ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzLokhlmn / M / 42 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backche (on bedning forwards) with paresthesias in BLE since 1 year.

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 small posterior disc bulge at the L5-S1 level with mild anterior indentation of the thecal sac.

A right paracentral disc herniation with peridiscal osteophyte is seen at the D11-D12 level. This intervertebral disc shows loss of water content.

A small hemangioma with fat content is noted in the L2 vertebral body.

The lumbar vertebral bodies and the remaining 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-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 :

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


IMPRESSION :

Degenerated D11-D12 disc with a right paracentral disc herniation with peridiscal osteophyte at that level.

ke/bv
Date : 00.00.00

Name of the Patient : Abc XyzSalmn / M / 66 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches with giddiness and gait ataxia since 2-4 years which has increased since 10 days.
Known hypertensive. On Rx.

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.
MR cisternogram was also obtained.

After administration of contrast the following parameters were used :

3 mm thick T1 Weighted axial and coronal images.
5 mm thick T1 Weighted axial (with magnetization transfer) and sagittal images.

OBSERVATION :

There are hyperintense areas on the proton, T2 Weighted and FLAIR images in the bilateral corona radiata, centrum semiovale, left temporal region, right thalamus, frontal and the periatrial deep white matter. These are isointense to white matter on the T1 Weighted images and are most likely ischemic in origin.

The seventh and eighth nerve complex on either side is unremarkable. No abnormal area of enhancement is seen along the seventh and eighth nerve complex.

A hyperintense area is seen in the interhemispheric region, better appreciated on the FLAIR images (scan 110.8) is seen to ..2/.








enhance in the interhemispheric region (scan 108.18-19) ? meningeal thickening.

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.

There is no other abnormal area of enhancement in the brain parenchyma or along the meninges.

Incidental note is made of right maxillary sinusitis and inflammatory changes in the ethmoidal air cells.

IMPRESSION :

The MRI features are suggestive of :

1. Altered signal in the bilateral corona radiata, centrum semiovale, left temporal region, right thalamus and frontal and the periatrial deep white matter suggestive of areas of ischemia.

2. Altered signal with contrast enhancement in the interhemispheric region is ? meningeal thickening.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzal Mlmn / M / 42 yrs.
Referred by : Dr. Abc Xyznna / Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with swelling over the ribs on the left side since 15-20 days.
H/O fall 15 days back.

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 L1 vertebral body is as marked on the film.

There is replacement of the normal marrow of the D12 vertebral body by hypointense signal on the T1 Weighted images which is seen to turn hyperintense on the T2 Weighted images. The right pedicle of D12 is involved by the pathology. There is erosion of the anterior cortex with prevertebral soft tissue extension slightly to the right of the midline. This soft tissue lesion is seen to extend over the D11 to D12-L1 levels. The antero-inferior aspect of the D11 vertebra is also involved.

The lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints and the visualized paravertebral soft tissues are unremarkable.
Scan-00005



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
12.0 mm at L2-L3
12.0 mm at L3-L4
11.0 mm at L4-L5
11.0 mm at L5-S1.

The lower chest was screened with 5 mm thick T1 Weighted and STIR axial images and 5 mm thick T1 Weighted coronal images which shows a well-defined lesion along the antero-lateral aspect of lower chest wall on the left at the D12 vertebral level (se/im 105.12). This lesion is hypointense to muscle on the T1 Weighted images and turns hyperintense on the STIR images. Inflammation is noted in the adjacent soft tissue.

IMPRESSION :

The MRI features are suggestive of altered signal of the D11 and D12 vertebral bodies with a right, prevertebral soft tissue lesions as described. This most likely represents osteitis, probably tuberculous osteitis.

Lesion along the antero-lateral chest wall on the left as described may be involving a left lower rib.

The possibility of a neoplasm seems less likely.

PROVISIONAL REPORT

Date : 00.00.00

Name of the Patient : Abc Xyzuranmlmn / M / 63 yrs.
Referred by : Dr. Abc Xyzpta.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O dizziness and diplopia since 2 days.
C/O headaches since several years.
Known hypertensive.

EXAMINATION :

The brain was screened with 5 mm thick T2 Weighted axial images, 5 mm thick Fast Scan (T2 *) coronal images and 5 mm thick T1 Weighted sagittal images.

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

OBSERVATION :

There is a hyperintense area in the right cerebellar hemisphere anteriorly and the middle cerebellar peduncle on the T2 Weighted and Fast Scan (T2 *) images. This is hypointense to the white matter on the T1 Weighted images and suggestive of an area of infarct.

There is mild fullness of both the lateral ventricles.
The third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulcal spaces in the fronto-parietal regions bilaterally. There is no shift of the midline structures.







INTRACRANIAL MRA :

There is hypoplasia of the anterior communicating artery on the right side.

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.

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. An infarct in the right cerebellar hemisphere anteriorly and in the middle cerebellar peduncle.

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


Thanks for the reference.


Please send the films back for the final report.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyz N. Palmn / M / 75 yrs.
Referred by : Dr. Abc XyzV.Shah.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

H/O fall on 00.00.00 with paraplegia and bladder/bowel involvement since 00.00.00.

EXAMINATION :

M.R.I of the dorso-lumbar 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 forward translation of the D11 over the D12 vertebra with disruption of the D11-D12 facets. Probable fracture of the right lamina of D12 is noted.

There is resultant indentation on the dorsal cord by the fractured fragment is noted posteriorly and the postero-superior aspect of the D12 vertebra anteriorly. The cord at this level appears irregular and ill-defined. The cord at the D12 level appears like a thin strand and this would be suggestive of a partial transaction. The spinal cord from the conus cauda to atleast the D9 vertebral level shows a hyperintense signal, centrally, on the T2 Weighted images (isointense to normal cord on the T1 Weighted images) and would represent cord edema/contusion in the given clinical setting.





There is wedging of the D12 vertebral body which shows an ill-defined, hypointense signal replacing the normal marrow on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. Hyperintense signal is seen in the right paraspinal soft tissue at the D12 and L1 vertebral levels on the T1 Weighted and T2 Weighted images and would represent contusion/haemorrhage. Probable fracture of the right transverse processes of D11 and D12 vertebrae is noted.

Few mid-dorsal intervertebral discs show loss of water content.

The conus medullaris terminates at the D12-L1 level.

Gross degenerative changes are seen in the lumbar spine on the screening, T1 Weighted sagittal images.

IMPRESSION :

In a known C/O trauma, the MRI features are suggestive of :

1. Altered cord signal from the conus-cauda to atleast the D9 vertebral level would represent cord edema/contusion.

2. Forward translation of the D11 over the D12 vertebra and wedging with altered signal of the D12 vertebral body suggests bone bruise.

3. Probable fracture of the right lamina of D12 and the right transverse processes of D12 and L1 vertebrae with compromise of the spinal canal at the D11-D12 level.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzm Bhalmn / M / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain radiating to the LUE and LLE since 20-25 days.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

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

OBSERVATION :

There is a posterior disc herniation at the C5-C6 level with anterior indentation of the thecal sac and indentation on the left C6 nerve root. Posterior peridiscal osteophyte is also noted at this level.

Small posterior disc herniation is noted at the C4-C5 level. The C4-C5 and C5-C6 intervertebral discs show loss of water content.

Small, posterior peridiscal osteophyte is noted at the C3-C4 level.

The cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
Scan-00002


The cervical spinal cord shows normal signal intensity.

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

IMPRESSION :

1. A posterior disc herniation with peridiscal osteophyte at the C5-C6 level with indentation of the left C6 nerve root.

2. Small posterior disc herniation at the C4-C5 level.

3. Small posterior peridiscal osteophyte at the C3-C4 level.

sb/ke
Date : 00.00.00

Name of the Patient : Abc XyzAli lmn / F / 40 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Operated for a suprasellar and planumsphenoidal meningioma on 00.00.00. Patient developed right hemiparesis, 1 episode of seizure and diminished vision in the right eye. Also C/O drowsiness and fever off and on.

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 evidence of a right frontal craniotomy with post-operative changes in the soft tissues in the right frontal region. A small, epidural collection is also noted in the right frontal region, deep to the craniotomy flap.

There is seen an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the right inferior frontal cortex, left para-third ventricular region and left cerebral peduncle. These lesions appear hypointense to normal grey matter on the T1 Weighted images.

There is a small, subdural CSF intensity lesion on all the pulse sequences in the left fronto-temporo-parietal region which represents a small subdural hygroma.
Scan-00001


There is an ill-defined, hyperintense signal on the T1 Weighted images in the suprasellar cistern, which remains hyperintense on the proton and T2 Weighted images. The pituitary stalk is not well-identified from the lesion which is seen to indent the optic chiasma to the left of the midline. The pituitary gland is well identified on the present study. The cavernous sinuses on either side are unremarkable.

There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the mastoid air cells bilaterally.

IMPRESSION :

1. Post-operative status.

2. Altered signal in the right inferior frontal cortex,
left para-third ventricular region and left cerebral peduncle as described, most likely represent ischemic changes (The inferior right frontal lesion may be due to previous surgery).

3. Altered signal in the suprasellar cistern, more to the left of the midline, may represent haemorrhage/hemostatic material like gel foam, in the given clinical setting.

4. A small, subdural CSF intensity lesion on all the pulse sequences in the left fronto-temporo-parietal region may represent a small subdural hygroma.

..3/.









- 3 - Scan-00001


As compared to the previous MRI (study no:00002) dated 00.00.00,
there is no significant change in the size of the ventricles on the present study. The post-operative epidural collection and subgaleal collection in the right frontal region have also decresed in size. The intensity of the ischemic lesion in the left parathird ventricular lesion and left cerebral peduncle has also decreased.

There is however slight increase in the size of the subdural hygroma in the left fronto-temporo-parietal region.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyzkumar Plmn / M / 46 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias since 5 years which has increased since 1 month.
H/O Kochs lesion at L3 level 5 years back for which patient received AKT.

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 reduction in height of the L2-L3 intervertebral disc and loss of water content of L2-L3, L3-L4 and L5-S1 intervertebral discs.

Fatty marrow changes are noted in the L2 and L3 vertebral bodies adjacent to the L2-L3 intervertebral disc. Slight irregularity of the inferior cortical endplate of L2 and superior cortical endplate of L3 is noted. Anterior and posterior peridiscal osteophytes are seen at the L2-L3 level.

There are small posterior and bilateral far lateral disc bulges with peridiscal osteophytes at the L5-S1 level.

A small postero-central protruded disc is noted at the L4-L5 level.

- 2 - Scan-00000


Type II degenerative marrow changes are noted adjacent to the L5-S1 intervertebral disc.

The rest of the lumbar vertebral bodies and the remaining 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 S1 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
16.0 mm at L2-L3
16.0 mm at L3-L4
13.0 mm at L4-L5
15.0 mm at L5-S1.

IMPRESSION :

1. Reduction in height of the L2-L3 disc with fatty marrow changes in the L2 and L3 vertebral bodies as described and irregularity of the cortical endplates adjacent to the L2-L3 disc may be the sequelae of previous osteitis with discitis, in the given clinical setting (no previous radiological investigations were available for review/comparison).

2. Small posterior and bilateral far lateral disc bulge with peridiscal osteophyte at the L5-S1 level.

3. A small postero-central protruded disc at the L4-L5 level.

Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 78 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tingling on the right side of the body with altered sensorium since 6 days.
Known hypertensive. On Rx.

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 fairly large, subdural collection overlying the right cerebral convexity with a maximum width of about 2.0 cms. The bulk of this lesion is nearly isointense to gray matter on the T1 Weighted images but appears significantly more hyperintense on the proton, T2 Weighted and FLAIR images. Posteriorly, within the lesion, there is a hyperintense signal on all the pulse sequences which may suggest recent haemorrhage. A loculated pocket is noted in the right parietal region. There is resultant compression of the underlying brain parenchyma and the right lateral and the third ventricles with subfalcine herniation of the ventricles to the left, distortion of the upper brainstem axis and effacement of the cortical sulcal spaces. Transtentorial herniation of the right medial temporal pole is also noted.

There is an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the head of right caudate nucleus and right lentiform nucleus. This lesion appears slightly hypointense to normal white matter on the T1 Weighted images.

There is seen a much smaller, similar (as described above) signal intensity, subdural collection overlying the left cerebral hemisphere with a maximum width of about 1.2 cms in the left high parietal region.

There is mild dilatation of the left lateral ventricle. There is an ill-defined hyperintense signal on proton, T2 Weighted and FLAIR images in the periventricular white matter around the left lateral ventricle. Similar signal is also noted in the head of left caudate nucleus. This signal appears hypointense to normal white matter on the T1 Weighted images.

There is prominence of the cerebellar folia bilaterally with mild fullness of the fourth ventricle.

No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the sphenoid sinus on the left.

IMPRESSION :

1. A fairly large, acute on chronic subdural hematoma overlying the right cerebral convexity with a maximum width of about 2.0 cms. with resultant mass effect.

2. A smaller, acute on chronic subdural hematoma overlying the left cerebral hemisphere.

3. Altered signal in the head of caudate nuclei bilaterally and right lentiform nucleus may represent ischemic changes.

4. Mild dilatation of the left lateral ventricle with periventricular white matter hyperintense signal on proton, T2 Weighted and FLAIR images may represent a trapped ventricle with periventricular CSF ooze. Alternatively, the left periventricular white matter altered signal may represent ischemic changes.

sb/ke
Date : 00.00.00

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

CLINICAL PROFILE :

C/O seizures since 8-10 years.

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.

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.

IMPRESSION :

Normal study of the Brain.