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    The document describes MRI findings of the lumbar spine which include disc bulges and tears from L1/2 through L5/S1 with neural foraminal stenosis. It also notes Schmorl's nodes at L1 and a few cortical cysts in the kidneys.

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    The document describes MRI findings of the lumbar spine which include disc bulges and tears from L1/2 through L5/S1 with neural foraminal stenosis. It also notes Schmorl's nodes at L1 and a few cortical cysts in the kidneys.

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    The document describes MRI findings of the lumbar spine which include disc bulges and tears from L1/2 through L5/S1 with neural foraminal stenosis. It also notes Schmorl's nodes at L1 and a few cortical cysts in the kidneys.

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    36 views3 pages

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    eosfield
    The document describes MRI findings of the lumbar spine which include disc bulges and tears from L1/2 through L5/S1 with neural foraminal stenosis. It also notes Schmorl's nodes at L1 and a few cortical cysts in the kidneys.

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    Non enhanced lumbar spine MRI


    Imaging Protocol : Sagittal FSE T1WI & FSE T2WI
    Axial FSE T1WI & FSE T2WI
    Coronal FSE T2WI

    Findings :
    A. General overview & Spinal alignment :
    - Multiple marginal bony spur change in thoracolumbar spine.
    B. Disc & spinal canal
    - L1/2 : HIVD - Unremarkable.
    - L2/3 : HIVD - Protrusion and anular tear at central zone.
    - L3/4 : HIVD - Bulging disc.
    Posterocentral anular tear.
    Moderate both neural foraminal stenosis (right>left).
    - L4/5 : HIVD - Bulging disc.
    Posterocentral anular tear.
    Moderate both neural foraminal stenosis.
    Mild central canal stenosis.
    - L5/S1 : HIVD - Bulging disc.
    Right and left posterocentral anular tear.
    Moderate both neural foraminal stenosis
    C. Bony lesion :
    - Schmorl's node and decreased vertebral body height in upper endplate of L1.
    D. Synovial and fibrous joints :
    - Unremarkable.
    E. Spinal cord (Conus & Cauda equina) :
    - Unremarkable.
    F. Back muscles : Unremarkable.
    G. Others : A few cortical cysts in both kidneys.

    Ankle MR
    Imaging Protocol : Axial PD & Fat suppressed FSE T2WI
    Coronal PD & Fat suppressed FSE T2WI
    Sagittal PD & Fat suppressed FSE T2WI
    Coronal 3D SPGR with fat suppression

    Findings :
    1. Old fracture deformity and internal fixator removal related bony change in distal fibula.
    2. Marginal spur change is noted in distal tibiofibular, ankle and posterior subtalar joints.
    3. Uneven hypointense thickening is noted in deep and superficial deltoid ligaments.
    4. Partial fiber disruption is noted in the cranial anterior talofibular ligament.
    5. Irregular fluid signal intensity lesion is noted near the left 1st TMT joint (partial inclusion).

    1. Old healed fracture and internal fixator removal of left distal fibula.
    2. Degenerative change of left distal tibiofibular, ankle and posterior subtalar joints.
    3. Chronic tear and fiberotic remodeling of left deltoid ligaments.
    4. Chronic partial tear of left cranial ATFL.
    5. Periarticular gnalion near the left 1st TMT joint (partial inclusion).
    Clinical Information : neck pain
    Imaging Protocol : Sagittal  FSE T1WI & FSE T2WI
                               Axial FSE T1WI & FSE T2WI
                               Coronal FSE T2WI
                             
    Findings :

    A. General overview & Spinal alignment : Multiple marginal bony spur change in cerivcal spine.
                                                 
    B. Disc & Spinal canal
       1) C2/3 : HIVD - Small protrusion at central zone.           
       2) C3/4 : HIVD - Protrusion at central zone.           
       3) C4/5 : HIVD - Protrusion at central zone.
                     Mild both neural foraminal stenosis.
                     Grade 1 central canal stenosis.
                     Both ligamenta flava hypertrophy.               
       4) C5/6 : HIVD - Bulging disc.
                               Decreased disc height and degeneration.
                     Moderate both neural foraminal stenosis.
                     Grade 1 central canal stenosis.
                     Both ligamenta flava hypertrophy.               
       5) C6/7 : HIVD - Bulging disc.
                               Decreased disc height and degeneration.
                     Moderate both neural foraminal stenosis.
                     Grade 1 central canal stenosis.               
       6) C7/T1 : HIVD - Bulging disc.
                       Grade 1 central canal stenosis.
                       Both ligamenta flava  hypertrophy.
                      
    C. Vertebral body :
       1) Bilateral uncovertebral joint hypertrophy at C5/6, C6/7.
       2) Right facet joint hypertrophy at C4/5.
      
    D. Spinal cord : Unremarkable.
                 
    E. Paraspinal muscles : Unremarkable.
                         
    F. Others : Unremarkable.

    --------------------------------------------------------------------------------------

    References ]
    1)  Nomenclature of HIVD
         - Recommendations of the combined task forces ofth NASS, ASSR, ASNR
    (http://www.asnr.org/spine_nomenclature)

    2) Grade of degenerative cervical spinal stenosis


        A. Central canal stenosis (AJNR Am J Neuroradiol 2011;197:W1-W7)
             - Grade 0 : Abscence of central canal stenosis.
             - Grade 1 : Near complete obliteration of subarachnoid space, including obliteration of the
    arbitrary subarachnoid space exceeding 50% without any sign of cord deformity.
             - Grade 2 : Central canal stenosis with cord deformity but absent spinal cord signal change.
             - Grade 3 : Presence of spinal cord signal change near the compressed level on T2-
    weighted images.

        B. Foraminal stenosis (Radiology 1998;207:391-398 / AJR 2010;194:1095-1098)


             - Mild foraminal stenosis : Perineural fat obliteration in the two opposing direction (vertical
    or transverse). No evidence of morphologic change.
             - Moderate foraminal stenosis : Perineural fat obliteration surrounding the nerve root in the
    four directions without morphologic change, in both vertical and transverse directions.
             - Severe foraminal stenosis : Nerve root collapse or morphological change.

    Normal temporal lobe MR

    1. There is no evidence of abnormal mass lesion or unusual signal intensity in the bilateral internal
    acoustic canals, inner ear structures and tympanic cavities.
    2. Vestibulo-cochlear nerves and facial nerves are well delineated in both internal acoustic canals
    and CP angle cisterns.
    3. Any evidence of abnormal enhancing lesion is not noted in both temporal bones and both
    internal acoustic canals.
    4. There is no evidence of abnormality in the bilateral CP angle cisterns and brainstem.
    5. Otherwise, no remarkable finding.

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