hs/sb
Date : 00.00.00


Name of the Patient : Abc XyzAbdul Mlmn / F / 17 yrs.
Referred by : Dr. Abc Xyzh.
Examination :M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 7-8 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.

A small lesion which is isointense to CSF on all the pulse sequences is seen anterior to the right cerebellar hemisphere. This may represent an arachnoid cyst (scans 104.5, 102.5)

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

Note is made of pansinusitis and inflammatory changes in the right mastoid air cells.

IMPRESSION :

1. A probable small arachnoid cyst anterior to the right cerebellar hemisphere.
2. No abnormality detected within the brain per se on this study.

Date : 00.00.00

Name of the Patient : Abc Xyzhlmn / F / 40 yrs.
Referred by : Dr. Abc Xyzmpat.
Examination : Intracranial and Neck M.R.A.

CLINICAL PROFILE :

C/O headaches since 20 years.

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.

INTRACRANIAL MRA :

The A1 segment of the right anterior cerebral artery is hypoplastic.

The petrous, cavernous and supraclinoid segments of the internal carotid arteries bilaterally show normal signal and calibre. The visualized left 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 :

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

Date : 00.00.00

Name of the Patient : Abc Xyzoylmn / M / 30 yrs.
Referred by : Dr. Abc Xyzs.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

H/O accidental injury in October 0000 with quadriplegia. Treated with traction and improved partially.
C/O weakness of grip on the right side, walks with crutches, low back pain, gait imbalance, more to the left and buckling of knees since then.

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 slight loss of water content of the cervical intervertebral discs.

A small postero-central protruded disc with peridiscal osteophytes is noted at the C2-C3 level.

A small postero-central and right postero-lateral disc herniation with peridiscal osteophytes is noted at the C3-C4 level with right neural foraminal narrowing.

Small posterior peridiscal osteophytes are noted at the C4-C5 and C5-C6 levels.
Scan : 00000


There is a focal hypointense signal on the T1 Weighted images in the cervical spinal cord at the C3-C4 level. This lesion appears hyperintense on the T2 Weighted and Fast Scan (T2 *) images and represents an area of myelomalacia ? the sequelae of previous cord contusion (past H/O cervical injury).

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 :

1. A small postero-central protruded disc with peridiscal osteophytes at the C2-C3 level.

2. A small postero-central and right postero-lateral disc herniation with peridiscal osteophytes at the C3-C4 level.

3. Altered signal in the cervical spinal cord at the C3-C4 level which may represent an area of myelomalacia ? the sequelae of previous cord contusion (past H/O cervical injury).

a Date : 00.00.00

Name of the Patient : Abc Xyzoylmn / M / 30 yrs.
Referred by : Dr. Abc Xyzs.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

H/O accidental injury in October 0000 with quadriplegia. Treated with traction and improved partially.
C/O weakness of grip on the right side, walks with crutches, low back pain, gait imbalance, more to the left and buckling of knees since then.

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 water content of the D12-L1 and L4-L5 intervertebral disc.

A small, postero-central and right postero-lateral disc bulge with peridiscal osteophytes is noted at the L4-L5 level with slight right neural foraminal narrowing. A minimal posterior disc bulge is noted 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 - Scan : 00009a


The conus medullaris terminates at the D12-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
17.0 mm at L2-L3
14.0 mm at L3-L4
11.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

Degenerated L4-L5 disc with a small postero-central and right postero-lateral disc bulge with peridiscal osteophytes narrowing the right neural foramen at this level.

Date : 00.00.00

Name of the Patient : Abc Xyzoylmn / M / 30 yrs.
Referred by : Dr. Abc Xyzs.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

H/O accidental injury in October 0000 with quadriplegia. Treated with traction and improved partially.
C/O weakness of grip on the right side, walks with crutches, low back pain, gait imbalance, more to the left and buckling of knees since then.

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 slight loss of water content of the D12-L1 intervertebral disc.

Slight ligamentum flavum/capsular ligament hypertrophy is noted at the D5-D6, D6-D7 and D7-D8 levels.

The visualized dorsal 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 appears slightly smaller in diameter, without signal intensity change. There is no cord compression.

The conus medullaris terminates at the D12-L1 level.

IMPRESSION :

1. Slight ligamentum flavum/capsular ligament hypertrophy at the D5-D6, D6-D7 and D7-D8 levels.
2. The dorsal spinal cord appears slightly small in diameter, without change in signal intensity.

sb/hs
Date : 00.00.00

Name of the Patient : Abc Xyz Mohalmn / M / 70 yrs.
Referred by : Dr. Abc Xyzarucha.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O difficulty in getting up without support since 4-5 months.
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.

OBSERVATION :

There is an ill-defined, hypointense signal on the T1 Weighted images in the right temporo-parieto-frontal lobes and in the right lentiform nucleus and head of the right caudate nucleus. This follows CSF signal on all the pulse sequences. Areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton, T2 Weighted and FLAIR images adjacent to this would represent gliotic changes. This lesion in toto represents an area of cystic encephalomalacia, most likely the sequelae of a previous vascular insult. Resultant mild fullness of the right lateral ventricle is noted when compared to the left.

A lacunar infarct (iso to hyperintense to CSF) is noted in the pons on the right.

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, cerebellar folia and basal cisternal spaces bilaterally.

There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
..2/.













- 2 -


IMPRESSION :

1. Altered signal in the right temporo-parieto-frontal lobes and in the right lentiform nucleus and head of right caudate nucleus represents an area of cystic encephalomalacia most likely the sequelae of a previous vascular insult.

2. A lacunar infarct in the pons to the right of the midline.

3. Mild age related cerebral cortical and cerebellar atrophy.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyz Patralmn / F / 37 yrs.
Referred by : Dr. Abc Xyzwalla.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to the LUE since 2 years which has increased since 1 month with paresthesias in the LUE.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted axial images.

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

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) coronal images.

OBSERVATION :

There is slight loss of water content of the cervical intervertebral discs.

A hemangioma is noted in the C7 vertebral body, to the right of the midline.

The cervical vertebral bodies reveal normal signal intensity. The joints of Luschka and the 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.

The left lobe of thyroid gland appears slightly larger than the right.

There is no obvious mass lesion identified at the thoracic inlet on this study.

IMPRESSION :

No significant abnormality is detected on this study.

sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyz. Almn / M / 70 yrs.
Referred by : Dr. Abc Xyznshah.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the left hip region since 1 month.

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 are well-marginated, geographical areas following fat signal characteristics on all the pulse sequences in the head of the left femur. The left femoral head shows loss of normal contour. The double line sign is well-identified. The neck of the left femur and the left acetabulum reveal an ill-defined hypointense signal on the T1 Weighted images which appears hyperintense on the T2 Weighted and STIR images. No obvious break in the cortex is noted. A small left hip joint effusion is noted. The articular cartilage overlying the left femoral head appears thinned out posteriorly. Slight atrophy of the left gluteal muscles in relation to the right is noted.

A well-marginated area following fat signal characteristics on all the pulse sequences is noted in the head of the right femur, which shows normal contour. The right femoral neck, right acetabulum and the articular cartilage overlying the right femoral head are unremarkable. There is no right hip joint effusion.

The pelvic bones and femora show spotty fatty changes suggesting osteoporosis.

IMPRESSION :

1. Class A avascular necrosis of the left femoral head with a small left hip joint effusion. Altered signal in the left acetabulum and neck of the left femur may represent bone bruise/edema.

2. Class A avascular necrosis of the right femoral head.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyza Deshlmn / M / 33 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to BLE (left more than right) with paresthesias 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.

OBSERVATION :

There is loss of normal lumbar lordosis and loss of water content of the L3-L4, L4-L5 and L5-S1 intervertebral discs.

A small, postero-central protruded disc with peridiscal osteophyte is noted at the L5-S1 level.

A posteriorly herniated disc with peridiscal osteophyte is noted at the L4-L5 level with thecal sac compression. There is ligamentum flavum hypertrophy at this level with a tight canal.

A fairly large, left paracentral extruded disc is noted at the L3-L4 level with left neural foraminal narrowing and indentation on the traversing left L4 nerve root.

A small posterior peridiscal osteophyte is noted at the L2-L3 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.

The pedicles of the lower lumbar vertebrae appear congenitally short in their antero-posterior dimensions.
....2/.







- 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 :

16.0 mm at L1-L2

13.0 mm at L2-L3

8.0 mm at L3-L4

6.0 mm at L4-L5

8.0 mm at L5-S1.

IMPRESSION :

1. A small, postero-central protruded disc with peridiscal osteophyte at the L5-S1 level.

2. A posteriorly herniated disc with peridiscal osteophyte at the L4-L5 level.

3. A fairly large, left paracentral extruded disc at the L3-L4 level with indentation on the traversing left L4 nerve root.

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

5. Canal stenosis at the L3-L4, L4-L5 and L5-S1 levels.

sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyza Blmn / M / 22 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

H/O fall from a train on 00.00.00 with weakness of BUE since than.

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.

3 mm thick Fast Scan (T2 *) coronal images and 4 mm thick T2 Weighted coronal images (with fat saturation) through the brachial plexus.

OBSERVATION :

There is slight loss of water content of the C5-C6 and C6-C7 intervertebral discs.

There is seen a horizontal fracture line passing through the base of the odontoid process
and the right lateral mass of C2. Minimal lateral translation and anti-clockwise rotation of the fractured fragment is noted with slight right neural foraminal narrowing at the C2-C3 level. The cervical spinal cord at the C2 vertebral level, at the fracture site, shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images suggesting cord contusion, in the given clinical setting. There is however no cord compression identified. The C2 vertebral body shows a subtle hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images which may suggest bone bruise in the given clinical setting.

A hyperintense signal on the Fast Scan (T2 *) images is noted in the periodontoid space, posteriorly and to the left, which may represent soft tissue injury, in the given clinical setting. The transverse ligament however appears intact. Hyperintense signal on the T2 Weighted images is also noted in the prevertebral space over the C2 to C4 vertebral levels which may also represent soft tissue injury.
...2/..








- 2 -



No significant abnormality is detected along the brachial plexus on either side.

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

IMPRESSION :

1. A horizontal fracture line passing through the base of the odontoid process
and the right lateral mass of C2 with minimal lateral translation and anti-clockwise rotation of the fractured fragment

2. Altered signal in the cervical spinal cord at the C2 vertebral level, at the fracture site, suggests cord contusion, in the given clinical setting.

3. Altered signal in the C2 vertebral body may suggest bone bruise in the given clinical setting.

4. Signal alteration in the periodontoid space, posteriorly and to the left and in the prevertebral space over the C2 to C4 vertebral levels may represent soft tissue injury, in the given clinical setting.