sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyz Shlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzs.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O gait imbalance with inability to concentrate and recognize objects on the right side.

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 is an ill-defined, hyperintense area on the T2 Weighted images in the left parieto-occipital lobe. This lesion appears hypointense on the T1 Weighted images and represents an area of cystic encephalomalacia, most likely the sequelae of a previous vascular insult. Resultant mild dilatation of the atrium and occipital horn of the left lateral ventricle is noted.

Ill-defined, hyperintense areas on the T2 Weighted images are noted in the periventricular white matter bilaterally and in the corona radiata, centrum semiovale and subcortical white matter in the fronto-parietal regions bilaterally. These also most likely represent ischemic changes.

A lacunar infarct is noted in the right periatrial region.

There is mild dilatation of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and cerebellar folia bilaterally. There is no midline shift.
Scan - 00002


An antro-choanal polyp is noted on the right side. A polyp is also noted in the left maxillary antrum.

Incidentally noted is an empty sella.

The basal cisternal spaces are unremarkable.

INTRACRANIAL MRA :

The right vertebral artery appears hypoplastic. The posterior cerebral arteries are slightly attenuated, bilaterally.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized anterior cerebral, middle cerebral, basilar, left 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 its bifurcation and branches bilaterally are unremarkable.

IMPRESSION :

1. An area of cystic encephalomalacia in the left parieto- occipital region, the sequelae of previous vascular insult.

2. Altered signal in the periventricular white matter and in the corona radiata, centrum semiovale and in the subcortical white matter in the fronto-parietal regions bilaterally, most likely represents ischemic changes.

3. Hypoplastic right vertebral artery with attenuated posterior cerebral arteries bilaterally.

4. Right sided antro-choanal polyp.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyz J. Nalmn / M / 36 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O involuntary movements of the right half of the body since 4 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.

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

OBSERVATION :

Small bright foci on the T2 Weighted and FLAIR images are noted in the subcortical white matter in the right frontal region and in the left posterior parietal region.

Prominent perivascular spaces are noted in the posterior parietal region.

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 right maxillary sinus, frontal sinus and ethmoidal air cells on the right.

IMPRESSION :

Altered signal in the subcortical white matter in the right frontal and in the left posterior parietal region is of undetermined etiology (? ischemic).

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzma P. Pislmn / F / 57 yrs.
Referred by : Dr. Abc Xyzi.
Examination :M.R.I. of the Right Ankle & Foot.

CLINICAL PROFILE :

C/O pain in the right ankle since 3 days.

EXAMINATION :

M.R.I. of the right ankle and foot was performed using the following parameters :

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

4 mm thick T1 Weighted and STIR coronal images.

4 mm thick T1 Weighted and GRASS sagittal images.

OBSERVATION :

There is evidence of a well-marginated approximately 1.0 cm diameter size hypointense signal on the T1 Weighted images in the right calcaneum, which appears hyperintense on the T2 Weighted and STIR images. Perilesional hyperintense signal on the T2 Weighted and STIR images is noted in the marrow of the calcaneum. Soft tissue lesion is also noted in the sinus tersi (? synovial thickening).

There is a well-defined approximately 3.0 x 1.5 x 2.2 cms sized hypointense lesion on the T1 weighted images in the subcutaneous fat of the right heel at the level of the insertion of the plantar aponeurosis. This lesion also appears hyperintense on the T2 Weighted and STIR images. A cystic area is also noted within this lesion. Hyperintense signal on the T2 Weighted and STIR images is noted in the talus, more so posteriorly and medially.
- 2 - Scan - 00000


The rest of the visualized bones constituting the ankle joint per se are unremarkable.

Fluid is noted in the subtalar joint and along the peroneus tendons.

IMPRESSION :

Altered signal in the right calcaneum and talus as described is not specific for a single etiology. This most likely represents osteitis. A soft tissue lesion is noted in the subcutaneous fat of the right heel which may represent a small abscess.

Tuberculous osteitis may be considered as a likely possibility.

hs/sb
Date : 00.00.00

Name of the Patient : Abc Xyz B. Banlmn / F / 2 1/2 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since the age of 6 months. 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.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

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

The hippocampal complex is unremarkable 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.

IMPRESSION :

Normal study of the Brain.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyz S. Wlmn / M / 36 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O weakness of BLE (right more than left) since 3 months.

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.

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

OBSERVATION :

There is loss of water content of the L4-L5 intervertebral disc.

A posterior disc herniation is noted at the L4-L5 level with bilateral neural foraminal narrowing. Mild ligamentum flavum hypertrophy is seen at this level.

Slight anterior wedging of the D11 and D12 vertebral bodies is noted, with fatty marrow changes, which may be the sequelae of previous trauma.

The rest of the visualized dorso-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.

- 2 - Scan - 00008

The visualized dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

Screening images of the cervical spine reveal loss of water content of the cervical intervertebral discs.

Postero-central disc herniations are noted at the C4-C5 and C6-C7 levels, indenting the cervical spinal cord anteriorly.

A fairly large, posteriorly herniated disc with posterior 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/ischemia.

Screening images of the upper dorsal region reveal slight central wedging of the D4, D5 and D8 vertebral bodies without change in their signal intensity.

IMPRESSION :

1. Degenerated L4-L5 disc with a posterior disc herniation at this level.

2. Postero-central disc herniations at the C4-C5 and C6-C7 levels.

3. A fairly large, posteriorly herniated disc with peridiscal osteophytes at the C5-C6 level, with cord compression.

4. Altered cord signal at the C5-C6 level suggests cord edema/ischemia.

5. Wedging of the D4, D5, D8, D11 and D12 vertebral bodies (may be the sequelae of previous trauma).

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyzh Amblmn / M / 21 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O radicular pain to the LLE with paresthesias since November 0000.

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.
8 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is loss of water content of the L1-L2 and L2-L3 intervertebral discs.

A postero-central disc protrusion is seen to indent the thecal sac at L2-L3 level.

Small postero-central protruded discs are noted at the L1-L2 and L5-S1 levels.

The visualized dorso-lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.

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

The conus medullaris terminates at the L1 level.

IMPRESSION :

1. A postero-central disc protrusion at the L2-L3 level.
2. Small postero-central protruded discs at the L1-L2 and L5-S1 levels.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzidevi Palmn / F / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O paresthesias on the right side of the face since 15 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.

3 mm and 5 mm thick FLAIR coronal images.

OBSERVATION :

There is a hyperintense signal in the right postero-lateral aspect of the ponto-medullary junction on the proton, T2 Weighted and the FLAIR images. This is hypointense on the T1 Weighted images and is suggestive of an area of ischemia.

A small, bright focus on the FLAIR images is noted in the subcortical white matter in the right frontal region.

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. Slight prominence of the cerebellar folia is noted.

IMPRESSION :

The MRI features are suggestive of an area of ischemia in the right postero-lateral aspect of the ponto-medullary junction.

hs/sb
Date : 00.00.00

Name of the Patient : Abc XyzTibrelmn / M / 67 yrs.
Referred by : Dr. Abc Xyzra.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O stiffness of back with radiating pain to the RLE and paresthesias since 2 years which has increased since 6 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.

After administration of contrast, the following parameters were used :

5 mm thick T1 Weighted sagittal and axial images with fat saturation.

3 mm thick T1 Weighted coronal images.

OBSERVATION :

There appears to be partial sacralization of the L5 vertebra on the left side and it is as marked on the film. Please correlate with plain radiographs.

There is Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra.

A small posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level. The L4-L5 facet joints show hypertrophic degenerative changes, bilaterally.
..2/.





- 2 - Scan - 00005

Mild ligamentum flavum hypertrophy is noted at the L4-L5 and L5 vertebral levels. A mild posterior disc bulge is noted at the L3-L4 level.

After contrast administration there is no enhancement along the intrathecal nerve roots in the lumbar region or within the visualized lumbar vertebral bodies or the meninges.

The L2-L3, L3-L4 and L4-L5 intervertebral discs show loss of water content.

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

The conus medullaris terminates at the D12-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 :

18.0 mm at L1-L2
19.0 mm at L2-L3
17.0 mm at L3-L4
12.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Partial sacralization of the L5 vertebra. Please correlate with plain radiographs.
2. Grade I spondylolisthesis of the L4 vertebra over the L5 vertebra.
3. A small posterior disc herniation and hypertrophic facetal arthropathy with a tight canal at the L4-L5 level.

ke/sb
Date : 00.00.00

Name of the Patient : Abc XyzMilmn / F / 50 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with paresthesias 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 loss of normal lumbar lordosis and loss of water content of the L4-L5 and L5-S1 intervertebral discs.

There is a postero-central disc herniation at the L4-L5 level with anterior indentation of the thecal sac and mild bilateral neural foraminal narrowing. There is resultant canal stenosis. Small disc portion is seen to migrate inferiorly.

There is a small postero-central disc herniation at the L5-S1 level with mild indentation upon the S1 nerve roots bilaterally.

Small postero-central disc herniation is seen at the L3-L4 level.

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.
.2/.




00004

- 2 -


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 :

16.0 mm at L1-L2

16.0 mm at L2-L3

12.0 mm at L3-L4

7.0 mm at L4-L5

7.0 mm at L5-S1.

Multiple paraaortic, interaorticocaval and retrocaval lymphnodes are noted.

IMPRESSION :

The MRI features are suggestive of :

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

2. A small postero-central disc herniation at the L5-S1 level with mild indentation upon the S1 nerve roots bilaterally.

3. Small postero-central disc herniation at the L3-L4 level.

4. Multiple paraaortic, interaorticocaval and retrocaval lymphnodes noted.

ke/hs
can No : 00003 Date : 00.00.00

Name of the Patient : Abc XyzMlmn / M / 28 yrs.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches 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.

OBSERVATION :

Few small bright foci on the FLAIR images are seen in the right frontal lobe.

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 ethmoidal air cells on the right side and deviation of the nasal septum to the right.

IMPRESSION :

The MRI features are suggestive of few foci of altered signal in the right frontal lobe and are of undetermined etiology (? related to migraine).