ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzankar D.lmn / M / 58 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O decreased sleep since 5-6 months.
C/O ? orofacial dyskinesia.

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 prominence of the sulcal spaces in the left posterior parietal region which could be due to past ischemic insult.

Small hyperintense areas are seen in the white matter in the
left frontal region on the proton, T2 Weighted and FLAIR images which are isointense to normal white matter on the T1 Weighted images and would represent ischemic changes.

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 :

1. Prominence of the sulcal spaces in the left posterior parietal region could be due to past ischemic insult.

2. Altered signal in the white matter in the left frontal region would represent ischemic changes.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzau Plmn / M / 56 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 15 years with loss of consciousness. On anti-epileptic 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.

3 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

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

Prominent perivascular spaces are noted in the posterior parietal region.

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 no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Mild inflammatory changes are noted in the ethmoidal air cells.

IMPRESSION :

Normal study of the Brain.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzAli Pavalmn / M / 28 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with tingling since 2 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.

OBSERVATION :

There is a posterior disc herniation at the L4-L5 level with anterior compression of the thecal sac and resultant canal stenosis. There is bilateral neural foraminal narrowing. The L4-L5 intervertebral disc shows loss of water content.

Small posterior disc herniation is seen at the L5-S1 level. Schmorls nodes are noted in the dorso-lumbar region.

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

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

The conus medullaris terminates at the 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 :

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

IMPRESSION :

1. A posterior disc herniation at the L4-L5 level
with resultant canal stenosis.

2. Small posterior disc herniation at the L5-S1 level.

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

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzGlmn / M / 27 yrs.
Referred by : Dr. Abc Xyzpra.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 3 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 :

A small posterior disc protrusion is seen at the L5-S1 level with anterior indentation of the thecal sac.

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.

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 :

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

IMPRESSION :

The MRI features are suggestive of a small posterior disc protrusion at the L5-S1 level.

sb/ke/nl/rg.
A Date : 00.00.00

Name of the Patient : Abc Xyzvlmn / M / 63 yrs.
Referred by : Dr. Abc Xyz. Sidhwa.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache (on and off) since several 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 probable sacralization of the L5 vertebra. There is minimal forward translation of the L5 over the S1 vertebra.

There is a postero-central disc herniation at the L5-S1 level indenting the dural theca anteriorly.

A postero-central and left paracentral disc herniation with peridiscal osteophytes is noted at the L4-L5 level, indenting the dural theca anteriorly.

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

The lumbar vertebral bodies show spotty fatty marrow changes and the intervertebral discs show loss of water content. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
Scan-00001A



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 :

24.0 mm at L1-L2
24.0 mm at L2-L3
20.0 mm at L3-L4
17.0 mm at L4-L5
17.0 mm at L5-S1.

IMPRESSION :

1. Probable sacralization of the L5 vertebra. Kindly correlate with plain radiographs.

2. Minimal forward translation of the L5 over the S1 vertebra.

3. A postero-central disc herniation at the L5-S1 level.

4. A postero-central and left paracentral disc herniation with peridiscal osteophytes at the L4-L5 level.

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

No plain films were available for review.

sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzvlmn / M / 63 yrs.
Referred by : Dr. Abc Xyz. Sidhwa.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache (on and off) since several years.

EXAMINATION :

M.R.I of the dorsal 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 dorsal spine with convexity to the left.

There is slight loss of water content of the dorso-lumbar intervertebral discs.

There is slight anterior wedging of the D6, D9 and D10 vertebral bodies without change in signal intensity.

There is hypointense signal on the T1 Weighted images in the dorsal spinal cord, centrally, over the D7 to D9 vertebral levels. This lesion appears hyperintense on the T2 Weighted images and most likely represents a syrinx.

Anterior peridiscal osteophytes are noted in the mid dorsal region.






The visualized dorsal vertebral bodies show spotty fatty marrow changes. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

There is no cord compression.

The conus medullaris terminates at the L1 level.

Screening, T2 Weighted sagittal images of the cervico-dorsal region do not reveal any significant feature of note.

IMPRESSION :

1. Anterior wedging of the D6, D9 and D10 vertebral bodies without change in signal intensity, may be the sequelae of previous trauma.

2. Altered signal in the dorsal spinal cord, centrally, over the D7 to D9 vertebral levels most likely represents a syrinx.

ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 47 yrs.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the right hip joint with limp.
H/O right metatarsal fracture 3 months back.
H/O left hip replacement 3 years back.

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 axial images.

5 mm thick Proton density sagittal images.

OBSERVATION :

There is slight loss of normal contour of the right femoral head which shows hyperintense areas on the T1 Weighted images in its antero-superior quadrant. These are seen to turn hypointense on the STIR images and follow fat signal intensity characteristics. Few hypointense areas are also noted on the T1 Weighted images which are seen to turn hyperintense on the T2 Weighted and FLAIR images. The double line sign is noted. There is slight effusion noted within the right hip joint.

The articular cartilage overlying the right femoral head appears normal. The acetabulum is unremarkable.

The musculature surrounding the right hip joint appears slightly atrophied.



- 2 - scan-00000


Susceptibility artifacts are noted in the left hip joint due to the previous surgery.

IMPRESSION :

The MRI features are suggestive of Class A and Class C avascular necrosis (Mitchells classification) of the right femoral head as described.

The patient is status post-operative for the left hip replacement.

sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzKanlmn / M / 52 yrs.
Referred by : Dr. Abc Xyzhta.
Examination : M.R.I. of the Brain and
Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O blurring of vision on the right side for 1 day, 5 days back.
C/O headaches since 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 coronal images.

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

OBSERVATION :

BRAIN :

There are ill-defined, hypointense areas on the T1 Weighted images in the cerebellar hemispheres bilaterally, more pronounced on the right side, pons on the right and in the left temporo-parieto-occipital region. These lesions appear hyperintense on the proton, T2 Weighted and FLAIR images and most likely represent recent ischemic lesions. Resultant effacement of the cerebellar folia, in the right cerebellar hemisphere and cerebral cortical sulci in the left temporo-parieto-occipital region is noted with minimal indentation on the posterior fourth ventricle.



Lacunar infarcts (isointense to hyperintense to CSF) are noted in the lentiform nuclei and thalami bilaterally, bilateral external capsular regions, right corona radiata and in the right centrum semiovale.

There are ill-defined, hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally, bilateral centrum semiovale and in the subcortical white matter in the frontal regions bilaterally. These lesions also appear hypointense on the T1 Weighted images.

There is mild dilatation of both the lateral and third ventricles. There is slight prominence of the cerebral cortical sulci bilaterally.

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

INTRACRANIAL MRA :

The A1 segment of the right anterior cerebral artery and the right vertebral artery appear hypoplastic.

The right posterior cerebral artery is visualized only its proximal segments.

Narrowing of the distal 0.5 cms of the left vertebral artery is noted. Slight irregularity of the mid segment of the left middle cerebral artery is also noted.

Slight tortuousity of the intracranial segments of the internal carotid arteries is noted, bilaterally.

No obvious aneurysm or vascular malformation is identified.

NECK MRA :

The right vertebral artery in the neck is also hypoplastic.
..3/.






- 3 - Scan-00009


There is slight flattening of the bulb of the right common carotid artery. No obvious stenosis of the origins of the right internal and external carotid arteries is however noted.

The left common carotid artery and its bifurcation are unremarkable.

IMPRESSION :

1. Altered signal in the cerebellar hemispheres bilaterally, more pronounced on the right side, pons on the right and in the left temporo-parieto-occipital region most likely represent recent ischemic lesions.

2. Lacunar infarcts in the lentiform nuclei and thalami bilaterally, bilateral external capsular regions, right corona radiata and in the right centrum semiovale.

3. Altered signal in the periventricular white matter bilaterally, bilateral centrum semiovale and in the subcortical white matter in the frontal regions bilaterally represent ischemic changes.

4. Hypoplasia of the A1 segment of the right anterior cerebral artery and the right vertebral artery.

5. The right posterior cerebral artery is visualized only in its proximal segments.

6. Narrowing of the distal 0.5 cms of the left vertebral artery and slight irregularity of the mid segment of the left middle cerebral artery may be due to atherosclerotic changes.

7. Slight flattening of the bulb of the right common carotid artery.

sb/hs/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzGorilmn / M / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O weakness on the right side of body with speech disturbance since 00.00.00. Patient has partially recovered.
(Weakness in the RLE still persists).

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 ill-defined, hyperintense areas on the T2 Weighted images in the pons, anteriorly and to the left of the midline, right lentiform nucleus, left corona radiata and in the subcortical white matter in the posterior parietal regions bilaterally and left frontal region.

Lacunar infarcts (iso to hyperintense to CSF) are noted in the left lentiform nucleus and in the left corona radiata.

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 right posterior communicating artery is hypoplastic. The proximal segment of the right posterior cerebral artery is faintly visualized. The rest of the right posterior cerebral artery is not very well identified on this study. The left posterior cerebral artery appears to be predominantly supplied by the left posterior communicating artery.



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

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 :

1. Altered signal in the pons, anteriorly and to the left of the midline, right lentiform nucleus, left corona radiata and in the subcortical white matter in the posterior parietal regions bilaterally and left frontal region most likely represent ischemic changes.

2. Lacunar infarcts in the left lentiform nucleus and in the left corona radiata.

3. Faint visualization of the proximal right posterior cerebral artery.

4. No other significant abnormality on the MRA on this study.

As compared to the previous MRI (study no:00005) dated 00.00.00, there is no significant change in the parenchymal lesions on this study.

sb/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzik Jarilmn / M / 14 yrs.
Referred by : Dr. Abc Xyzoshi.
Examination : Limited M.R.I. of the Brain.

CLINICAL PROFILE :

C/O myoclonic jerks.
For follow-up.

EXAMINATION :

Limited M.R.I of the brain was performed as requested using the following parameters :

5 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

OBSERVATION :

There is still seen a subtle diffuse, hyperintense signal on the T2 Weighted and FLAIR images in the subcortical and deep white matter in the right fronto-parietal region and to a much lesser extent in the left posterior parietal region. These lesions appear hypo to nearly isointense to normal white matter on the T1 Weighted images.

There is mild fullness of both the lateral and third ventricles.
The fourth ventricle is 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 maxillary antra bilaterally and in the left mastoid air cells.

Changes in the atlanto-axial region are described in the previous cervical spine study.
Scan-00009


IMPRESSION :

As compared to the previous MRI (study no:00009) dated 00.00.00, there is significant decrease in the size of the lesions in the right fronto-parietal and left posterior parietal regions. The lateral and third ventricles appear slightly full on the present study.