SARELGAURMD
Interventional Radiologist
Neuro CT:
Head CT R/o Stroke
Examination:
Head CT
History:
Possible Stroke
Technique:
Transaxial CT of the head was performed. Multiplanar reformats were provided for review.
Reference Study:
[ ]
Findings:
CT Evidence for Infarct:
Negative
Intracranial Hemorrhage:
Negative
Extra-Axial Collection:
Negative
Mass Effect or Midline Shift:
Negative
Hydrocephalus:
Negative
Depressed Calvarial Fracture:
Negative
Sinus Disease:
None Significant.
Impression:
No CT evidence of acute territorial infarct.
No intracranial hemorrhage.
Diffusion MR Should be considered for more sensitive evaluation of infarct, if indicated.
----------------------------
Head CT R/o Trauma
Examination:
Head CT
History:
[Trauma]
Technique:
Transaxial CT of the head was performed. Multiplanar reformats were provided for review.
Reference Study:
[ ]
Findings:
CT Evidence for Infarct:
Negative
Intracranial Hemorrhage:
Negative
Extra-Axial Collection:
Negative
Hydrocephalus
Negative
Mass Effect or Midline Shift:
Negative
Depressed Calvarial Fracture:
Negative
Sinus Disease:
None Significant.
Impression:
No intracranial hemorrhage.
----------------------------
CT Facial Bones Trauma
Examination:
CT Facial Bones
Technique:
Multiplanar CT of the facial bones was performed.
Reference Examination:
[ ]
Findings:
There is no facial bone fracture or destruction identified.
The orbits and their contents are unremarkable.
No significant disease is noted in the paranasal sinuses.
Impression:
Unremarkable study.
-------------------------------
CT Neck
Examination
CT neck with contrast
Clinical History
[ ]
Technique
CT of the neck was performed with intravenous contrast. Coronal and sagittal images were contructed.
Contrast Dose:
[ ] ml of iodinated contrast solution, intravenous
Comparison
[No images available for comparison.]
Findings
[There is no evidence of mass.]
[The major vascular structures are patent.]
[No significant lymphadenopathy is seen. ]
[The salivary glands and thyroid gland appear unremarkable. ]
[The larynx and supraglottic structures are normal. The infraglottic airway is not obstructed.]
[No abnormality is noted in the nasopharynx or oropharynx. ]
[The tissues in the oral cavity appear normal but are partially obscured by dental metal artifact. ]
[The bony structures appear normal. ]
Impression
Unremarkable Study.
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CT Angio Head and Neck including Perfusion
History:
Possible Stroke.
Technique:
Transaxial CT imaging was performed in the arterial phase from the level of the aortic arch to the vertex after the administration of intravenous contrast.
Post Processing including multiplanar reformats, MIPs, and volume renderings were provided for review.
CT Perfusion data was also constructed by measuring contrast flux through the vessels. The following perfusion maps were provided for review: Cerebral Blood Flow (CBF), Cerebral Blood Volume (CBV), Mean Transit Time (MTT), and IRF map.
Contrast Dose:
[ ] ml of iodinated contrast solution intravenous
NASCET criteria was used to evaluate stenosis of the neck vessels.
Findings:
CT Angio of the Neck:
Left Vertebral Artery:
Patent
Right Vertebral Artery:
Patent
Left Common Carotid and Internal Carotid Artery:
Patent
Right Common Carotid and Internal Carotid Artery:
Patent
Other:
N/A
CT Angio of the Head:
Aneurysm >3 mm (Note that small aneurysms can be missed and conventional angiography may be more sensitive):
Negative
Arteriovascular malformation:
Negative
Proximal Large Vessel Occlusion:
Negative
Other:
N/A
CT Perfusion:
No significant asymmetry is appreciated. No evidence for ischemic penumbra.
Impression:
Patent Neck Major Arterial Vasculature.
Patent Brain Arterial Vasculature.
No Perfusion Abnormality.
CT Temporal Bones:
History:
[ ]
Technique:
Thin Section Multiplanar CT of the temporal bones was performed.
Reference Study:
[ ]
Findings:
Evaluation of the right petrous bone reveals normal aeration of the external and middle ear cavity and of the mastoid complex. The ossicles are normal.
There is no evidence of fracture or bone destruction.
No abnormal soft tissue is recognized.
The inner ear structures are unremarkable without evidence of congenital abnormality.
The temporomandibular joint is intact.
Evaluation of the left petrous bone reveals normal aeration of the external and middle ear cavity and of the mastoid complex. The ossicles are normal.
There is no evidence of fracture or bone destruction.
No abnormal soft tissue is recognized.
The inner ear structures are unremarkable without evidence of congenital abnormality.
The temporomandibular joint is intact.
Impression:
Unremarkable temporal bones CT.
NEURO MR:
MR Brain without Contrast
Clinical History:
[ ]
Technique:
Multiple sequences were obtained through the brain without contrast.
Comparison:
[No images available for comparison.]
Findings:
There is no area of restricted diffusion to suggest acute infarction.
The ventricles are normal.
There is no mass effect, midline shift or focal parenchymal abnormality.
There is no intracranial hemorrhage or extra-axial collection.
The pituitary gland is normal in size.
Normal flow void is noted in the major arteries of the circle of Willis.
There is no significant disease in the paranasal sinuses.
The orbits are grossly unremarkable.
Impression:
Unremarkable MR of the brain.
-----------------
MR Brain with Contrast
Clinical History:
[ ]
Technique:
Multiple sequences were obtained through the brain without and with intravenous gadolinium.
Contrast:
Contrast Agent GADAVIST [ ] milliliters INTRAVENOUS
Comparison:
[No images available for comparison.]
Findings:
There is no area of restricted diffusion to suggest acute infarction.
The ventricles are normal.
There is no mass effect, midline shift or focal parenchymal abnormality.
There is no intracranial hemorrhage or extra-axial collection.
No abnormal contrast enhancement is noted in the brain or leptomeninges.
The pituitary gland is normal in size.
Normal flow void is noted in the major arteries of the circle of Willis.
There is no significant disease in the paranasal sinuses.
The orbits are grossly unremarkable.
Impression:
Unremarkable MR of the brain.
---------------------
MRI Brain Seizure Protocol:
Clinical History
Seizures
Technique
Multiple sequences through the brain were obtained including high res SFOV thin section T2W coronal imaging of the medial temporal lobes.
Comparison
[No images available for comparison.]
Findings
The ventricles are normal.
There is no mass effect, midline shift or focal parenchymal abnormality.
There is no intracranial hemorrhage or extra-axial collection.
The medial temporal lobes are unremarkable.
There is no evidence of migrational disorder or other congenital brain anomaly.
Impression
Unremarkable MR of the brain
------------------
MRI Brain Limited FLAIR and Diffusion
Clinical History:
[ ]
Technique:
FLAIR and Diffusion MR of the brain was performed.
Comparison:
[No images available for comparison.]
Findings:
There is no area of restricted diffusion to suggest acute infarction.
The ventricles are nondilated.
There is no mass effect, midline shift or focal parenchymal abnormality.
There is no significant disease in the paranasal sinuses.
Impression:
No acute infarct.
---------------
MRI Brain Multiple Sclerosis F/U
Clinical History:
[Multiple Sclerosis followup]
Technique:
Multiple sequences were obtained through the brain without and with intravenous gadolinium.
Contrast:
Contrast Agent GADAVIST [ ] milliliters INTRAVENOUS
Comparison:
Prior contrast enhanced Brain MR dated: [ ]
Findings:
New enhancing lesions:
[Negative]
New nonenhancing lesions:
[Negative]
MS Plaques:
Periventricular:
[ ]
Juxtacortical:
[ ]
Infratentorial:
[ ]
Spinal Cord:
[ ]
Corpus Callosum Atrophy:
[Negative]
There is no area of restricted diffusion to suggest acute infarction.
The ventricles are nondilated.
There is no mass effect or midline shift.
There is no intracranial hemorrhage or extra-axial collection.
The pituitary gland is normal in size.
Normal flow void is noted in the major arteries of the circle of Willis.
There is no significant disease in the paranasal sinuses.
The orbits are grossly unremarkable.
Impression:
Stable MS, as above.
--------------------
MRA Neck
Clinical History
[ ]
Technique
3D time-of-flight imaging was performed for the arteries in the neck. Following this MIP images were created. NASCET methodology was employed to evaluate the degree of stenosis.
Comparison
No images available for comparison.
Findings
The visualized aortic arch and its major branches demonstrate normal anatomic configuration.
Evaluation of bilateral common carotid and cervical internal carotid arteries demonstrate normal flow signal, contour, and caliber. There is no evidence of dissection.
Evaluation of bilateral vertebral arteries demonstrate normal flow signal, contour, and caliber. There is no evidence of dissection.
Impression
No stenosis or evidence for dissection.
-----------------
MRA Head without contrast
Clinical History
[ ]
Technique
3D TOF imagin of the arteries of the Circle of Willis was performed.
Comparison
No prior studies are available for comparison.
Findings
There is no occlusive disease, aneurysm or AVM noted.
Impression
Unremarkable Study.