L5-S1 Circumferential Disc Bulge No Significant Central Canal Narrowing. Mild to Moderate

Oklahoma University Medical Center - Radiology Report
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OU MEDICAL CENTER - THE CHILDREN''S HOSPITAL
940 N.E. 13th MAGNETIC RESONANCE IMAGING PHONE: (405) 271-7454
Oklahoma City, OK 73104 CONSULTATION REPORT FAX: (405) 271-1764
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LOC/RM: EA.RTX/ MRN: E002397674
PT. TYPE: REG RCR RAUN,WILLIAM ROBERT
ACCT#: E00635680160 DOB: 06/21/1957 AGE: 53 SEX: M
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ORD PHYSICIAN: Algan MD,Ozer EXAM STARTED: 10/09/10 1047
ATT PHYSICIAN: Algan MD,Ozer EXAM COMPLETED: 10/09/10 1047
ADMISSION CLINICAL DATA: EPENDYMOMA
EXAMS: CPT:
002951518 MR L SPINE W WO 72158
MR lumbar spine with and without contrast: October 9, 2010.
Clinical History: Ependymoma.
Comparison Study: April 27, 2010.
Technique utilizing 1.5 Tesla magnet and 20 cc of Magnevist contrast,
following pulse images were obtained: Sagittal T1 pre- and
postcontrast, T2, and stir; axial T1 pre- and postcontrast, T2.
Findings: There is maintenance of the lumbar lordosis. No
intraretrolisthesis. Posttreatment changes of the marrow demonstrated.
No abnormal focal marrow enhancement.
Disc desiccation demonstrated at the lower thoracic and at the L4-L5
level.
Small annular fissure demonstrated at L4-L5 and L5-S1.
Conus terminates at L1 and demonstrates unremarkable signal and no
abnormal enhancement.
No abnormal enhancement demonstrated within the spinal canal on either
the axial or sagittal images.
Surrounding structures are grossly unremarkable.
L5-S1 mild circumferential disc bulge with no significant central
canal or neuroforaminal narrowing.
L2-L3 a minimal circumferential disc bulge with ligamentum flavum
hypertrophy but no evidence of significant neuroforaminal or central
canal narrowing.
L3-L4 demonstrates mild circumferential disc bulge with an eccentric
right foraminal component there is mild central canal and mild right
neuroforaminal narrowing. Left neuroforamina is unremarkable. Mildly
increased fluid within the facet joints.
L4-L5 demonstrates circumferential disc bulge eccentric to the right
foraminal region no significant central canal narrowing but mild to
moderate right neuroforaminal narrowing mild left neuroforaminal
narrowing.

L5-S1 circumferential disc bulge no significant central canal
narrowing. Mild to moderate bilateral neuroforaminal narrowing.
Impression:
1. Degenerative changes lumbar spine.
2. No evidence of enhancement to suggest drop metastases.
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I have viewed the images and/or data and approve the report.
** Electronically Signed by M.D. 146 ANTHONY ALLEMAN **
** on 10/09/2010 at 1802 **
Reported and signed by: ANTHONY ALLEMAN, M.D. 146
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DICTATED: 10/09/2010 @ 1801 TRANSCRIBED: 10/09/10 @ 1802
TYPIST: RAD.VR PRINTED: 10/09/2010 @ 1811
ELECTRONIC SIGNATURE DATE/TIME: 10/09/2010 @ 1802 BATCH#: N/A
PAGE 2 Signed Report
Authored by :
Approval Date :

Oklahoma University Medical Center - Radiology Report
------
OU MEDICAL CENTER - THE CHILDREN''S HOSPITAL
940 N.E. 13th MAGNETIC RESONANCE IMAGING PHONE: (405) 271-7454
Oklahoma City, OK 73104 CONSULTATION REPORT FAX: (405) 271-1764
------
LOC/RM: EA.RTX/ MRN: E002397674
PT. TYPE: REG RCR RAUN,WILLIAM ROBERT
ACCT#: E00635680160 DOB: 06/21/1957 AGE: 53 SEX: M
------
ORD PHYSICIAN: Algan MD,Ozer EXAM STARTED: 10/09/10 1047
ATT PHYSICIAN: Algan MD,Ozer EXAM COMPLETED: 10/09/10 1047
ADMISSION CLINICAL DATA: EPENDYMOMA
EXAMS: CPT:
002951516 MR BRAIN W WO INF 70553
MR brain with and without infusion: October 9, 2010.
Clinical History: Ependymoma.
Comparison Study: April 27, 2010.
Technique: Utilizing 1.5 Tesla magnet and 20 cc of Magnevist contrast,
following pulse was were obtained, axial T1 pre- and postcontrast, T2,
; sagittal T1 pre- and postcontrast, coronal T2 and postcontrast T1.
Findings: Again demonstrated are changes of a suboccipital craniotomy
and prior surgery. Enhancing lesion in the floor of the fourth
ventricle in the region of the pontomedullary junction is again
demonstrated and is not significantly changed in appearance or size
measuring approximately 3 mm x 1 cm. T2 images do not demonstrate any
increase in the previously described surrounding T2 signal change.
Midline is nondisplaced. Ventricular system is mildly prominent
suggesting some degree of global volume loss. Scattered T2 signal
abnormalities are present in the high frontal white matter, not
significantly changed. Basal cisterns are preserved. Vascular flow
voids appear maintained. No new areas of abnormal enhancement
demonstrated.
Proximal cord covered under cervical spine discussion surrounding
structures demonstrate minimal mucosal thickening in the paranasal
sinuses and mild fluid in the mastoids. Osseous structures demonstrate
posttreatment changes. No evidence of herniation present. Nasal septum
is deviated.
No diffusion weighted imaging provided.
Impression:
1. Stable examination demonstrating a focus of enhancement along the
floor of the fourth ventricle. No new lesions or enhancement
demonstrated.
***************************************************************
I have viewed the images and/or data and approve the report.
** Electronically Signed by M.D. 146 ANTHONY ALLEMAN **
** on 10/09/2010 at 1747 **
Reported and signed by: ANTHONY ALLEMAN, M.D. 146
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DICTATED: 10/09/2010 @ 1743 TRANSCRIBED: 10/09/10 @ 1747
TYPIST: RAD.VR PRINTED: 10/09/2010 @ 1756
ELECTRONIC SIGNATURE DATE/TIME: 10/09/2010 @ 1747 BATCH#: N/A
PAGE 2 Signed Report
Authored by :
Approval Date :