 Please note, there is significant patient motion during the examination degrading the image quality of the contrast enhanced neck MRI. Within the constraints of motion deterioration, the right common carotid artery demonstrates luminal narrowing approximately 32% at the proximal segment. There is minimal narrowing at the distal left common carotid artery approximately 10% without significant stenosis.On the Neck MRA performed using TOF technique, there is demonstration of long segment of luminal narrowing at the proximal left internal carotid artery just beyond the bifurcation. The lesion extends to involve 11.5 mm craniocaudally. However, this long segment luminal narrowing is likely related to TOF MRA related artifacts.Contrast enhanced MRA was not optimal either due to patient's motion, however, based on source image analysis and measurement, the degree of right extracranial ICA stenosis by NASCET criteria is about 60%.The prior CT angiogram dated 9/7/2015, showed moderate wall irregularity and luminal narrowing of about 60% at the same location. Direct comparison was also made with prior MR angiogram there was demonstration of at least 50% stenosis of the right ICA just above the right CCA bifurcation. Therefore, there is no MRA evidence of the degree of luminal stenosis of the right extracranial ICA just above the right CCA bifurcation since prior MRA performed in 2013.There is a separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. There is luminal narrowing the origin of the right vertebral artery with at least 40% stenosis, which is also similar to previous exam. Remaining right vertebral artery and the left vertebral artery shows normal flow and patency.
1.This study is significantly motion degraded. There is at least 60% stenosis at the origin of the right extracranial internal carotid artery with no significant progression compared to previous CT dated 9/7/2015 and MRI dated 2/25/2013.2. 40% stenosis at the origin of the right vertebral artery, unchanged from previous. 