral margin of the uterus and is in close relation to it. This lesion is hyperintense to normal muscle on the T1 Weighted images and is heterogeneously hypointense on the T2 Weighted and STIR images. Few hypointense areas are noted within this lesion on the T1 Weighted images which turn hyperintense on the T2 Weighted and STIR images and would represent cystic/necrotic changes. The uterus is displaced to the left and anteriorly. There is slight widening of the endometrial cavity. The urinary bladder is compressed and indented upon its superior aspect. The iliac vessels are displaced further laterally. Multiple flow void signals at the periphery of this lesion are suggestive of increased vascularity of the lesion.

The right ovary is not well identified on this study. The left ovary appears normal (scan 105.13/14).


The ischio-rectal fossae on either side appear normal.

There are no abnormally enlarged pelvic lymph nodes identified. There is no free fluid in the pelvis.

IMPRESSION :

The MRI features are suggestive of a mass lesion within the pelvis which measures approximately 16.0 x 12.7 x 10.2 cms and is to the right of the uterus and most probably represents a subserosal/broad ligament fibroid.



Sunday, 27 December 2015 16:48

14031

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzNilmn / M / 70 yrs.
Referred by : Dr. Abc Xyzshar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O malignancy in the lung and mediastinal nodes and metastasis in the bone in December 0000. Received chemotherapy and radiotherapy. Relieved.
Now C/O weakness of the left hand with forgetfulness since 2 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 a large lesion in the left temporal region which measures approximately 3.0 x 3.5 x 2.0 cms. This lesion shows a small slightly hyperintense area in the lateral aspect on the T1 Weighted images which is heterogeneously hypointense on the proton, T2 Weighted and FLAIR images. A fluid level is also noted. The medial aspect of this lesion is slightly hyperintense to CSF on all the pulse sequences. There is gross surrounding edema with mass effect and slight indentation upon the body of the left lateral ventricle and effacement of the adjacent sulci in that region.

Similar smaller lesions of varying sizes (atleast nine) are seen in the right cerebellar hemisphere, right temporal and occipital lobes, right temporal lobe, both frontal regions and the right high parietal region.


The right 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 left maxillary polyp.

IMPRESSION :

In a known C/O small cell carcinoma of lung, the MRI features are suggestive of metastasis in the supratentorial and infratentorial regions as described.
Sunday, 27 December 2015 16:48

14030

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz Lawrlmn / M / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is reduction in the volume of the hippocampus on the right side. Hyperintense signal is noted within the hippocampus on the T2 Weighted images. The underlying collateral white matter is unremarkable (scans 105.5 to 105.10, 106.5 to 106.10).

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

Incidental note is made of right maxillary sinusitis.

IMPRESSION :

The MRI features are suggestive of mesial temporal sclerosis on the right side.

Sunday, 27 December 2015 16:48

14029

hs/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzootlmn / M / 15 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

Known C/O osteosarcoma of the left femur. Operated for the same on 00.00.00.
C/O neck pain radiating to BUE with numbness and weakness.

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.

OBSERVATION :

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

The cervical spinal cord reveals normal signal intensity. There is no cord compression.

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

IMPRESSION :

Normal study of the Cervical Spine.