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What Do These MR Angiography Findings Indicate?
Question: XXXX, XXXXXXX (MRN 0000)
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PATIENT NAME: XXXX, XXXXXXX
Exam: MRA NECK WO/W CONTRAST
DATE OF EXAM: 07/23/2015 8:39 PM
AGE AT THE TIME OF EXAM: 73 yrs
ADMITTING PHYSICIAN:
REQUESTING PHYSICIAN: XXXX
CC:
Imaging Medication: gadobutrol (GADAVIST) injection 10 mL 9 mL, Total Given: 9 mL (1 dose)
MRA NECK WO/W CONTRAST 7/23/2015 8:39 PM
CLINICAL INDICATION: Carotid stenosis
COMPARISON: CT angiogram 2/14/2013
TECHNICAL FACTORS:
1. 2-D time-of-flight MR angiography
2. Postcontrast 3-D time-of-flight MR angiography
3. NASCET criteria were applied for measurement.
IMAGING MEDICATIONS: Gadolinium
Fri Jul 24, 2015 3:59 PM Page 1 of 4
CSN MRN PATIENT TYPE BIRTHDATE
0000 0000 Outpatient 12/16/1941
Radiation:
XXXX 900 0000
IMAGING REPORT
0000
FINAL RESULT
XXXX, XXXXXXX (MRN 0000)
FINDINGS:
Aortic arch: Normal
Origins of the great vessels: Normal
Right carotid arteries: Plaque along the medial wall the right
carotid bulb not resulting in any stenosis.
Left carotid arteries: Just beyond the carotid bulb there is a
narrowing of the vessel extending almost a centimeter, with a
55-60% stenosis
Right vertebral artery: Terminates in the upper neck or the base
of the skull with no evidence of it joining the left vertebral
artery
Left vertebral artery: Normal and dominant
Soft tissues of the neck: Normal
Cervical spine: Normal
IMPRESSION:
55-60% stenosis of almost a 1 cm segment of the left carotid
artery just beyond the carotid bulb. This is progressed since the
study of 2/14/2013 when the stenosis appeared to be approximately
40%
Plaque of the right carotid bifurcation without stenosis
Reviewed and Interpreted by: XXXXXXX XXXX, MD FACR 7/24/2015
11:47 AM
Fri Jul 24, 2015 3:59 PM Page 2 of 4
ELECTRONICALLY SIGNED ON:
07/24/2015 11:47 AM
Important Message: This information is intended for the use of the person or entity to which it is addressed
and may contain information that is privilege and confidential, the disclosure of which is governed by
applicable law. If the reader of this information is not the intended recipient, or the employee or agent
responsible to deliver it to the intended recipient, you are hereby notified that any dissemination,
distribution or copy of this information is STRICTLY PROHIBITED. If you have received this information by
error, please notify us immediately at 0000 and destroy the related message. Thank you for
your cooperation.
DICTATED BY: ELECTRONICALLY SIGNED BY:
XXXX
XXXX, XXXXXXX (XXXX 0000)
Fri Jul 24, 2015 3:59 PM Page 3 of 4
XXXX, XXXXXXX (XXXX 0000)
END OF REPORT
When I turn to the right or I lay down I feel stiff and a lot of discomfit.
and when i get up very stiff
-------------------------------------------------------------------------------------------------------------------------------------------
PATIENT NAME: XXXX, XXXXXXX
Exam: MRA NECK WO/W CONTRAST
DATE OF EXAM: 07/23/2015 8:39 PM
AGE AT THE TIME OF EXAM: 73 yrs
ADMITTING PHYSICIAN:
REQUESTING PHYSICIAN: XXXX
CC:
Imaging Medication: gadobutrol (GADAVIST) injection 10 mL 9 mL, Total Given: 9 mL (1 dose)
MRA NECK WO/W CONTRAST 7/23/2015 8:39 PM
CLINICAL INDICATION: Carotid stenosis
COMPARISON: CT angiogram 2/14/2013
TECHNICAL FACTORS:
1. 2-D time-of-flight MR angiography
2. Postcontrast 3-D time-of-flight MR angiography
3. NASCET criteria were applied for measurement.
IMAGING MEDICATIONS: Gadolinium
Fri Jul 24, 2015 3:59 PM Page 1 of 4
CSN MRN PATIENT TYPE BIRTHDATE
0000 0000 Outpatient 12/16/1941
Radiation:
XXXX 900 0000
IMAGING REPORT
0000
FINAL RESULT
XXXX, XXXXXXX (MRN 0000)
FINDINGS:
Aortic arch: Normal
Origins of the great vessels: Normal
Right carotid arteries: Plaque along the medial wall the right
carotid bulb not resulting in any stenosis.
Left carotid arteries: Just beyond the carotid bulb there is a
narrowing of the vessel extending almost a centimeter, with a
55-60% stenosis
Right vertebral artery: Terminates in the upper neck or the base
of the skull with no evidence of it joining the left vertebral
artery
Left vertebral artery: Normal and dominant
Soft tissues of the neck: Normal
Cervical spine: Normal
IMPRESSION:
55-60% stenosis of almost a 1 cm segment of the left carotid
artery just beyond the carotid bulb. This is progressed since the
study of 2/14/2013 when the stenosis appeared to be approximately
40%
Plaque of the right carotid bifurcation without stenosis
Reviewed and Interpreted by: XXXXXXX XXXX, MD FACR 7/24/2015
11:47 AM
Fri Jul 24, 2015 3:59 PM Page 2 of 4
ELECTRONICALLY SIGNED ON:
07/24/2015 11:47 AM
Important Message: This information is intended for the use of the person or entity to which it is addressed
and may contain information that is privilege and confidential, the disclosure of which is governed by
applicable law. If the reader of this information is not the intended recipient, or the employee or agent
responsible to deliver it to the intended recipient, you are hereby notified that any dissemination,
distribution or copy of this information is STRICTLY PROHIBITED. If you have received this information by
error, please notify us immediately at 0000 and destroy the related message. Thank you for
your cooperation.
DICTATED BY: ELECTRONICALLY SIGNED BY:
XXXX
XXXX, XXXXXXX (XXXX 0000)
Fri Jul 24, 2015 3:59 PM Page 3 of 4
XXXX, XXXXXXX (XXXX 0000)
END OF REPORT
When I turn to the right or I lay down I feel stiff and a lot of discomfit.
and when i get up very stiff
Brief Answer:
It is probably from the degenerative cervical spine changes
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The above findings are form a MR angiogram of the neck vessels dated 24 July 2015.
2. There is an area of narrowing of the lumen of left carotid system which is decreasing the lumen by 60 percent. This has increased from 40 percent from 14 February 2013
3. There is an area of narrowing in the right carotid system from a plaque where the common carotid bifurcates in to the internal and external carotid arteries. This is not causing significant narrowing
4. In the vertebral arteries, the left one is the dominant and shows normal blood flow. The right vertebral artery is smaller and does not join the left vertebral artery. The vertebral artery system supplies blood to the posterior fossa structures in the brain.
5. A 60 percent stenosis in left carotid system should not cause discomfort when you turn your head to the right side.
It is probable that your cervical spine has developed degenerative changes and that is causing pinching of nerve roots when turning to the right side or lay down. The neck spine information is not mentioned in this report.
Hope your query is answered.
Please write back if you have any doubts.
Regards,
It is probably from the degenerative cervical spine changes
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The above findings are form a MR angiogram of the neck vessels dated 24 July 2015.
2. There is an area of narrowing of the lumen of left carotid system which is decreasing the lumen by 60 percent. This has increased from 40 percent from 14 February 2013
3. There is an area of narrowing in the right carotid system from a plaque where the common carotid bifurcates in to the internal and external carotid arteries. This is not causing significant narrowing
4. In the vertebral arteries, the left one is the dominant and shows normal blood flow. The right vertebral artery is smaller and does not join the left vertebral artery. The vertebral artery system supplies blood to the posterior fossa structures in the brain.
5. A 60 percent stenosis in left carotid system should not cause discomfort when you turn your head to the right side.
It is probable that your cervical spine has developed degenerative changes and that is causing pinching of nerve roots when turning to the right side or lay down. The neck spine information is not mentioned in this report.
Hope your query is answered.
Please write back if you have any doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr what can i do?
Brief Answer:
The neck discomfort needs to be interpreted with MRI cervical spine results
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. For the stenosis in left carotid system, you have to discuss with your doctor (cardiologist or neurologist) and be on medication that will prevent the plaque from increasing in the coming years.
2. The discomfort in neck when turning to right side and when you lay down needs to be discussed with your neurologist and interpreted with results of cervical spine MRI scan. This will tell if there is any spinal disc in the cervical region which is herniated and causing pinching of nerves (especially on the right side).
3. Treatment for neck discomfort from degenerative cervical spine changes includes physiotherapy, limitation of heavy physical activities and mild pain relievers.
Hope your query is answered.
Please write back if you have any doubts.
Regards,
The neck discomfort needs to be interpreted with MRI cervical spine results
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. For the stenosis in left carotid system, you have to discuss with your doctor (cardiologist or neurologist) and be on medication that will prevent the plaque from increasing in the coming years.
2. The discomfort in neck when turning to right side and when you lay down needs to be discussed with your neurologist and interpreted with results of cervical spine MRI scan. This will tell if there is any spinal disc in the cervical region which is herniated and causing pinching of nerves (especially on the right side).
3. Treatment for neck discomfort from degenerative cervical spine changes includes physiotherapy, limitation of heavy physical activities and mild pain relievers.
Hope your query is answered.
Please write back if you have any doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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