44 years Female (DOB:10/15/1971)Reason: eval positioning of carotid arteries, pt feels air suffocation History: as abovePROVIDER/ATTENDING NAME: MAUREEN CROWLEY MAUREEN CROWLEY MRA neck:There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. The right common carotid artery and the proximal right vertebral artery are not well imaged at the level of the thyroid gland. To a large degree this is related to breathing artifact. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries. At the C3 and C2 vertebral body levels there is medial deviation of the internal carotid arteries bilaterally above the level of the hyoid bone and at the level of the hypopharynx.MRI neck:Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits and paranasal sinuses are intact. The paranasal sinuses and mastoid air cells are clear.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.There is medial deviation of the internal carotid arteries bilaterally above the level of the hyoid bone at the C2-3 vertebral body levels.The cervical vertebral bodies in general are intact. There are multilevel degenerative changes present in the cervical spine which appear worse at C3-4 where there is a disc protrusion present which narrows the spinal canal and is suspected to be associated with spinal stenosis.
1.The right common carotid artery and the right vertebral artery not adequately imaged proximally. Perhaps additional imaging with ultrasound may be of benefit in evaluating this. The possibility of a stenosis of the proximal right vertebral artery or the right common carotid artery cannot be excluded on the basis of this exam.2.There is medial deviation of the internal carotid arteries bilaterally above the level of the hyoid bone at the C2-3 vertebral body levels.3.Findings raise the question of spinal stenosis at C3-4. Please correlate with clinical symptoms. If clinically appropriate dedicated cervical spine imaging may be helpful.