hs/bv
Date: 00.00.00

Name of the Patient : Abc Xyznath Chaudlmn / M / 42 yrs.
Referred by : Dr. Abc Xyzlwalkar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain with occasional weakness of the LUE since 1 year.

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 :

Diffuse areas of hypointensity on the T1 Weighted images which turn mildly hyperintense on the T2 Weighted and Fast Scan (T2 *) images are seen to involve the C4 vertebral body (more to the right) and the left lateral mass of the C1 and C2 vertebrae. There is mild extension of this pathologic process into the left pre and paravertebral soft tissues at the C1/C2 levels. Suspicious involvement of the periodontoid tissues is noted.

A postero-central disc protrusion with peridiscal osteophytes, more to the right of the midline is seen to indent the thecal sac at the C3-C4 level.

The cervical intervertebral discs show loss of water content.




- 2 - Scan - 00005


The cervical vertebral bodies show normal signal intensity. The joints of Luschka are unremarkable.

The cervical spinal cord shows normal signal intensity.

Small subcentimetre lymph nodes are identified deep to the sternomastoid muscles bilaterally.

The cervico-medullary junction is unremarkable.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the C4 vertebral body (more to the right) and the left lateral mass of the C1 and C2 vertebrae. The differential diagnosis may include :

1. Infective processes like tuberculosis (more likely).

2. Neoplastic processes like secondaries or small cell tumors (less likely).

sb/bv
Date : 00.00.00

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

CLINICAL PROFILE :

H/O spinal surgery in 0000 (details unavailable), (? dermoid).
C/O numbness in toes, ankles and fingers of BLE since 0000.

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 evidence of laminectomy over the L1 to L3 vertebral levels with post-operative changes in the soft tissues in the posterior lumbar region over these levels.

There is a well-marginated, hyperintense lesion on the T1 Weighted images within the thecal sac over the D12 to L2 vertebral levels. This lesion follows fat signal characteristics and appears relatively hypointense on the T2 Weighted images. The lesion is noted along the anterior and left lateral margin of the lower dorsal spinal cord. A smaller, similar signal intensity lesion is noted at the L5 vertebral level, in close relation to the intrathecal nerve roots at that level.

The intrathecal nerve roots at the L2 and L3 vertebral levels appear clumped, suggesting arachnoiditis.



Slight retroplacement of the thecal sac at the operative site is noted.

The lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The left facet joint at the L2-L3 level appears slightly hypertrophied. The visualized pre and paravertebral soft tissues are unremarkable.

It is difficult to identify the conus medullaris separately from the lesion.

The visualized lower dorsal spinal cord appears atrophied without any change in signal intensity.

The thecal sac terminates at the S3 level.

IMPRESSION :

1. Post-operative status.

2. Residual fat signal intensity lesion within the thecal sac over the D12 to L2 vertebral levels along the posterior and left lateral margin of the lower dorsal spinal cord as described is not specific for a single etiology. This may represent a dermoid or a lipoma.

3. Clumped intrathecal nerve roots at the L2 and L3 vertebral levels suggest arachnoiditis.

4. Atrophy of the visualized lower dorsal spinal cord.

As compared to the previous MRI dated 00.00.00, there is reduction in the size of the lesion.

sb/hs
A Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 57 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O gait imbalance since 10 days with paresthesias in the LUE and BLE.

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 loss of water content of the D1-D2 to D4-D5 and D8-D9 intervertebral discs.

There is a right paracentral disc herniation with peridiscal osteophytes at the D8-D9 level, indenting the dorsal spinal cord at this level.

The visualized dorsal 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 dorsal spinal cord shows normal signal intensity.

The conus medullaris terminates at the L1 level.

Screening T1 Weighted sagittal images of the lumbo-sacral spine reveal small posterior disc bulges in the lower lumbar region.

IMPRESSION :

Right paracentral disc herniation with peridiscal osteophytes at the D8-D9 level.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 57 yrs.
Referred by : Dr. Abc Xyzlkaka.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O gait imbalance since 10 days with paresthesias in the LUE and BLE.

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 loss of water content of the cervical intervertebral discs.

A postero-central protruded disc is noted at the C2-C3 level and a small postero-central disc herniation at the C3-C4 level.

A small, posterior disc herniation with peridiscal osteophytes is noted at the C4-C5 level with indentation upon the cord at this level.

A fairly large, posteriorly extruded disc with peridiscal osteophytes is noted at the C5-C6 level with cord compression. The cervical spinal cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images suggesting cord edema/ishcemia. There is bilateral neural foraminal narrowing at this level.
Scan - 00003

A posterior and left postero-lateral disc herniation with peridiscal osteophytes is also noted at the C6-C7 level with left neural foraminal narrowing. Mild ligamentum flavum hypertrophy is noted at the C6-C7 level.

Degenerative changes of the joints of the Luschka on the left is noted at the C3-C4 and C4-C5 levels, with left neural foraminal narrowing. The facet joints at the C5-C6 and C6-C7 levels bilaterally and on the left side at the C3-C4 and C4-C5 levels shows hypertrophic degenerative changes.

The C3 to C5 vertebral bodies show spotty fatty marrow changes.

The visualized pre and paravertebral soft tissues are unremarkable.

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

IMPRESSION :

1. A fairly large, posteriorly extruded disc with peridiscal osteophytes at the C5-C6 level with canal stenosis, cord compression and cord signal alteration at this level suggests cord edema/ischemia.

2. A posterior and left postero-lateral disc herniation with peridiscal osteophytes at the C6-C7 level.

3. A small, postero-central disc herniation at the C3-C4 level.

4. Degenerative changes of the joints of the Luschka on the left at the C3-C4 and C4-C5 levels.

5 Hypertrophic facetal arthropathy bilaterally at the C5-C6 and C6-C7 levels and on the left side at the C3-C4 and C4-C5 levels.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzana lmn / F / 72 yrs.
Referred by : Dr. Abc Xyzhah / Dr. Abc Xyzmani.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache with radicular pain in BLE and paresthesias since 2 days.
h/O fall on 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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is central and anterior wedging of the D7 vertebral body which shows a probable vertical fracture line, centrally. Central hypointense signal on all the pulse sequences in the D7 vertebral body may suggest sclerosis/compressed trabeculae. The adjacent discs are herniated into the D7 body, centrally.

There is slight central wedging of the D12 vertebral body, which is slightly retroplaced. Hypointense signal on the T1 Weighted images is noted in the D12 vertebral body, which appears heterogeneously hyperintense on the T2 Weighted images. Generalized bulging of the D12 body circumferentially is noted with mild indentation on the anterior dural theca and the dorsal spinal cord at that level. The adjacent intervertebral discs are unremarkable.

- 2 - Scan - 00001


The rest of the visualized dorsal and lumbar vertebral bodies show spotty fatty marrow suggesting osteoporosis. The dorso-lumbar intervertebral discs show loss of water content.

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 L1-L2 level.

Screening T1 Weighted coronal images of the hip joints reveal an ill-defined, hypointense signal in the right acetabulum and iliac bones. Probable old healed fracture of the right superior pubic ramus is noted (scan 109.14). The rest of the visualized pelvic bones show osteoporotic changes. Note is made of a distended bladder.

Calcification is seen in the right gluteal region in the soft tissues.

IMPRESSION :

1. Central and anterior wedging of the D7 vertebral body is the sequelae of previous trauma.

2. Central wedging of the D12 vertebral body with altered signal and altered signal in the right acetabulum is not specific for a single etiology. This may represent metastasis in view of multifocal involvement or may be post-traumatic in etiology.

3. Osteoporotic changes in the rest of the visualized bones.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzath T. Mlmn / M / 54 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of giddiness, vomiting with difficulty in swallowing, speech difficulty and gait ataxia since 00.00.00.

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 an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the right middle cerebellar peduncle, pons, lentiform nucleii bilaterally, left thalamus, bilateral corona radiata, fronto-parietal deep white matter and in the posterior parietal, periventricular white matter bilaterally. These lesions appear iso to hypointense to normal white matter on the T1 Weighted images.

Dilated perivascular spaces are seen in the lentiform nuclei bilaterally.

There is mild dilatation 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 basal cisternal spaces bilaterally.





- 2 - Scan-00000


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

IMPRESSION :

1. Altered signal in the right middle cerebellar peduncle, pons, lentiform nucleii bilaterally, left thalamus, bilateral corona radiata, fronto-parietal deep white matter and in the posterior parietal, periventricular white matter bilaterally most likely represents ischemic changes.

2. Mild cerebral and cerebellar atrophy.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzhivrao Arvaplmn / M / 45 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O sudden onset of giddiness and deviation of the mouth to the left, inability to close eyes and swallow with regurgitation since 00.00.00.
Chronic alcoholic/smoker.
Known diabetic/hypertensive (recently detected).

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 an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the lower pons to the right of the midline, posteriorly extending into the proximal medulla. This lesion appears iso to hypointense to normal white matter on the T1 Weighted images.

Lacunar infarcts (iso to hyperintense to CSF) are noted in the left lentiform nucleus and in the left corona radiata. Perilesional hyperintense signal on the T2 Weighted and FLAIR images around the lacunar infarcts in the left corona radiata represents gliotic changes.

Ill-defined hyperintense signal on the proton, T2 Weighted and FLAIR images in the right external capsular region and in the region of the anterior limb of the internal capsules bilaterally and left temporal lobe most likely represents ischemic changes.

00009
- 2 -

Both the lateral, third and the fourth ventricles are normal. There is slight prominence of the cerebral cortical sulci, cerebellar folia and basal cisternal spaces bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. Alterd signal in the lower pons to the right of the midline, posteriorly extending into the proximal medulla most likely represents a recent ischemic lesion.

2. Lacunar infarcts in the left lentiform nucleus and in the left corona radiata with perilesional gliotic changes.

3. Altered signal in the right external capsular region and in the region of the anterior limb of the internal capsules bilaterally, most likely represents ischemic changes.

sb/hs
Date : 00.00.00

Name of the Patient : Abc XyzVishwaklmn / F / 18 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 5 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 in the brain parenchyma.

The hippocampal complex is unmarkable 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.

Inflammatory changes are noted in the paranasal sinuses.

There is an expansile, hypointense lesion on the T1 Weighted images in the ramus of the right mandible. This lesion appears hyperintense on the T2 Weighted images.

IMPRESSION :

No abnormality is detected in the brain parenchyma per se.

An expansile lesion in the ramus of the right mandible is not specific for a single etiology. This may represent ? cyst, ?? fibrous dysplasia.

sb/hs
Scan No: 00006 Date : 00.00.00

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

CLINICAL PROFILE :

C/O seizures since the age of 10-12 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 Weighed and 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.

There is mild assymetric fullness of the temporal horn of the right lateral ventricle.

The rest of the lateral, third and the fourth ventricles are unremarkable. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

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

IMPRESSION :

The MRI features are suggestive of slight prominence of the cerebral cortical and cerebellar folia bilaterally.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / M / 28 yrs.
Referred by : Dr. Abc Xyzrdiwala.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with numbness (below knee) since 1 week.
H/O fall 2 months ago.

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.

7 and 5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is erosion of the spinous process of the L4 vertebra. In place is noted an intermediate signal intensity soft tissue mass lesion on the T1 Weighted images which appears hyperintense on the T2 Weighted images. This soft tissue lesion extends over the L4 and l5 vertebral levels on either side of midline. Extension of the soft tissue lesion into the posterior and right lateral epidural space over the L3 to S1 vertebral levels is noted with resultant compression and displacement of the thecal sac anterior to the left of the midline. The posterior soft tissue lesion and the epidural lesion show small pockets of altered signal which are slightly more hyperintense to the CSF on all pulse sequences, which most likely represents an abscess. Probable involvement of the laminae of L4 and L5 vertebrae is noted with involvement of the interspinous ligament. Encasement of the right sided L3, L4 and L5 nerve roots in the corresponding neural foramen is also noted.

00005
- 2 -


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

The D12 vertebral body shows a well-defined hypointense lesion on the T1 Weighted images to the left of the midline which appears hyperintense on the T2 Weighted images.

The conus medullaris terminates at the L2 level and the thecal sac terminates at the S2 level.

IMPRESSION :

Erosion of the spinous process of L4 with a soft tissue mass lesion, posteriorly over the L4 and L5 vertebral levels and in the posterior and right lateral epidural space with encasement of the L3, L4 and L5 nerve roots in the right neural foramina as described most likely represents an infective pathology, probably tuberculous in etiology. The soft tissue lesions described above represent granulation tissue/abscess. There is resultant thecal sac compression over the L3 to S1 vertebral levels.

Focal lesion at the D12 may represent osteitis.

The possibility of a neoplasm seems less likely.