MRI My Medall Reports

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Cross – Sectional Imaging Formats

Magnetic Resonance Imaging

TABLE OF CONTENTS

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WRITTEN RADIOLOGY REPORT

John R. Wilcox, MD; Applied Radiology; Journals - Volume 35, Number 7, July 2006

The written radiology report is the most critical component of the service provided by a radiologist. It constitutes the formal documentation and communication of the results of a radiologic study or procedure. The reports are usually dictated by a trained radiologist, but reports may vary greatly in style, format, and effectiveness. A major cause of litigation against radiologists is failure to effectively communicate results. As radiologists, it is time that we look at this issue with renewed diligence.Part of the problem with radiology reports arises because we do not really understand how important this document has become to the non-radiologist caregiver. This lapse is more understandable when you realize that most major radiology textbooks do not address the subject of report composition. This would be equivalent to a journalism textbook without a chapter on how to write an article. But journalism and radiology have a lot in common. Both professions require spending a great deal of time gathering "facts" and "data" and then reporting that material in written form for a reader.The purpose of this article is to help radiologists improve the quality of their written radiology reports by reviewing the components of a report, addressing grammar and writing style, and considering appropriate standardization.

Communication

One of the 3 most common reasons for malpractice suits against radiologists is failure to communicate results clearly and effectively. Poor communication is a common reason patients choose to sue the doctor. In some situations, such as mammograms, it is helpful to give a copy of the report directly to the patient, which makes it even more important that the report is clear and understandable. If a report is written so that a patient can understand what is said, it is much more likely that a healthcare provider, who depends upon the report to make decisions concerning patient management, will also understand the report.

In order to achieve clear communication, the radiologist should be aware of the intended reader of the report and how that reader will understand what is written. Most often, the reader of the radiology report is the individual responsible for providing direct patient care. In some cases, the reader will be the patient. The report should be written with these readers in mind. The use of difficult or ambiguous terms should be avoided. Esoteric terms and language not commonly understood will detract from effective communication. The radiology report may provide information critical to patient care, but these findings can be helpful only if the reader understands what is said. Unfortunately, the proper use of grammar becomes a part of understandable communication.

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Effective report writing means that useful information obtained from the radiologic study will be transmitted clearly, concisely, and unambiguously. The report is the written communication of the radiologist's interpretation, discussion, and conclusions about the radiologic study. The written report is frequently the only source of communication of these results. The report should communicate relevant information about diagnosis, condition, response to therapy, and/or results of a procedure performed.

The written report should also answer any clinical question raised by the requesting patient-care provider that is relevant to the radiologic study. For example, if the study was requested with the clinical information "cough and fever," then the report should specifically address whether or not the findings are consistent with pneumonia.The key to a clear and concise radiology report that will provide reliable high-quality communication is a coherent format. The radiology report is a diagnostic test result that should stand independent of the individual interpreting radiologist. The quality of the report should not vary as a result of there being different interpreting radiologists. This is a key principle in statistical quality control. The control of variation reduces liability risk because it ensures that important issues are addressed systematically. Using a standard format will significantly improve the ability of the report to communicate effectively. Variations in the report format create confusion for the reader, whereas a consistent location for the results, discussion, and conclusions assists the reader in understanding the report and its clinical implications.The scientific report format is a practical choice for the radiology report. This format is used by major scientific journals, is familiar to most physicians, and follows the general outline recommended by the American College of Radiology (ACR). It also supports the notion that the radiologic study is a "scientific test."

Title

In most situations, the title of the radiologic report is already standardized. In some institutions, this title is provided to the transcriptionist with the request. However, it is customary to include the report title for the purpose of identification. The name of the study that is used during ordering or scheduling the study may not be the desired title for the official report. The correct title of the study actually performed should be clarified at the time of dictation. Complicated procedures, such as arteriograms, biopsies, or drainage procedures, may require a statement of the title at the time of report dictation.

Indication

With many standard studies, a stated indication, or history, is not necessary in the written report. Requirements for an appropriate indication for a "test" do not necessarily require documentation of that indication within the report. In some institutions, the indication, or reason for the examination, is part of the request for the study and is automatically included in the heading of the report. However, this information may or may not represent the true indication for the study. As the consultant, the radiologist is responsible for determining the appropriateness of the study. Often, the real reason for the study is determined from information from the

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patient's chart or from a verbal discussion with the referring provider. Therefore, recapitulation of the indication for the study at the time of the report dictation is appropriate because it will document the actual reason the study was performed.In addition, many third-party payers and Medicare now require an appropriate indication before they will reimburse for a study. Therefore, the radiologist is responsible for ensuring that the study was performed for an appropriate reason. The ACR Standards also include this requirement and even suggest including the corresponding ICD-9 diagnosis code in the report. This can greatly expedite billing.The indication should be a simple, concise statement of the reason for the study and/or applicable clinical information or diagnosis. A clear understanding of the indication may also clarify appropriate clinical questions that should be addressed by the study. For example, a chest radiograph requested for "cough and fever" implies the question, "Does this study indicate the presence of pneumonia?"Even without a stated reason for the study, it is the radiologist's responsibility to identify the appropriate indication. This may be as simple as the recognition of the implied indication as understood by the context of the study and does not necessarily need to be included in the report. This information may also be available from the patient, the patient's chart, or the referring provider. This information should be pursued with reasonable thoroughness, as it may significantly change the focus of the study.

Procedure

Every radiologic study has a procedure associated with performing the examination. For most routine studies, the procedure is implied by the title. For example, a routine study such as a "PA & LAT Chest," by accepted use, implies the procedure (posteroanterior and lateral chest radiograph), and a separate "Procedure" section of the report is not necessary. However, a separate "Procedure" section may be convenient to document informed consent, technical limitations, drugs, and isotopes or contrast material associated with the study. Frequently, reports for invasive procedures are best organized in a separate "Procedure" section.

Findings and discussion

The "Findings and Discussion" section of the report includes the description of the results of the study, relevant information from previous studies, pertinent clinical information, and any discussion. The discussion should explain the relationship of the results, previous studies, clinical information, and the reasoning supporting the radiologist's conclusions. However, the statements in this section should be clear and concise. Long, wordy reports are less likely to be read by the intended reader. Approaching the radiologic study as if it were a scientific test will help limit the findings that need to be described. To do this, we assume a "null hypothesis" or we anticipate that the findings will fall within the expected range of normal for the given population. Therefore, it is necessary to describe only those findings that are abnormal and disprove the null hypothesis. These are referred to as positive findings. The exception occurs when a clinical question implies the possible presence of a specific abnormality. This introduces a positive hypothesis that the findings will document the questioned abnormality. In this case, normal findings that refute the presence of the questioned abnormality should be described and are referred to as pertinent negatives.

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This section of the report must be organized in an orderly format so that the reader will understand the basis of the final conclusions and impressions. The reader should be able to find support in the "Findings and Discussion" section for each item listed in the "Impression" section.

Impression

The abstract is the summary of a scientific report. In a radiology report, the summary has been referred to as the "Impression," "Conclusion," or "Diagnosis" section. Sometimes this summary is an impression, sometimes it is a conclusion or diagnosis, and sometimes it is a concise statement of the findings. Practice patterns seem to favor "Impression" for the name of this section of the report.In a large survey, >50% of referring physicians read only the "Impression" section of a radiology report! This places great importance on this section of the report and emphasizes the need to view this section as a summary.The common practice of using a numbered list for the "Impression" section helps produce a concise summation. Numbered statements or phrases should be ordered logically to make use of implied ranking. Statements in the numbered list should maintain a parallel structure-that is, if complete sentences are used, then complete sentences should be used throughout the list, or if phrases are used, then phrases should be used throughout. For clarity, it is best to limit each numbered item to a single sentence or phrase.The "Impression" section is a list of summary statements that includes both conclusions about the radiographic study and recommendations for further evaluation and patient management. Recommendations are appropriate if the radiologist is knowledgeable about what is being recommended and if the recommendation will improve the care of the patient. Recommendations are based on the results of the radiologic study and the experience of the individual radiologist. The range of appropriate recommendations should be limited to the scope of knowledge of the individual radiologist. The use of appropriate recommendations can greatly contribute to the management of patient care and can provide consultative information that may not otherwise be available. However, the use of recommendations with the misguided notion that it is effective risk management should be avoided.The "Impression" section is the most commonly read portion of the radiology report and is generally considered to be a summary of the study. In addition, this section may be all that is required in certain routine "normal" studies. Consequently, the "Impression" section is the most important part of the radiologic report.

Footnotes to the report

Other, more timely forms of communication of the report are also important to good radiology practice. Phone, fax, and email communication of serious, time-critical, or life-threatening information is becoming the standard of practice, and documentation of these communications is good risk management. Since these forms of communication are separate from the report itself, it is convenient to use a postscript or footnote to document such communication. A short postscript at the end of the written report is sufficient. Here are some examples:

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"P.S. Dr. Doctor was contacted by phone at 1300 on 1/1/01 and the results discussed";"P.S. Fax of report sent to Dr. Doctor";"P.S. A copy of the report was sent by email to Dr. Doctor"; or"P.S. Patient contacted by telephone and informed of results and the need for follow-up."

Conclusion

The written radiology report is the critical service of radiology and should provide clear and concise communication that is understandable by the intended reader. Since increasingly more often the patient is the reader of the report, it is even more important to keep the report clear and concise. Additionally, failure to clearly communicate results continues to be a leading cause of delayed diagnosis and resultant lawsuits. It is time to take a new and positive look at the radiology report from a different perspective. Efforts to make the radiology report an effective means of communication that is independent of individual radiologists and that focuses on the intended readers can contribute to both improved patient care and reduced liability risk.

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HEAD AND NECK

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Patient Name : Patient ID:

Age : Sex :

Referring Doctor : Date :

MRI REPORT – BRAIN

Clinical details:

Technique:

Axial T1 FLAIR, T2 FRFSE Sagittal T1 FLAIR Coronal T2 FRFSE Axial T2 FLAIR and Diffusion b = 1000 sec/mm2

Findings:

The posterior fossa shows normal cerebellum. The fourth ventricle shows normal size, shape and position. Both the C.P angles are clear. The orbits and their contents are normal.

The medulla, pons and midbrain show normal signals in both the sequences. The basal cisterns are normal. The pituitary gland and optic chiasm are normal.

The third and lateral ventricles are of normal in size, shape and position. No midline shift is noted. The thalami, basal ganglia and internal capsules are normal on both sides.

Both the cerebral hemispheres show normal intensities of grey and white matter. The cerebral sulci are normal. The extra cerebral spaces are clear.

Impression:

No significant abnormality noted in the brain parenchyma.

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Age : Sex :



Clinical details:

Technique:


Axial, Coronal and Sagittal post contrast T1

Findings:





No abnormal parenchymal / dural enhancement seen.

Impression:

No significant abnormality noted in the brain parenchyma.

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Age : Sex :


MRI Report – Brain With Angiography

Clinical details:

Technique:


Findings:





MR – Angiography (Brain)

MR angiography of brain is done by 3D TOF technique and correlated with axial, sagittal and coronal reconstructed images.

The study reveals normal course and caliber of intracranial portion of internal carotid arteries. Proximal portion of ACA and MCA are normal. No intraluminal thrombus seen.

Basilar artery and PCA are normal. No vascular malformation noted.

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Impression:

No significant abnormality is detected in the brain. No significant abnormality is detected in the circle of Willis

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Age : Sex :


MRI Report – Brain with MRA Brain and Neck

Clinical details:

Technique:

Axial T1 FLAIR, T2 FRFSE Sagittal T1 FLAIR Coronal T2 FRFSE Axial Diffusion b = 1000 sec/mm2

Findings:





MR – Angiography (Brain and Neck)

MR angiography of brain and neck is done by 3D TOF technique and correlated with axial, sagittal and coronal reconstructed images.

Both common carotid arteries show normal caliber and course. The bifurcation of both common carotid arteries is normal.

The course and caliber of extra and intracranial internal carotid artery on both sides are normal. There is no obvious stenosis of the internal carotid artery.

The external carotid arteries are normal in course and caliber.

Both vertebral arteries are of normal caliber and course.

Proximal portion of ACA and MCAs are normal.

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Basilar artery and PCA are normal in course and caliber.

No intraluminal thrombus seen. No vascular malformation noted.

Impression:

No significant abnormality noted in the brain parenchyma. No significant abnormality noted in the intracranial and neck

vessels.

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Age : Sex :


MRI Report – Brain With Venography

Clinical details:

Technique:


Findings:





MR – Venography (Brain)

MR venography of brain is done by 2D TOF technique and correlated with axial, sagittal and coronal reconstructed images.

The superior sagittal sinus and straight sinuses are showing normal flow signal.

The sigmoid, transverse sinuses and jugular bulbs are also showing normal flow signal.

Impression:

No significant abnormality is detected in the brain. No significant abnormality is detected in the MR venogram.

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Age : Sex :



Clinical details:

Seizures for evaluation.

Technique:

Axial T1 FLAIR, T2 FRFSE Sagittal T1 FLAIR Axial T2 FLAIR and Diffusion b = 1000 sec/mm2

Coronal T2 FRFSE, T1 SE and 3D SPGR Hippocampal volumetry

Findings:

The hippocampal gyri on both sides demonstrate normal signal intensity and volume. The amygdala is unremarkable.

Right hippocampus volume – grams

Left hippocampus volume – grams.

The parahippocampal gyri, forniceal pillars, anterior commissures and the mamillary bodies are normal. The superior, middle, inferior temporal gyri and the temporal lobe white matter are unremarkable.





Impression:

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No significant abnormality noted in the brain parenchyma.Patient Name : Patient ID:

Age : Sex :


MRI Report – Brain and Orbit

Clinical details:

Technique:

Brain: Axial FLAIR and DWI,

Orbit: Axial T1 SE and T2 FRFSE,

Coronal T1 SE and T2 FRFSE

Findings:

The posterior fossa shows normal cerebellum. The fourth ventricle shows normal size, shape and position. Both the C.P angles are clear.




Both globes appear normal in anatomical configuration and signal characteristics. The lens and vitreous appear normal. The extra ocular muscles are normal in thickness and signal characteristics.

Both optic nerves display normal course, caliber and signal characteristics.

Both lacrimal glands are normal. Retro orbital fat shows normal signal intensity.

Impression:

No significant abnormality noted in the brain parenchyma. No significant abnormality noted in the orbit.

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Age : Sex :


MRI Report – Brain and Orbit

Clinical details:

Technique:

Brain: Axial FLAIR and DWI, Orbit: Axial T1 SE and T2 FRFSE,

Coronal T1 SE and T2 FRFSE

Findings:

The posterior fossa shows normal cerebellum. The fourth ventricle shows normal size, shape and position. Both the C.P angles are clear.




Both globes appear normal in anatomical configuration and signal characteristics. The lens and vitreous appear normal. The extra ocular muscles are normal in thickness and signal characteristics.

Both optic nerves display normal course, caliber and signal characteristics.

Both lacrimal glands are normal. Retro orbital fat shows normal signal intensity.

MR venography (Brain)

MR venography of brain is done by 2D TOF technique and correlated with axial, sagittal and coronal reconstructed images.

The superior sagittal sinus and inferior sagittal sinuses are showing normal flow signal.

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The sigmoid and transverse sinus and jugular bulbs are also showing normal flow signal.

Impression:

No significant abnormality noted in the brain parenchyma. No significant abnormality noted in the orbit.


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Age : Sex :


MRI Report – Sella

Clinical details:

Technique:

Axial T2 FLAIR and Diffusion b = 1000 sec/mm2 - Brain Sagittal T1 & T2 - Sella Coronal T1 & T2 – Sella Axial, Sagittal & Coronal post contrast T1

Findings:

The size, position, and configuration of the sella are normal. The floor and walls of the sella are smooth and well-defined.

The pituitary is normal in size, shape, and position. The pituitary tissue shows normal signal characteristics both before and after contrast injection, with no circumscribed abnormalities of signal intensity.

The infundibulum is centered and of normal size.

The optic chiasm and suprasellar CSF spaces appear normal.

The cavernous sinus and imaged portions of the internal carotid artery and carotid siphon are unremarkable.

Rest of the neurocranium shows no abnormalities.

The sphenoid sinus is clear and pneumatized.

Impression:

The pituitary appears normal.


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Age : Sex :


MRI Report – Inner Ear / Brain and inner ear

Clinical details:

Technique:

Axial T2 FLAIR and Diffusion b = 1000 sec/mm2 - Brain Sagittal T1 FLAIR - Brain Axial T1 FLAIR, T2 FRFSE – Inner ear Coronal T2 FRFSE – Inner ear Axial 3D FIESTA – Inner ear Axial, Sagittal & Coronal post contrast T1

Findings:

The petrous pyramids appear normal and symmetrical. The internal acoustic meatus is of normal width, and its walls are smooth and sharply defined. The vestibulocochlear nerve on each side shows normal course and diameter. Contrast administration is not followed by abnormal rise of signal intensity within the nerve, especially its intrameatal portion.

The cochlea and semicircular canals appear normal. The mastoid air cells are clear and pneumatized. The tympanic cavity and external auditory canal are normal.

The cerebellopontine angle area shows normal configuration on each side.

The brain stem shows normal configuration and normal signal characteristics, with normal emergence of the nerves of the auditory canal.

The cerebellopontine angle cistern is clear and symmetrical on each side.

Rest of the neurocranium is unremarkable.

Impression:

The internal auditory canals appear normal.


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Age : Sex :


ENT PACKAGE – COMBINED CT / MR IMAGING

Clinical details:

Study protocol:

CT:

HRCT axial sections of the temporal bone were performed. Coronal reformatting was then obtained.

MR:

Axial T2 FLAIR & DWICoronal T2 FRFSEAxial 3D FIESTA

Findings:

Internal auditory canals:

The internal auditory canals are normal in size. The cochlear nerve and vestibular nerves appear normal in size. There is no abnormal mass in the nerves / canal. No abnormal vascular loop.

Inner ear:

The vestibule is normal in size and shows normal signals. The superior, posterior and lateral semicircular canals appear normal.The cochlea shows normal 2 ¾ turns. Normal fluid signals are visualized in the entire cochlea. The cochlear & vestibular aqueducts and the endolymphatic sac appear normal.

Middle ear:

No significant abnormality is visualized in the middle ear cavity or mastoid air cells.The facial nerve and geniculate ganglion appear normal bilaterally.Ossicles of the middle ear show normal configuration and alignment.

External ear:

Bony and cartilaginous parts of bilateral external ear canal appear normal.No evidence of narrowing or mass is visualized.

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Screening of brain and PNS:

Bilateral cerebral hemispheres, cerebellum and brainstem appear normal.Paranasal sinuses appear normal.

Remarks:

No abnormality noted in bilateral inner and middle ear structures. Bilateral cerebello-pontine angles with 7th-8th nerve complexes appear

normal. No demonstrable mass lesion.


Age : Sex :


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MR – Angiography (Brain and Neck)

Clinical details:

Technique:

Axial T2 FLAIR and Diffusion b = 1000 sec/mm2 - Brain MR angiography of brain and neck is done by 3D TOF technique and

correlated with axial, sagittal and coronal reconstructed images.

Findings:

Both common carotid arteries show normal caliber and course. The bifurcation of both common carotid arteries is normal.

The course and caliber of extra and intracranial internal carotid artery on both sides are normal. There is no obvious stenosis of the internal carotid artery.

The external carotid arteries are normal in course and caliber.

Both vertebral arteries are of normal caliber and course.

Proximal portion of ACA and MCAs are normal.

Basilar artery and PCA are normal in course and caliber.

No intraluminal thrombus seen. No vascular malformation noted.

Screening brain does not reveal any significant abnormality.

Impression:

No significant abnormality noted in the brain parenchyma. No significant abnormality noted in the intracranial and neck

vessels.


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Age : Sex :


MR – Angiography (Brain)

Clinical details:

Technique:

Axial T2 FLAIR and Diffusion b = 1000 sec/mm2 - Brain MR angiography of brain is done by 3D TOF technique and correlated

with axial, sagittal and coronal reconstructed images.

Findings:

The study reveals normal course and caliber of intracranial portion of internal carotid arteries. Proximal portion of ACA and MCA are normal. No intraluminal thrombus seen.

Basilar artery and PCA are normal. No vascular malformation noted.


Impression:

No significant abnormality is detected in the brain. No significant abnormality is detected in the circle of Willis.


Age : Sex :


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MR – Venography (Brain)

Clinical details:

Technique:

Axial T2 FLAIR and Diffusion b = 1000 sec/mm2 - Brain MR venography of brain is done by 2D TOF technique and correlated

with axial, sagittal and coronal reconstructed images.

The superior sagittal sinus and straight sinuses are showing normal flow signal.

The sigmoid, transverse sinuses and jugular bulbs are also showing normal flow signal.


Impression:

No significant abnormality is detected in the brain. No significant abnormality is detected in the MR venogram.


Age : Sex :


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MR – Spectroscopy (Brain)

Clinical details:

Technique:

Single voxel PROBE spectroscopy (PRESS) done with the sample including the lateral ventricle / periventricular white matter using 144 TE and 35 TE:

Findings:

NAA peak – Normal.

Cho peak – Normal.

NAA / Cr ratio – Normal.

Cho / Cr ratio – Normal.

Small bifid lactate / lipid peak noted at 1.3ppm on the long TE images. However no definite corresponding peak noted on the short TE images indicating no significant elevation.

No significant interval changes appreciated in the metabolite levels on post exercise sampling.

Impression:

No significant abnormality is detected on this study.


Age : Sex :


MRI Report – Brain with Perfusion

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Clinical details:

Technique:


Findings:





MR Perfusion (Brain)

MR perfusion was performed using EPI: 10ml of gadolinium was injected at the rate of 2.5 ml/sec. Post processing was performed in different regions of the brain.

Normal symmetrical perfusion of the brain was seen with no perfusion defect in any region of the brain.

----------------------------------------------------------------------------------------------------------CBF ml/100 gm CBV ml MTT Time to

Peak----------------------------------------------------------------------------------------------------------Right frontal

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Left frontal ----------------------------------------------------------------------------------------------------------Right parietal

Left parietal ----------------------------------------------------------------------------------------------------------Right temporal

Left temporal ----------------------------------------------------------------------------------------------------------Right occipital

Left occipital----------------------------------------------------------------------------------------------------------Right cerebellar

Left cerebellar----------------------------------------------------------------------------------------------------------Right thalamus

Left thalamus ----------------------------------------------------------------------------------------------------------

Impression:

No significant abnormality noted in the brain parenchyma. Normal MR perfusion brain study.


Age : Sex :


MRI Report – Cervical Soft Tissues

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Clinical details:

Technique:

Axial T1 spin echo, T2 fast spin echo, Axial T2 STIR Sagittal T1 spin echo, T2 spine echo Coronal T1, spin echo, T2 spin echo, T2 STIR

Findings:

The cervical soft tissues show normal configuration. The position of the cervical spine is normal.

The oral floor muscles are normally developed and bilaterally symmetrical. The spaces of the oral cavity and neck are clear and well defined.

Imaged portions of the parotid and submandibular glands show no abnormalities.

The pharynx and larynx show normal boundaries and normal wall thickness.

The thyroid gland shows reasonable symmetry and normal size. The thyroid lobes display normal internal structure.

Cervical vessels that are evaluable with MRI have normal appearance.

The muscular structures of the neck are normal.

There are no signs of cervical lymphadenopathy.

No abnormalities are seen in the cervical spinal cord or cervical plexus.

Impression:

The cervical soft tissues appear normal.


Age : Sex :


MRI Report – Paranasal Sinuses

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Clinical details:

Technique:

Coronal T1, T2 and STIR Axial T1, T2 Sagittal T2

Findings:

The frontal sinuses are normally developed, clear, and pneumatized with smooth wall contours.

The ethmoid cells show normal development and intact bony walls, with no defects on the orbital side. There are no areas of wall erosion or mucosal thickening.

The sphenoid sinus is normally developed and presents a coarse honeycomb structure. There are no fluid collections or mucosal swelling.

The maxillary sinuses are bilaterally symmetrical and have smooth walls of normal thickness.

The sinuses are clear and aerated with no foci of bone erosion or destruction.

The nasal septum is centered on the midline.

The nasal turbinates show a normal arrangement and normal signal intensity.

The nasal cavity, pharynx, and imaged parapharyngeal structures show no abnormalities.

Impression:

The paranasal sinuses appear normal.


Age : Sex :

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MR – Temporomandibular joint

Clinical details:

Study protocol:

Multiplanar imaging of the TM joint was performed using T1 and T2 weighted images in both open and close mouth views.

Findings:

The mandibular condyle has normal configuration and articulates with a normally shaped glenoid fossa.

The joint space is of normal width, and the articular surfaces have smooth, sharp borders. Cortical thickness and signal intensity of the bone marrow are normal.

The articular disk presents a hoodlike configuration on paracoronal images.It is dumbbell-shaped on parasagittal images. The posterior ligament is at approximately the 11 o’clock position relative to the circumference of the mandibular condyle. When the mouth is opened, the articular disk follows the movement of the mandibular condyle onto the articular tubercle.

Imaged portions of the paranasal sinuses are clear and pneumatized.

Imaged portions of the neurocranium show no abnormalities.

Remarks:

The temporomandibular joint appears normal.

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CHEST AND ABDOMEN


Age : Sex :


PROCEDURE: MR CHEST NON-CONTRAST

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CLINICAL INDICATION:

COMPARISON:

TECHNIQUE: Axial T1, Axial T2, Coronal T2, Coronal T2, Sagittal T2.

FINDINGS:

Lungs: Normally aerated and closely applied to the chest wall on all sides. No focal lesion.

Airways: Normal.

Pleura: No pleural effusion, thickening.

Thoracic aorta and supra-aortic vessels: Unremarkable.

Pulmonary arteries: Unremarkable.

Heart: Unremarkable.

Pericardium: Normal.

Mediastinal lymph nodes: Not enlarged.

Hilar lymph nodes: Not enlarged.

Axillary and supraclavicular regions: Normal.

Thoracic esophagus: Normal.

Thoracic spine: Normal.

Chest wall: Normal.

REMARKS:

The thoracic organs appear normal at MR.


Age : Sex :


PROCEDURE: MR CHEST CONTRAST

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COMPARISON:

TECHNIQUE: Axial T1, Axial T2, Coronal T2, Coronal T2, Sagittal T2, Axial, Sagittal and Coronal post contrast T1.

FINDINGS:

Lungs: Normally aerated and closely applied to the chest wall on all sides. No focal lesion.

Airways: Normal.

Pleura: No pleural effusion, thickening.

Thoracic aorta and supra-aortic vessels: Unremarkable.

Pulmonary arteries: Unremarkable.

Heart: Unremarkable.

Pericardium: Normal.

Mediastinal lymph nodes: Not enlarged.

Hilar lymph nodes: Not enlarged.

Axillary and supraclavicular regions: Normal.

Thoracic esophagus: Normal.

Thoracic spine: Normal.

Chest wall: Normal.

REMARKS:

The thoracic organs appear normal at MR.


Age : Sex :


PROCEDURE: MR WHOLE ABDOMEN AND PELVIS NON-CONTRAST

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COMPARISON: None.

PROTOCOL: Axial T1 & T2; Coronal T1 & T2; Sagittal T2.

FINDINGS:

Liver: Normal.

Biliary tree:

Intra and extra hepatic biliary radicals: Not dilated.

Common bile duct: Not dilated.

Gall bladder: Normal.

Pancreas: Normal.

Pancreatic duct: Not dilated.

Spleen: Normal.

Stomach and duodenum: Normal configuration.

Bowel: Normal configuration.

Aorta and IVC: Unremarkable.

Lymph nodes:

Mesenteric lymph nodes: Not enlarged.

Retroperitoneal lymph nodes: Not enlarged.

Peritoneal fluid: Absent.

Retroperitoneal spaces: Normal.

Adrenal glands: Normal

Kidneys: Normal

Collecting system including ureters: Normal; no dilatation.

Urinary bladder: Normal.

Prostate: Normal.

Ischiorectal fossae: Normal.

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Bones: Normal.

Abdominal wall muscles: Normal.

Skin and subcutaneous tissue: Normal.

REMARKS:

Normal study.


Age : Sex :


PROCEDURE: MR WHOLE ABDOMEN AND PELVIS CONTRAST

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COMPARISON: None.

PROTOCOL: Axial T1 & T2; Coronal T1 & T2; Sagittal T2; Axial, Sagittal and Coronal post contrast FS T1.

FINDINGS:

Liver: Normal.

Biliary tree:




Pancreas: Normal.


Spleen: Normal.




Lymph nodes:






Kidneys: Normal



Prostate: Normal.

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Bones: Normal.



REMARKS:

Normal study.


Age : Sex :


PROCEDURE: MR WHOLE ABDOMEN AND PELVIS NON-CONTRAST


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COMPARISON: None.


FINDINGS:

Liver: Normal.

Biliary tree:




Pancreas: Normal.


Spleen: Normal.




Lymph nodes:





Adrenal glands: Normal.

Kidneys: Normal.



Uterus / Ovaries: Normal.

Adnexa: Normal; no mass seen.

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Parametrial tissue planes: Normal.


Bones: Normal.



REMARKS:

Normal study.


Age : Sex :


PROCEDURE: MR WHOLE ABDOMEN AND PELVIS CONTRAST


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COMPARISON: None.

PROTOCOL: Axial T1 & T2; Coronal T1 & T2; Sagittal T2; Axial, Coronal & Sagittal Post Contrast FS T1.

FINDINGS:

Liver: Normal.

Biliary tree:




Pancreas: Normal.


Spleen: Normal.




Lymph nodes:





Adrenal glands: Normal.

Kidneys: Normal.



Uterus / Ovaries: Normal.

Adnexa: Normal; no mass seen.

42



Bones: Normal.



REMARKS:

Normal study.


Age : Sex :


PROCEDURE: MR PELVIS NON-CONTRAST

43


COMPARISON:


FINDINGS:


Seminal vesicles: Normal.

Prostate: Normal.

Periprostatic tissue planes: Normal.

Lymph nodes: Not enlarged.


Rectum and pararectal tissue planes: Normal.

Other imaged bowel structures: Normal.


Bones: Normal.



REMARKS:

The pelvic organs appear normal at MR.


Age : Sex :


44

PROCEDURE: MR PELVIS CONTRAST


COMPARISON:


FINDINGS:


Seminal vesicles: Normal.

Prostate: Normal.

Periprostatic tissue planes: Normal.

Lymph nodes: Not enlarged.


Rectum and pararectal tissue planes: Normal.

Other imaged bowel structures: Normal.


Bones: Normal.



REMARKS:

The pelvic organs appear normal at MR.

45


Age : Sex :


PROCEDURE: MAGNETIC RESONANCE ENTEROCLYSIS


COMPARISON: None.

PROTOCOL: Axial T2 FRFSE FS, Coronal T2 SSFSE; 3D MR enteroclysis, 2D FIESTA FS, T1 SPGR axial.

FINDINGS:

The morphologic features of the jejunal and ileal loops are as follows:

Jejunum ileum

Approximate diameter cm cm

Wall thickness mm mm

Mucosal folds Not thickened Not thickened

The morphology of the ileo-caecal junction is as follows:

Location Right iliac fossa

Wall thickness mm

Peri-ileal fat planes Normal

Pathology:

Obstruction: Present / absent; If present mention the level of obstruction and the transition zone.

Strictures: Present / absent; If present, number and extent; also mention if associated obstruction is present or not.

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Wall thickening: Present / absent; If present mention the average thickness and the extent.

Fistula: Present / absent.

Sinus tracts: Present / absent.

Any significant extra-intestinal finding: None; No significant fat stranding, tissue thickening / inflammation or lymph nodes enlargement.

Other abdominal organs: Normal.

REMARKS:

Normal MR enteroclysis study.


Age : Sex :


PROCEDURE: MAGNETIC RESONANCE CHOLANGIOPANCREATICOGRAM


47

COMPARISON: None.

PROTOCOL: Axial T2 FRFSE FS, Axial T2 SSFSE; 3D MRCP, 2D FIESTA FS axial and coronal, DWI axial, T1 SPGR axial.

FINDINGS:

Liver: Normal.

Biliary tree:

Intra hepatic biliary radicals: Not dilated.

Common bile duct: Not dilated

Gall bladder: Normal

Cystic duct: Not dilated.

Pancreas: Normal


Spleen: Normal


Bowel in the sections studied: Normal configuration.


Lymph nodes:






Kidneys: Normal

Bones: Normal.

Abdominal wall muscles: Normal

Skin and subcutaneous tissue: Normal

REMARKS:

48

Normal study.


Age : Sex :


PROCEDURE: MR KUB NON-CONTRAST INCLUDING STATIC MR UROGRAPHY AND 3D INHANCE


49

COMPARISON: None.

PROTOCOL: Axial T1 & T2; Coronal T1 & T2; Axial FIESTA, Heavily T2 weighted urogram sequence, 3D INHANCE.

FINDINGS:

Right kidney: Normal.

Right collecting system including ureter: Normal.

Left kidney: Normal.

Left collecting system including ureter: Normal.

Renal arteries: Normal.

Right adrenal: Normal.

Left adrenal: Normal.

Bowel in the sections studied:

Aorta and IVC:

Lymph nodes:




Retroperitoneal space: Normal.


Prostate: Normal.

Ischiorectal fossae: Normal

Bones: Normal.



REMARKS:

50


Age : Sex :


PROCEDURE: MR KUB NON-CONTRAST INCLUDING STATIC MR UROGRAPHY AND 3D INHANCE


51

COMPARISON: None.

PROTOCOL: Axial T1 & T2; Coronal T1 & T2; Axial FIESTA, Heavily T2 weighted urogram sequence, 3D INHANCE.

FINDINGS:

Right kidney: Normal.

Right collecting system including ureter: Normal.

Left kidney: Normal.

Left collecting system including ureter: Normal.

Renal arteries: Normal.

Right adrenal: Normal.

Left adrenal: Normal.

Bowel in the sections studied:

Aorta and IVC:

Lymph nodes:




Retroperitoneal space: Normal.


Uterus: Normal.


Ovaries: Normal.

Adnexa: No mass seen.

Ischiorectal fossae: Normal

Bones: Normal.


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REMARKS:


Age : Sex :


PROCEDURE: MR BREAST WITH DYNAMIC CONTRAST AND SPECTROSCOPY


COMPARISON: None.

53

PROTOCOL: Axial and coronal T2 STIR; Axial T2 non fat sat; Sagittal SPAIR; post contrast 3D FLASH Dyna.

FINDINGS:

Right breast:

Back ground enhancement: None / Minimal / Mild / Moderate / Marked.

The study reveals mass in the right breast. Its morphology, location, dimensions and signal / enhancement characteristics are as mentioned below:

Lesion morphology:

Size -

T1 signal Hypo / Hyper intense

T2 signal Hypo / Hyperintense

Location -

Shape Round / Oval / Lobulated / irregular

Margins Smooth / Spiculated / Irregular

General mass internal enhancement Homogeneous / Heterogeneous

Specific internal enhancement pattern

Dark internal septation / Enhancing septation / Central enhancement / Rim

enhancement

Lesion kinetics evaluation:

Early phase Slow / Medium / RapidDegree of enhancement Less intense / IntenseDelayed phase Persistent / Plateau / Wash-out

Spectroscopic signature:

Adjacent structures status:

Skin NormalChest wall Not involved

Axillary lymph nodes:

Left breast:

54

Back ground enhancement: None / Minimal / Mild / Moderate / Marked.

No abnormal mass lesion is seen in the left breast.

The skin and chest wall appear normal.

No axillary lymphadenopathy is evident.

REMARKS:

Mass in the right breast. Its morphology, dimensions, signal / enhancement characteristics and spectroscopic signature are as mentioned above.

Normal left breast.


Age : Sex :


PROCEDURE: Dynamic MR defecography


COMPARISON: None.

55

PROTOCOL: Axial, Sagittal, Coronal T2; Dynamic FSPGR & FIESTA sequences in sagittal planes. Images obtained in rest, squeezing, maximum straining and during evacuation.

FINDINGS:

Pelvic floor muscles: Normal configuration. No obvious defect / tears demonstrated on this study.

Pelvic fascia: Normal configuration; no obvious defect is demonstrated on this study.

Distance of anterior, middle and posterior compartments from the pubococcygeal line (PC line):

Rest (in cm) Maximal strain (in cm)

Bladder neck (above PC line) (above PC line)

Cervix- vaginal vault (above PC line) (above PC line)

Ano-rectal junction (above PC line) (above PC line)

Anorectal angle (ARA):

Anorectal angle

Rest degrees

Squeezing degrees

Defecation degrees

Percentage change in ARA between rest and squeezing: degrees.

Percentage change in ARA between rest and defecation: degrees.

H, M lines and angle of levator plate:

Rest Defecation

Length of H line cm cm

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Length of M line cm cm

Angulation of levator plate

Nearly parallel to PC line Nearly parallel to PC line

Rectocele: No anterior / posterior / lateral rectocele.

Rectal invagination: Absent.

Enterocele: Absent.

REMARKS:

Normal study.


Age : Sex :


MR – RENAL ANGIO

Clinical details:

57

Study protocol:

Axial FRFSE. Coronal SSFSE. Contrast MRA - Coronal oblique 3D spoiled gradient-echo sequence

with arterial, venous & delayed phase imaging.

Findings:

Arterial assessment:

Single renal arteries are seen on both sides.

The main renal arteries and their lobar and segmental branches are normal in caliber.

There is no evidence of renal artery aneurysm or arteriovenous communications.

Venous assessment:

Single veins are seen on either side.

No evidence of thrombus within.

The IVC is normal.

Renal Parenchymal assessment:

Both kidneys appear normal in size and position, with normal width and intensity of renal parenchyma.

Contrast – enhanced scans show symmetrical contrast excretion into the renal pelves with no filling defects.

There is no obvious evidence of collection in the renal parenchyma.

No global or regional nephrographic abnormalities could be detected.

The perirenal and pararenal spaces are unremarkable.

Assessment of excretory system;

The renal pelvis is normal and there is no obstruction of urinary drainage.

Delayed sections taken 5 minutes after IV contrast injection reveal adequate excretion by both the kidneys.

The ureters are single on both sides and appear normal.

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No stricture or dilatation is seen.

The urinary bladder is normal with no evidence of intravesical mass or calculus.

Assessment of aorta and its other major branches:

The suprarenal, renal and infrarenal segments of the abdominal aorta are normal in course and caliber.

Adrenal glands:

Both adrenal glands present normal size and position with normally developed crura. There is no evidence of a mass and no circumscribed expansion.

Remarks:

Normal MRA study of renal arteries.


Age : Sex :


MR – RENAL ANGIO

Clinical details:

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Technique:


with arterial, venous & delayed phase imaging.

Findings:

Both kidneys appear normal in size and position, with normal width and intensity of renal parenchyma.

The renal pelvis is normal and there is no obstruction of urinary drainage.

The right kidney extends from the level of the L1 to L3 vertebrae.

The left kidney extends from the level of the D12 to the L3 vertebrae.

Contrast – enhanced scans show symmetrical contrast excretion into the renal pelves with no filling defects.

The perirenal and pararenal spaces are unremarkable.

The ureters are single on both sides and appear normal.

No stricture or dilatation is seen.

The measurements of the renal vessels are as follows:

RRA RRV LRA LRVNumber

Level

Length (cms) upto hilum

60

Upto first branch

Diameter at ostium (mm)

The urinary bladder is well distended with smooth contour. No intravesical mass or calculus is detected.

Remarks:

Single renal arteries on either side. Single draining renal veins on either side. Single ureters on either side. Normal kidneys and bladder.


Age : Sex :


MR – ABDOMINAL AORTOGRAM / ABDOMINAL ANGIOGRAM & VENOGRAM

Clinical details:

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Study protocol:


with arterial & venous phase imaging.

Findings:

The abdominal aorta is normal in course and caliber.

There is no evidence of aortic aneurysm / rupture / dissection.

No flow limiting stenosis is seen.

The celiac artery, superior mesenteric artery and its branches are normal.

Single renal arteries are seen on either side. No stenosis is evident.

The inferior mesenteric artery is normal.

The aortic bifurcation and iliacs to the extent visualized are normal sized.

The hepatic, renal veins and IVC are normal.

The spleno-portal axis is normal with no thrombus.

No significant non-vascular finding is evident.

Remarks:

Normal study.


Age : Sex :


MR – ANGIOGRAM STUDY OF THE THORACIC AORTA

Clinical details:

62

Study protocol:

Axial FRFSE. Coronal FIESTA. Contrast MRA - Coronal oblique 3D spoiled gradient-echo sequence.

Findings:

The thoracic aorta is normal in course and caliber.



The arch vessels are within normal limits to the extent visualized.

The pulmonary arteries and veins are grossly normal.

No significant non-vascular finding is evident.

Remarks:

Normal study.


Age : Sex :


MR – ANGIOGRAM STUDY OF THE AORTA AND ITS BRANCHES

Clinical details:

63

Study protocol:

Axial FRFSE. Coronal FIESTA. Contrast MRA - Coronal oblique 3D spoiled gradient-echo sequence.

Findings:

The thoracic and abdominal aorta is normal in course and caliber.



The arch vessels are within normal limits to the extent visualized.

The celiac artery, superior mesenteric artery and its branches are normal.

Single renal arteries are seen on either side. No stenosis is evident.

The inferior mesenteric artery is normal.

No significant vascular finding is evident.

Remarks:

Normal study.

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SPINE & EXTREMITIES


Age : Sex :


MR - CRANIOVERTEBRAL JUNCTION

Clinical details:

65

Study protocol:

Multi-planar, multi-sequence imaging of the cervico-vertebral junction was

performed.

Findings:

The bilateral atlanto-occipital and atlanto-axial joints are within normal limits.

The atlanto-dental interval is normal.

No evidence of basilar invagination / impression / platybasia.

The alignment, stature and marrow signal intensity of the visualized upper cervical spine is normal.

The prevertebral soft tissues are unremarkable.

Impression:

Unremarkable CV Junction.


Age : Sex :


MRI Report – Cervical Spine

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Clinical details:

Technique:

Axial T1 and T2 Field Echo Sagittal T1 and T2 Fast Spin Echo Coronal T2 STIR Cervical myelogram

Findings:

The study shows the cervical spines well and they display normal signal characters in all sequences. The cervical vertebral bodies, pedicles, laminae and spinous process show normal alignment.

The intervertebral discs show normal signal intensity with normal disc height. No evidence of any abnormal disc prolapse made out.

The cervical cord is well displayed and it is of normal size. No evidence of any abnormal signal intensity lesions seen within the cord. The cervicomedullary junction is normal.

The cerebrospinal fluid displays normal signal intensity in all sequences and there is no evidence of any mass lesion seen in or around the CSF pathway.

The atlanto axial and atlanto occipital junction is normal.

The pre and paraspinal regions do not show any abnormal soft tissue lesion.

The anteroposterior spinal canal dimensions at various levels are as follows:

C2C3C4C5C6C7

Screening dorsal spine was performed using sagittal T2 FRFSE:

Screening lumbar spine was performed using sagittal T2 FRFSE:

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Impression:

No evidence of any significant spinal or cord pathology made out.


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Age : Sex :


MRI Report – Dorsal Spine

Technique:

Axial T1 Spin Echo And T2 Fast Spin Echo Sagittal T1 Spin Echo And T2 Fast Spin Echo Coronal T2 STIR

Findings:

The study shows normal signal intensity and anatomical configuration of dorsal segment of spinal cord.

The dorsal vertebral bodies, pedicles, laminae and spinous process show normal alignment and marrow signal characteristics.

The intervertebral discs show normal signal intensity and MR features. No evidence of any disc prolapse made out.

The cerebro spinal fluid displays normal signal intensity in all sequences and there is no evidence of any filling defect within it.

The paraspinal regions do not show any abnormal soft tissue lesion.

Screening cervical spine was performed using sagittal T2 FRFSE:

Screening lumbar spine was performed using sagittal T2 FRFSE:

Impression:



Age : Sex :


MRI Report – Lumbar Spine

Technique:

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Axial T1 Spin Echo and T2 Fast Spin Echo Sagittal T1 Spin Echo and T2 Fast Spin Echo Coronal T2 STIR Lumbar myelogram

Findings:

The study shows normal MR morphology and alignment of the vertebral bodies, pedicles, laminae and spinous processes. The vertebral bodies marrow signal intensity is well maintained in both sequences.

The intervertebral discs show normal signal intensity with normal disc height. No evidence of any disc prolapse made out.

The conus medullaris well visualized and is of normal size displaying normal signal characters. Roots of cauda equina are normal. The CSF subarachnoid space displays normal signal intensity variations. No evidence of any mass lesion seen within thecal sac.


The SI joints are normal.


L1L2L3L4L5

Screening cervical spine was performed using sagittal T2 FRFSE:

Screening dorsal spine was performed using sagittal T2 FRFSE:

Impression:

70

Normal study.


Age : Sex :


MRI Report – Whole Spine

Clinical details:

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Technique:

Axial T1 Spin Echo and T2 Fast Spin Echo Sagittal T1 Spin Echo and T2 Fast Spin Echo Coronal STIR Cervical & Lumbar myelogram

Findings:

The study shows the spines well and they display normal signal characters in all sequences. The vertebral bodies, pedicles, laminae and spinous process show normal alignment.

Cervical:

No significant abnormality.

Dorsal:


Lumbar:


The intervertebral discs show normal signal intensity with normal disc height. No evidence of any abnormal disc prolapse made out at other levels.

The cord is well displayed and it is of normal size. No evidence of any abnormal signal intensity lesions seen within the cord. The cervicomedullary junction is normal.

The cerebro spinal fluid displays normal signal intensity in all sequences and there is no evidence of any mass lesion seen in or around the CSF pathway.

The conus medullaris well visualized and is of normal size displaying normal signal characters. Roots of cauda equina are normal. The CSF subarachnoid space displays normal signal intensity variations. No evidence of any mass lesion seen within thecal sac.

The atlanto axial and atlanto occipital junction is normal.


The SI joints are normal.


C2

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C3C4C5C6C7L1L2L3L4L5

Impression:



Age : Sex :


MR – Shoulder Joint

Clinical details:

Technique

73

Axial GRE, T1, PD FS Coronal PD FS, T2 Sagittal PD FS

Findings:

The humeral head has normal configuration and articulates properly with the normally developed glenoid. The articular surfaces are smooth and show normal cortical thickness. The width of the joint space is normal. The bone marrow displays homogeneous, fat-equivalent signal intensity.

The glenoid labrum is intact on all sides.

The acromioclavicular joint has normal configuration, with no hypertrophy. The subacromial fat is intact.

The muscles comprising the rotator cuff show normal course and configuration. In particular, the supraspinatus muscle is normal in its position, width, and signal characteristics and shows a normal musculotendinous junction.

The intact biceps tendon appears normal and occupies a normal position in the bicipital groove.

The other muscles that cover the shoulder joint appear normal, as do imaged portions of the lungs and soft tissues.

The neurovascular bundle is normal.

The skin and subcutaneous tissue are normal.

Impression:

The shoulder joint appears normal.


Age : Sex :


MR – Elbow Joint

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Clinical details:

Technique:

Axial T1 SE and PD FS Sagittal T1 SE and PD FS Coronal PD FS

Findings:

The elbow joint shows normal configuration with normal articulation of the bone ends. The articular surfaces are smooth and congruent, especially in the radiohumeral and ulnohumeral joints, with no discontinuities. There are no osteophytes or subchondral joint changes.

The joint spaces are of normal width. The olecranon fossa is clear, and there are no intra-articular loose bodies.

The cortex of the tubular bones is of normal thickness. The bone-marrow signal is normal.

Imaged ligamentous structures appear normal, particularly the annular ligament.

The ulnar, radial, and median nerves display a normal course and diameter.

The imaged muscles show no abnormalities.


Impression:

The elbow joint appears normal.


Age : Sex :


MRI – Wrist And Hand

Clinical details:

Technique:

75

Axial - T1 spin echo and PD fat sat Coronal - T1 spin echo, GRE and PD fat sat Sagittal - T1 spin echo and PD fat sat.

Findings:

The study demonstrates normal marrow signal of ulna and radius as well as the carpal bones.

The inferior radio-ulnar joint, radio-carpal, inter-carpal and carpo-metacarpal joints appear normal.

There is no joint erosion or joint effusion.

The TFCC has normal integrity and signal.

The carpal tunnel structures viz, flexor tendons as well as median nerve appear normal. There is no synovial effusion.

The extensor tendons appear unremarkable.

The thenar and hypothenar group of muscles appear normal

All the visualized palmar spaces are clear. There is no abnormal inflammatory process demonstrated.


Impression:

The wrist and hand appear normal.


Age : Sex :


CT – ACROMIO-CLAVICULAR JOINT

Clinical details:

Study protocol:

76

Serial axial high resolution scans of the AC joint were studied. Multiplanar reformations and 3D reconstructions of the region were then performed.

Findings:

The study shows normal configuration and density of the clavicles.

No mass is seen in the lateral end of the right clavicle or the acromion process.

The acromio-clavicular joint is normal.

The humeral head and the glenoid appear normal.

The muscles around the shoulder are normal.

No calcification is seen in any of the tendons.

The sterno-clavicular joints are normal.

Remarks:



Age : Sex :


MRI Report – Both Hip Joints

Clinical details:

77

Technique:

Axial T1 SE & T2 FSE Sagittal PD FS Coronal T1 SE, PD FS and T2 STIR

Findings:

The study shows both hip joint normal in size. Joint space is well maintained. The articular surface is smooth. Articular cartilage is normal.

The femoral heads on both sides show normal MR morphology and signal intensity. Femoral shafts are normal.

Acetabulum is normal.

The pelvic bones are normal.

The pelvic organs do not show any abnormality.

The muscle planes are well maintained.

The subcutaneous tissue and skin appear normal.

Impression:

No significant abnormality noted in both hip joints.


Age : Sex :


MRI Report - Knee

Clinical details:

78

Technique:

Axial PD FS Sagittal T1 SE, PD FS and T2 * Coronal PD FS, T1 SE

Findings:

The knee joint space is normal. The lower end of femur, upper ends of tibia and fibula display normal marrow signal intensity.

Both the menisci are well visualized and appear to be normal.

The anterior and posterior cruciate ligaments appear normal.

Medial and lateral collateral ligament appear normal.

No evidence of meniscal tear or degeneration is noted.

There is no evidence of any ligamental injury.

The quadriceps and patellar tendons are normal.

The patellar retinacula are normal.

No evidence of joint effusion is seen.

The periarticular musculature is normal.


Impression:

No evidence of meniscal tear or ligamental injury.


Age : Sex :


MRI – Ankle

Clinical details:

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Technique:

Coronal T1W SE, PD FS Axial T1W SE, PD FS Sagittal PD FS, T2 STIR

Findings:

The bones comprising the ankle joint show normal position and configuration, with normal development of the ankle mortise.

The bone marrow signal, trabecular pattern, and epiphyseal lines are all normal.

The joint space is of normal width. The cortex shows normal thickness and smooth contours, especially along the tibial and talar articular surfaces. There are no subchondral signal changes and no osteophytes.

The lateral and medial ligaments are normal in their course, width, and signal characteristics.

The talocalcaneal and talonavicular joints appear normal. The interosseous ligament between the talus and calcaneum is intact. The Achilles tendon is normal in its course, width, and signal characteristics, and the preachilles fat is clear. The tendons and plantar aponeurosis are unremarkable.

The soft tissues show no abnormalities.

Impression:

The ankle joint and subtalar joint appear normal.


Age : Sex :


MR – Foot

Clinical details:

80

Technique:

Coronal T1W SE, PD FS Axial T1W SE, PD FS Sagittal PD FS, T2 STIR

Findings:

The study shows normal configuration and marrow signal intensity of the tarsals, metatarsals and phalanges.

The joints are normal.

The muscles and inter-muscular planes are normal.

The skin and subcutaneous tissue including the fascia appear normal.

Remarks:



Age : Sex :


PROCEDURE: CT LOWER LIMBS ANGIOGRAM


COMPARISON:

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PROTOCOL: Axial sections were obtained through the lower limbs during dynamic intravenous administration of Iohexol 350.

IMMEDIATE IV CONTRAST REACTIONS: No.

FINDINGS: The study reveals normal course and caliber of the abdominal aorta and its major branches. No flow limiting stenosis is seen in any of these vessels. No aneurysm / dissection are evident.

No end organs infarctions are seen.

Artery Wall thickenin

g

Wall irregularity

Wall calcification

s

Plaque / thrombus

Stenosis

Celiac axis - - - - -

Hepatic A - - - - -

Splenic A - - - - -

SMA - - - - -

Right renal A

- - - - -

Left renal A - - - - -

IMA - - - - -

The status of the lower limbs arteries is as mentioned below.

Right side:

Artery Wall thickening

Wall irregularit

y

Wall calcification

s

Plaque / thrombu

s

Stenosis

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CIA

EIA

IIA

CFA

PFA

Proximal SFA

Mid SFA

Distal SFA

Popliteal

TP trunk

Proximal PTA

Distal PTA

Peroneal

Proximal ATA

Distal ATA

Dorsalis pedis

Left side:

Artery Wall thickening

Wall irregularit

y

Wall calcification

s

Plaque / thrombu

s

Stenosis

CIA

EIA

IIA

CFA

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PFA

Proximal SFA

Mid SFA

Distal SFA

Popliteal

TP trunk

Proximal PTA

Distal PTA

Peroneal

Proximal ATA

Distal ATA

Dorsalis pedis

REMARKS:

Normal CT angiogram study of the infra-renal abdominal aorta and the lower limbs arteries.

PROCEDURE: CT UPPER LIMBS ANGIOGRAM


COMPARISON:

PROTOCOL: Axial sections were obtained through the upper limbs during dynamic intravenous administration of Iohexol 300.

IMMEDIATE IV CONTRAST REACTIONS: No.

FINDINGS:

Aortic arch: Normal / no arch anomalies.

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Supra-aortic vessels:

RIGHT LEFT

Brachiocephalic trunk -

Common carotid Normal Normal

Subclavian Normal Normal

Upper limbs vessels:

RIGHT LEFT

Axillary Normal Normal

Brachial Normal Normal

Ulnar Normal Normal

Radial Normal Normal

Inter-osseous Normal Normal

Palmar arch Normal Normal

REMARKS:

Normal CT angiogram study of the aortic arch, supra-aortic vessels and the upper limbs arteries.

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MRI My Medall Reports

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