MRA OF THE CAROTID ARTERIES
CLINICAL HISTORY: Headache, neck pain and jaw pain.
TECHNIQUE AND FINDINGS: Multiple time-of-flight images were obtained through both carotid arteries. Images through the right side show wide patency. No indication of any stenosis. No findings to suggest dissection. Images through the left side bifurcation also show wide patency, again without evidence of stenosis or dissection. The vertebral arteries show relatively symmetric appearance with no particular dominance.
IMPRESSION: Unremarkable examination of each carotid artery without findings of any specific stenosis or dissection. Normal appearance through the vertebral arteries as well without particular dominance.
MRI SCAN OF THE HEAD WITHOUT CONTRAST
TECHNIQUE AND FINDINGS: Multiplanar sagittal and axial images were obtained through the brain without contrast administration. Sagittal images show normal level of the craniocervical junction. The ventricles and sulci are normal in appearance. No clear indication of any specific midline shift. No mass effect demonstrated. Basal cisterns are still well visualized. Structures of the posterior fossa are unremarkable.
IMPRESSION: Unremarkable intracranial examination. No findings of any contained mass or midline shift. Normal appearance of the ventricles and sulci. Structures of the posterior fossa are unremarkable as well.
MRA OF THE CAROTID ARTERIES WITH CONTRAST:
INDICATION FOR STUDY: Status post CVA.
TECHNIQUE AND FINDINGS: Raw data and composite images were available. A 2D time-of-flight study was performed. The left vertebral artery is much larger than that of the right and clearly dominant. There is some narrowing of the right vertebral artery compared to the left. The left internal carotid artery is slightly narrowed compared with that of the right suggestive of some mild to moderate stenosis. There is no severe stenosis. There is no alteration. The left ICA/ECA complex is slightly splayed compared with that of the right. There is no obvious mass seen on the raw data. This may be congenital anomaly or some tortuosity.
IMPRESSION:
1. The left vertebral artery is dominant compared with that of the right, as the right is more narrowed.
2. The internal carotid arteries are minimally narrowed more in the left than the right. This is suggestive of some mild to moderate stenosis. There is no severe narrowing. There is no alteration.
3. The left internal carotid artery/external carotid artery complex is slightly splayed compared with that on the right. We do not see a discrete mass on the raw data. This may be some atherosclerosis, some tortuosity, or congenital asymmetry.
4. If clinically warranted, carotid Doppler ultrasound could be obtained to confirm the mild to moderate stenosis in the carotid artery system, more in the left than the right.
MRI OF THE HEAD WITH CONTRAST ONLY:
This is a followup from the MRI of the head without contrast dated MM/DD/YYYY.
INDICATION FOR STUDY: Questionable neurofibromatosis.
TECHNIQUE AND FINDINGS: Images were taken in the coronal and axial planes through the posterior fossa and the orbital regions following contrast administration.
There is no evidence of an acoustic neuroma or other pathology in the IAC or CP angle regions.
In the orbital areas, we see no evidence of asymmetric uptake within the optic nerves to indicate a glioma or other pathology. There is no abnormal uptake seen with contrast throughout this study.
IMPRESSION: No abnormal findings with contrast to indicate neurofibromatosis or associated tumors in the area of the orbital regions or the posterior fossa. Also, images taken through the entire head without any contrast administration showed no remarkable pathology as well.
MRI OF THE HEAD WITHOUT CONTRAST:
Multiplanar images were obtained without contrast. The ventricles are symmetric. There is no mass, mass effect, or shift of midline structures. The region of the pituitary gland is unremarkable. The IACs are symmetric. The recti muscles are symmetric and unremarkable. Optic nerves are unremarkable. There is some incidental right maxillary mucosal thickening versus polyp versus mucus retention cyst. Craniocervical junction is within normal limits.
IMPRESSION:
1. Incidental ovoid area of high signal in the right maxillary sinus on T2 weighted sequences. This could be a mucus retention cyst, polyp, focal mucosal thickening.
2. No other focal lesion is identified. There is no mass or mass effect. The recti muscles are symmetric and unremarkable.
CLINICAL HISTORY: Headache, neck pain and jaw pain.
TECHNIQUE AND FINDINGS: Multiple time-of-flight images were obtained through both carotid arteries. Images through the right side show wide patency. No indication of any stenosis. No findings to suggest dissection. Images through the left side bifurcation also show wide patency, again without evidence of stenosis or dissection. The vertebral arteries show relatively symmetric appearance with no particular dominance.
IMPRESSION: Unremarkable examination of each carotid artery without findings of any specific stenosis or dissection. Normal appearance through the vertebral arteries as well without particular dominance.
MRI SCAN OF THE HEAD WITHOUT CONTRAST
TECHNIQUE AND FINDINGS: Multiplanar sagittal and axial images were obtained through the brain without contrast administration. Sagittal images show normal level of the craniocervical junction. The ventricles and sulci are normal in appearance. No clear indication of any specific midline shift. No mass effect demonstrated. Basal cisterns are still well visualized. Structures of the posterior fossa are unremarkable.
IMPRESSION: Unremarkable intracranial examination. No findings of any contained mass or midline shift. Normal appearance of the ventricles and sulci. Structures of the posterior fossa are unremarkable as well.
MRA OF THE CAROTID ARTERIES WITH CONTRAST:
INDICATION FOR STUDY: Status post CVA.
TECHNIQUE AND FINDINGS: Raw data and composite images were available. A 2D time-of-flight study was performed. The left vertebral artery is much larger than that of the right and clearly dominant. There is some narrowing of the right vertebral artery compared to the left. The left internal carotid artery is slightly narrowed compared with that of the right suggestive of some mild to moderate stenosis. There is no severe stenosis. There is no alteration. The left ICA/ECA complex is slightly splayed compared with that of the right. There is no obvious mass seen on the raw data. This may be congenital anomaly or some tortuosity.
IMPRESSION:
1. The left vertebral artery is dominant compared with that of the right, as the right is more narrowed.
2. The internal carotid arteries are minimally narrowed more in the left than the right. This is suggestive of some mild to moderate stenosis. There is no severe narrowing. There is no alteration.
3. The left internal carotid artery/external carotid artery complex is slightly splayed compared with that on the right. We do not see a discrete mass on the raw data. This may be some atherosclerosis, some tortuosity, or congenital asymmetry.
4. If clinically warranted, carotid Doppler ultrasound could be obtained to confirm the mild to moderate stenosis in the carotid artery system, more in the left than the right.
MRI OF THE HEAD WITH CONTRAST ONLY:
This is a followup from the MRI of the head without contrast dated MM/DD/YYYY.
INDICATION FOR STUDY: Questionable neurofibromatosis.
TECHNIQUE AND FINDINGS: Images were taken in the coronal and axial planes through the posterior fossa and the orbital regions following contrast administration.
There is no evidence of an acoustic neuroma or other pathology in the IAC or CP angle regions.
In the orbital areas, we see no evidence of asymmetric uptake within the optic nerves to indicate a glioma or other pathology. There is no abnormal uptake seen with contrast throughout this study.
IMPRESSION: No abnormal findings with contrast to indicate neurofibromatosis or associated tumors in the area of the orbital regions or the posterior fossa. Also, images taken through the entire head without any contrast administration showed no remarkable pathology as well.
MRI OF THE HEAD WITHOUT CONTRAST:
Multiplanar images were obtained without contrast. The ventricles are symmetric. There is no mass, mass effect, or shift of midline structures. The region of the pituitary gland is unremarkable. The IACs are symmetric. The recti muscles are symmetric and unremarkable. Optic nerves are unremarkable. There is some incidental right maxillary mucosal thickening versus polyp versus mucus retention cyst. Craniocervical junction is within normal limits.
IMPRESSION:
1. Incidental ovoid area of high signal in the right maxillary sinus on T2 weighted sequences. This could be a mucus retention cyst, polyp, focal mucosal thickening.
2. No other focal lesion is identified. There is no mass or mass effect. The recti muscles are symmetric and unremarkable.
