sb/sb/rg.
/13 Date : 00.00.00

Name of the Patient : Abc Xyzv Mlmn / M / 36 yrs.
Referred by : Dr. Abc Xyzai.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O momentary giddiness with headaches and weakness on the left half of the body for 15-20 minutes, 15 days back.
Known hypertensive. On Rx.

EXAMINATION :

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

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

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is no focal area of altered signal intensity within 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.

INTRACRANIAL MRA :

The vertebro-basilar system is ectatic.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
Scan-00001/13


NECK MRA :

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

IMPRESSION :

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

sb/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyznt Klmn / M / 24 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures 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.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

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

The hippocampal complex on either side is unremarkable.

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.

IMPRESSION :

Slight prominence of the cerebellar folia bilaterally.

No other significant abnormality is detected on this study.

hs/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzontralmn / M / 74 yrs.
Referred by : Dr. Abc Xyz Lalkaka.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O decreased memory with tinnitus since 1 year.
C/O decreased hearing (left more than right).

EXAMINATION :

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

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

OBSERVATION :

There are areas of hyperintensity on the T2 Weighted images within the periatrial and fronto-parietal white matter and the lentiform nuclei bilaterally and the left cerebellar hemisphere. These are most likely ischemic in etiology. Lacunar infarcts are noted near the haed of the right caudate nucleus and right corona radiata.

There is fullness of the third and both the lateral ventricles. There is prominence of the cerebral cortical sulci bilaterally.

The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.

Inflammatory changes are noted in the left maxillary antrum.

INTRACRANIAL MRA :

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, vertebral and posterior cerebral arteries also show normal signal, calibre and wall margins. No obvious aneurysm or vascular malformation is identified.
..2/.






NECK MRA :

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

IMPRESSION :

The MRA features are suggestive of :

1. Altered signal within the periatrial and fronto-parietal white matter and the lentiform nuclei bilaterally and the left cerebellar hemisphere which are most likely ischemic in etiology.

2. Lacunar infarcts near the haed of the right caudate nucleus and right corona radiata.

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

sb/bv/rg
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 42 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

C/O pain in the left knee joint.
Alleged H/O fall.

EXAMINATION :

M.R.I of the left knee joint was performed using the following parameters :

4 mm thick T1 Weighted, proton and GRASS sagittal images.

4 mm thick T1 Weighted and T2 Weighted coronal images.

5 mm thick GRASS axial images.

OBSERVATION :

There is slight posterior and medial subluxation of the femur over the tibia.

Menisci :

There is seen a vertically oriented hyperintense signal on all the pulse sequences in the posterior horn of the medial meniscus of the left knee joint extending upto both the articular margins. This represents a vertical tear.

The anterior horn of the medial meniscus and posterior horns of the lateral and medial menisci reveal normal configuration and signal characteristics.

Cruciate Ligaments :

The posterior cruciate ligament appears slightly buckled without change in signal intensity.
..2/.





The anterior cruciate ligament is ill-defined and shows a hyperintense signal on the GRASS and STIR images which may suggests a partial tear/strain of the anterior cruciate ligament.

Collateral Ligaments and the Patellar Tendon :

The medial and lateral collateral ligaments and the patellar tendon are normal.

Hoffas Fat Pad :

The Hoffas fat pad is normal.

Articular cartilage and bones :

There is an ill-defined, hyperintense signal on the GRASS and STIR images is the subchondral region along the inferior margin of the lateral femoral condyle, more so laterally. This lesion appears hypointense to normal marrow on the T1 Weighted images. The articular cartilage overlying this region and around the patella and tibia appears normal.

There is a small left knee joint effusion.

IMPRESSION :

1. Slight posterior and medial subluxation of the femur over the tibia.

2. A vertical tear of the posterior horn of the medial meniscus of the left knee joint.

3. Ill-defined anterior cruciate ligament with altered signal along its course may suggests a partial tear/strain.

4. Altered signal in the subchondral region along the inferior margin of the lateral femoral condyle, more so laterally may represent a subchondral fracture/bone bruise in the given clinical setting.

5. A small left knee joint effusion.

sb/hs/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 42 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O difficulty in squatting position due to pain in the right groin region since 1 year.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.
5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
5 mm thick Proton density sagittal images.

OBSERVATION :

There is seen a well-marginated approximately 1.2 cms diameter sized hypointense lesion on the T1 Weighted images at the base of the greater trochanter of the left femur. This lesion appears hyperintense on the T2 Weighted and STIR images with a few hypointensities within it. No perilesional bone edema is noted.

The femoral head and the acetabulum reveal normal signal intensity bilaterally. The articular cartilages are unremarkable. There is no effusion within both the hip joints.

The musculature surrounding both the hip joints and the visualized pelvis is unremarkable.

IMPRESSION :

An approximately 1.2 cms diameter sized lesion at the base of the greater trochanter of the left femur as described is not specific for a single etiology. An enchondroma should be considered in the differential diagnosis.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzanu lmn / F / 35 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the right hip since 10 years with a limp.
H/O tuberculosis of the right hip 10 years back. Received AKT.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

5 mm thick Proton density sagittal images.

OBSERVATION :

There is loss of normal contour of the right femoral head which appears to be subluxed supero-laterally. There is reduction of the right hip joint space. The articular cartilage around the right femoral head appears irregular with evidence of subchondral pits in the right femoral head and the right acetabulum. Marginal osteophytes are noted around the right femoral head and the right acetabulum.

There is an ill-defined, hyperintense signal in the region of the neck of the right femur which appears iso to hypointense to normal marrow on the T1 Weighted images. The muscles around the right hip joint appears atrophied when compared to the left.

The visualized left hip joint is unremarkable.

IMPRESSION :

Changes in the right hip joint suggests secondary osteoarthritis, probably a result of the previous infective/inflammatory arthritis.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyztalmn / F / 23 yrs.
Referred by : Dr. Abc Xyzah Matkar.
Examination : M.R.I. of the Sella & Perisellar Region.

CLINICAL PROFILE :

C/O headaches with weight gain since 1 year.
S. Prolactin level is 39 ng/ml.

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 sagittal images.

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

After contrast administration, 3 mm thick T1 Weighted sagittal and coronal images and delayed, 3 mm thick T1 Weighted coronal images were also obtained.

The brain was screened with 5 mm thick T1 Weighted axial images with magnetization transfer after contrast administration.

OBSERVATION :

The pituitary gland is normal in its size, contour and location and reveals normal signal intensity. The pituitary gland measures approximately 5.0 mms in height. The posterior pituitary gland reveals normal hyperintense signal on the T1 Weighted images. The pituitary stalk is in the midline. The hypothalamus is unremarkable. The cavernous sinus and the suprasellar cistern are unremarkable.

After administration of contrast, there is no focal area of abnormal enhancement in the pituitary gland or the perisellar region.
..2/.






The study of the brain reveals focal dilatation of the left temporal horn when compared to the right, which may be a normal variant. No other significant abnormality is detected in the brain parenchyma before and after contrast administration.

IMPRESSION :

No significant abnormality is detected within the pituitary gland on this study.

ke/hs/nl/rg.
Date : 00.00.00
Name of the Patient : Abc XyzWlmn / M / 63 yrs.
Referred by : Dr. Abc Xyzlsara. Examination : M.R.Cholangiogram.
CLINICAL PROFILE : C/O abdominal pain since 6 months.
EXAMINATION :
MR Cholangiogram was performed. 6 mm thick T1 Weighted and T2 Weighted axial images. 6 mm thick T2 Weighted coronal images.OBSERVATION :
There are multiple hypointense areas on all the pulse sequences within the neck of the gall bladder and which represent gall stones. Similar areas are also noted within the cystic duct. The common bile duct in its extrahepatic portion is dilated along with dilatation of the right and left hepatic ducts with mild prominence of the intrahepatic biliary radicles. There are multiple hypointense areas within the common bile duct on all the pulse sequences which may represent calculi. The distal portion of the common bile duct is narrow and is seen to taper towards the ampulla. This is most probably due to edema, probably the result of passage of a stone (? inflammatory stricture).

The pancreatic duct is unremarkable.

The intrahepatic venous architecture is normal.






The gall bladder is well-distended and appears folded upon itself.
IMPRESSION :

The MRI features are suggestive of :

1. Multiple gall stones.

2. Presence of stones in the cystic duct and common bile duct.

3. Tapering of the distal portion of the common bile duct, probably due to passage of a stone (? inflammatory stricture).

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzedali Nazlmn / M / 45 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

Alleged H/O being hit by a heavy object on the back 15-20 days back with pain in the back radiating to the LLE since then.

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 L2-L3 and L4-L5
intervertebral discs.

There is anterior wedging of the L1 vertebral body with break in the superior cortex anteriorly. Hypointense areas on the T1 Weighted images are seen to replace the normal marrow of the L1 vertebra. These are seen to turn hyperintense on the T2 Weighted images and would represent edema/bruise, in the given clinical setting.

There is a left paracentral disc herniation at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing at this level, more marked on the left side. The facet joints appear hypertrophied.

A small posterior disc herniation is seen at the L2-L3 level.

..2/.







Posterior disc bulges are identified at the L3-L4 and L5-S1 levels. A left far lateral disc bulge is seen at the L1-L2 level.

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 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 :

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

IMPRESSION :

1. Altered signal in the L1 vertebral body with anterior wedging and break in the superior cortex suggests a fracture with bone edema/bruise, in the given clinical setting.

2. A left paracentral disc herniation at the L4-L5 level with bilateral neural foraminal narrowing, facetal hypertrophy and tight lumbar canal.

3. A small posterior disc herniation at the L2-L3 level.

ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xlmn / M / 62 yrs.
Referred by : Dr. Abc Xyzankhla.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O neckpain with pain radiating to the LLE and RUE with weakness in the LLE.
H/O cervical spine surgery. No details available.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T2 Weighted and Gradient axial images.

OBSERVATION :

The visualized dorsal intervertebral discs show loss of water content.

The visualized dorsal 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 D12 level and the thecal sac terminates at the S1 level.

The lumbar spine was screened with 5 mm thick T1 Weighted and T2 Weighted sagittal images and which shows sacralization of the L5 vertebral body. Posterior disc herniations are seen at the L1-L2 L2-L3, L3-L4 and L4-L5 levels with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. There is facetal arthropathy at the L2-L3 and L3-L4 levels. Lateral disc herniations with peridiscal osteophytes are seen in the lumbar region.

Anterior disc herniations with peridiscal osteophytes are seen at the D12-L1, L1-L2 and L2-L3 levels.
..2/.





IMPRESSION :

No significant abnormality is detected within the dorsal spine on this study.

Sacralization of the L5 vertebra.

Posterior disc herniations at the L1-L2, L2-L3, L3-L4 and L4-L5 levels with canal stenosis over the L2-L3 and L3-L4 levels.

Facetal arthropathy at the L2-L3 and L3-L4 levels.