ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzllah Chaudlmn / M / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (right more than left) with paresthesias since 2 years.
H/O fall.

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 and 8 mm thick T2 Weighted axial images.

OBSERVATION :

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

The dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L2 level.

The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images and 5 mm thick T2 Weighted axial images. There is a posterior and right postero-lateral disc herniation at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing, right more than left. There is indentation upon the foraminal and extraforaminal portion of the right L4 nerve root. A small portion of the disc is seen to lie in the right lateral recess of L5 vertebra with impingement of the right L5 nerve root.
.2/.








- 2 - Scan - 00002


There is a posterior and left postero-lateral disc herniation at the L5-S1 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing, left more than right.
There is indentation upon the foraminal and extraforaminal portion of the left L5 nerve root. There is suggestion of inflammation of left L5 nerve root.

A small postero-central disc herniation is seen at the L1-L2 level with mild superior migration of the disc.

The lumbar facet joints show mild degenerative changes.

IMPRESSION :

1. No significant abnormality is detected within the dorsal spine.

2. A posterior and right postero-lateral disc herniation at the L4-L5 level with indentation upon the foraminal and extraforaminal portion of the right L4 nerve root. A small portion of the disc is seen to lie in the right lateral recess of L5 vertebra with impingement of the right L5 nerve root.

3. A posterior and left postero-lateral disc herniation at the L5-S1 level with indentation upon the foraminal and extraforaminal portion of the left L5 nerve root.

4. A small postero-central disc herniation at the L1-L2 level with mild superior migration of the disc.

5. Mild facetal arthropathy in the lumbar region.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzumar Slmn / M / 18 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O gradually progressive wasting of the RUE with weak grip since 3 years.
H/O fall prior to this.
EMG s/o anterior horn cell disorder in bilateral C8, T1 and right C7 segment.

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 appears to be slight reduction in the antero-posterior dimension of the spinal cord over the C5 to the C7 levels with loss of normal ventral bulge, more so on the left side.
However there is no altered signal intensity seen in the spinal cord.

Small posterior disc bulges with peridiscal osteophytes are noted at the C4-C5, C5-C6 and C6-C7 levels.

The C5-C6 and C6-C7 intervertebral discs show loss of water content.

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.

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




00001

- 2 -


IMPRESSION :

1. Slight reduction in the antero-posterior dimension of the spinal cord over the C5 to the C7 levels with loss of normal ventral bulge, more so on the left side is suggestive of anterior horn cell disease (motor neurone disease).

2. Small posterior disc bulges with peridiscal osteophytes at the C4-C5, C5-C6 and C6-C7 levels.

Date : 00.00.00

Name of the Patient : Abc XyzHusain Olmn / M / 28 yrs.
Referred by : Dr. Abc Xyzurya.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O headaches and occasional giddiness since several 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 FLAIR coronal images.

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. No obvious vascular anomaly is identified on this study.

Inflammatory changes are noted in the left maxillary antrum.

IMPRESSION :

Normal study of the Brain.

ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzata Rasglmn / F / 40 yrs.
Referred by : Dr. Abc Xyznawane.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with paresthesias since 1 month.

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 mild retrolisthesis of the L5 over S1 vertebra.

A posterior and right postero-lateral disc herniation is seen at the L5-S1 level with anterior indentation of the thecal sac and right S1 nerve root and right neural foraminal narrowing. There is suggestion of the right S1 nerve root being inflammed. This disc shows loss of water content.

A small posterior disc bulge is noted at the L4-L5 level.

The lower lumbar facet joints show mild degenerative changes.

Type II degenerative changes are noted in the L5 and S1 vertebral bodies adjacent to the L5-S1 intervertebral disc.

The rest of 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.
..2/.




00009


- 2 -

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 :

18.0 mm at L1-L2

19.0 mm at L2-L3

19.0 mm at L3-L4

15.0 mm at L4-L5

10.0 mm at L5-S1.

IMPRESSION :

The MRI features are suggestive of :

1. Mild retrolisthesis of the L5 over S1 vertebra.

2. A posterior and right postero-lateral disc herniation at the L5-S1 level with indentation on the the right S1 nerve root, which is probably inflammed.

3. A small posterior disc bulge at the L4-L5 level.

Date : 00.00.00

Name of the Patient : Abc Xyz Hassan Muthlmn / F / 5 yrs.
Referred by : Dr. Abc Xyzraf.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Born of consanguineous marriage. Right sided seizures since 8 months. Difficulty in speech.

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 T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is no focal area of abnormal signal intensity within the brain parenchyma. (Diffuse, hyperintense signal on the T2 Weighted images in the posterior parietal periventricular white matter bilaterally, most likely represents areas of terminal myelination).

There is prominence of the cerebellar folia bilaterally with mild dilatation of the fourth ventricle. Mild fullness of both the lateral ventricles is noted. The third 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.

The hippocampal complex is unremarkable on either side.

IMPRESSION :

Prominent cerebellar folia with mild dilatation of the fourth ventricle suggests cerebellar atrophy.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Falmn / M / 20 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches and vomiting preceded by blurring of vision on the left side since 7 years - Left hemianopic migraine.

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 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.

The superior surface of the pituitary is convex ? cause ? normal.

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 :

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

Date : 00.00.00

Name of the Patient : Abc Xyznath Nilmn / M / 43 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O pain in the cervical region and in the right arm with pain in the little and ring fingers.

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 normal cervical lordosis and loss of water content of the C4-C5, C5-C6 and C6-C7 intervertebral discs.

There is a left paracentral disc herniation with a peridiscal osteophyte at the C4-C5 level with minimal indentation on the cervical spinal cord anteriorly.

A postero-central and right paracentral disc extrusion is noted at the C6-C7 level, with a part of the disc fragment lying along the posterior margin of the C7 vertebral body, to the right of the midline, in the anterior epidural space. Resultant mild indentation on the cervical spinal cord is noted.

A small posterior peridiscal osteophyte is noted at the C5-C6 level.

Degenerative changes of the joints of Luschka on the right at the C5-C6 level and on the left at the C6-C7 level is noted.

Type II degenerative marrow changes are noted adjacent to the C5-C6 disc.
.....2/..










- 2 - Scan No:00006


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

The cervical spinal cord shows normal signal intensity.

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

IMPRESSION :

1. A left paracentral disc herniation with a peridiscal osteophyte at the C4-C5 level.

2. A postero-central and right paracentral disc extrusion at the C6-C7 level, with a part of the disc fragment lying along the posterior margin of the C7 vertebral body, to the right of the midline.

3. Degenerative changes of the joints of Luschka on the right at the C5-C6 level and on the left at the C6-C7 level.

Date : 00.00.00

Name of the Patient : Abc Xyzlmn / M / 70 yrs.
Referred by : Dr. Abc Xyzmpat / Dr. Abc Xyzdeo.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O tingling in both hands since 8-10 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.

5 mm thick FLAIR coronal images.

3 mm thick STIR coronal images through the optic nerves.

OBSERVATION :

Diffuse areas of hyperintensity on the proton, T2 Weighted and FLAIR images are seen within the periventricular white matter bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.

Small areas with similar signal characteristics are noted within the subcortical and deep white matter in the fronto-parieto- temporal lobes bilaterally.

There is fullness of the third and both the lateral ventricles. There is prominence of the cerebral cortical spaces, basal cisternal spaces and cerebellar folia bilaterally.

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

- 2 - Scan :00005


The optic nerves on either side show normal signal.

Incidental note is made of pansinusitis.

IMPRESSION :

The MRI features are suggestive of :

1. Areas of altered signal within the periventricular white matter bilaterally are most likely ischemic in etiology.

2. Small areas of altered signal within the subcortical and deep white matter in the fronto-parieto-temporal lobes bilaterally. These may be ischemic in etiology or may represent demyelinating plaques especially in view of the findings in the cervical spinal cord (scan no:00003 dated 00.00.00).

Date : 00.00.00

Name of the Patient : Abc XyzB. lmn / F / 45 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O weakness of the RUE and RLE 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 and Fast Scan (T2 *) coronal images.

OBSERVATION :

There is prominence of the cerebral cortical sulci with loss of volume of the left fronto-parietal lobes (frontal more than parietal). Hyperintense areas on the proton, T2 Weighted and FLAIR images are noted within these lobes and which would most likely represent gliotic changes (? the result of a previous vascular insult). There is ex-vacuo dilatation of the left lateral ventricle and prominence of the left Sylvian fissure.

There is prominence of the cerebellar folia bilaterally. The left cerebral peduncle is decreased in volume (may represent Wallarian degeneration).

The right 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.

The left frontal sinus is overpneumatized.

IMPRESSION :

The MRI features are suggestive of :

1. Areas of encephalomalacia in the left fronto-parietal lobes (frontal more than parietal), with volume loss, suggesting left cerebral hemiatrophy.

2. Cerebellar atrophy.

Scan No: 00003 Date: 1/3/99
Name of the Patient : Abc Xylmn / M / 70 yrs.
Referred by : Dr. Abc Xyzpat / Dr. Abc Xyzdeo.
Examination :M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O tingling in both the hands since 8-10 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 evidence of a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images within the posterior columns of the cervical spinal cord bilaterally, over the C3 to C5 vertebral levels and on the left side at the C2 vertebral level. These areas are isointense to normal cord on the T1 Weighted images.

A right paracentral disc herniation with peridiscal osteophytes is seen to indent the right ventral aspect of the cord at the C5-C6 level.

A posterior disc herniation is seen to indent the thecal sac at the C4-C5 level. A small posterior disc herniation is seen to indent the thecal sac at the C6-C7 level.

Posterior disc bulges are evident at the C2-C3 and C3-C4 levels. Mild ligamentum flavum hypertrophy is noted at the C4-C5, C5-C6 and C6-C7 levels.

- 2 - Scan No: 00003



The cervical intervertebral discs show loss of water content.

The cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

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

IMPRESSION :

The MRI features are suggestive of areas of altered signal intensity within the posterior columns of the cervical spinal cord over the C2 to C5 vertebral levels. These may represent areas of demyelination (? multiple sclerosis, ? subacute combined degeneration of the cord).