Example MRI Report 2
MRI Consultation Report
Name: Ina Gateway
Referring Service, Clinic or Floor: _______________________
- [_] Ambulatory
- [_] Bed
- [_] O2
- [_] OR
- [_] Wheelchair
- [_] Portable
- [_] Isolation
Procedures Requested: MRI Abdomen
Primary Diagnosis (required): _______________________
Outpatient ICD-9 Code: _______________________
Clinical History Pertinent to this Radiology Consultation (required)
(Include precautions: diabetes, allergies, etc.) Serum Creatinine or BUN for CT, IVP, Angio
Requesting Physician Name: _______________________
Requesting Physician Phone: _______________________
Attending Physician Name: _______________________
Attending Physician Phone: _______________________
Report will be sent to Physician's Office, Clinic, Floor and Medical Records
Address (Street, City, State): _______________________
Date and Time Procedure Completed: _______________________
Technologist I.D.: _______________________
Part Exam: _______________________
Contrast Supplies and Comments: _______________________
Radiology Consultation Report
Name: Ina Gateway
Proc: MRI of abdomen (03/20/91)
MRI was performed on a GE Sigma 1.5 Tesla MRI machine. Axial images with TR of 500 and TE 15, slice thickness of 5 mm were taken from the dome of the diaphragm to the iliac wings. Also taken were axial images with TR 2000 and TE 30/80 with 5-mm thick sections. Coronal sections with TR 500 and TE 15. In addition, axial sections with TR 10 and TE 2.9 with 5-mm thick sections were also included.
- A left suprarenal perirenal mass with mixed intermediate signal on T1 and T2 with areas of peripheral high signal on T1 and T2. The mass measures approximately 2.5 x 2 x 2 cm. This most likely represents a neuroblastoma with hemorrhage in the left adrenal.
- No evidence of liver or spleen involvement or metastases.
- The mass is displacing the left kidney posteriorly, however.
- No identified skin involvement.
John Doe, M.D.