Narrative for CERVICAL
Routine multiplanar imaging through this 45-year-old females cervical spine was obtained with the addition of STIR sequence.

Vertebral body alignment appears adequate. Vertebral body heights appear well preserved. Intervertebral disc height loss noted at the C3-C4 C4-C5 C5-C6 C6-C7 levels.

Lymphatic tissue is noted in the posterior nasopharynx with 3 regions of fluid signal intensity of approximately 5 mm suggestive of minor salivary gland cysts. Direct visualization may be confirmatory if desired.

No STIR signal abnormality is noted to suggest an aggressive osseous process.

Mucous membrane thickening is noted along the walls of the right maxillary sinus and left maxillary sinus

At the C2-C3 level, mild uncovertebral spurring is noted left greater than right of 2-3 mm. Facet arthropathy is noted bilaterally. Mild left neural foraminal narrowing is noted greater than right neural foraminal narrowing. No significant central canal stenosis is noted.

At the C3-C4 level, uncovertebral spurring is noted bilaterally of 3-4 mm right greater than left. Facet arthropathy is noted bilaterally. Moderate left neural foraminal narrowing is noted with mild to moderate right neural foraminal narrowing. Mild central canal narrowing is noted with the thecal sac narrowed to 10 mm.

At the C4-C5 level, uncovertebral spurring is noted towards the left neural foramen greater than right and paracentric left greater than right of 4 mm. Moderate left neural foraminal stenosis is noted with possible exiting nerve root contact. Mild to moderate right neural foraminal stenosis is noted. Mild central canal narrowing is noted with the thecal sac narrowed to 9 mm. Anterior cord contact as questioned.

At the C5-C6 level, uncovertebral spurring or protrusion is noted towards the left neural foramen greater than right of 4 mm. Moderate left neural foraminal stenosis is noted with possible contact of the exiting nerve root. Mild right neural foraminal narrowing is noted. Mild central canal stenosis is noted with possible anterior cord contact, central canal is narrowed to 8 mm. Disc osteophyte bulge centrally is of 4 mm

At the C6-C7 level, uncovertebral disc osteophyte spur protrusion is noted paracentral to the right and towards the right neural foramen of 4 mm. Moderate right neural foraminal narrowing is noted with mild left neural foraminal narrowing. Mild central canal narrowing is noted to 9 mm.

At the C7-T1 level, no significant disk bulge, central canal stenosis, or neural foraminal stenosis is noted

At the T1-T2 level, a small protrusion is noted paracentric to the left of 3 mm. Mild right neural foraminal narrowing is noted along with mild left neural foraminal narrowing. Minimal central canal narrowing is noted.
FOR LUMBAR MRI
Impression
1. Multilevel degenerative changes probably most notable for a central disc protrusion at the L5-S1 level with bilateral lateral recess stenosis.

2. Thickened left adrenal gland with slight nodularity. An underlying adrenal nodule as can be seen with an adrenal adenoma cannot be excluded. This is favored to be relatively stable since 9/28/11.

Narrative
Routine multiplanar imaging through this 54-year-old female with lumbar spine was obtained with the addition of a STIR weighted sequence.

Vertebral body alignment appears adequate. Vertebral body heights appear well-preserved. The spinal cord appears to terminate at L1-L2 level. Mild intervertebral disc height narrowing may be noted at the L1-L2 and L4-L5 levels.

Some apparent nodularity to the left adrenal gland is noted without a dominant nodule being identified, this could relate to diffuse adrenal thickening but an adrenal adenoma is not excluded.

No STIR weighted signal abnormality was noted to suggest an aggressive bone marrow replacement process or recent fracture.

At the T12-L1 level, mild ligamentous hypertrophy appears to be present, no significant central canal stenosis, neural foraminal stenosis, or disc bulge is noted.

At the L1-L2 level, broad-based bulge appears to be present of 3 mm along with ligamentous hypertrophy. Minimal to mild bilateral neural foraminal narrowing is noted, minimal central canal narrowing is noted the thecal sac narrowed to 12 mm.

At L2-L3 level, ligamentous hypertrophy and facet arthropathy is noted along with a mild broad-based bulge paracentric towards each neural foramen and right slightly greater than left of approximately 3 mm. Mild right greater than left neural foraminal stenosis is noted. Minimal thecal sac narrowing is noted to 11 mm.

At L3-L4 level, facet arthropathy and ligamentous hypertrophy is noted. Broad-based bulge is noted towards each neural foramen of approximately 4 mm towards the right slightly greater than towards the left. Mild right greater than left neural foraminal stenosis is noted. Some epidural fat is noted. Mild thecal sac narrowing is noted to 9 mm. A congenitally narrowed central canal is noted.

At the L4-L5 level, facet arthropathy and ligamentous hypertrophy is noted along with a minimal synovial cyst formation off of the left facet of 3 mm. Broad-based bulge or protrusion appears to be present of 4 mm. Mild to moderate left neural foraminal narrowing is noted with mild right neural foraminal stenosis. Mild central canal narrowing is noted with thecal sac narrowed to 8 mm

At the L5-S1 level, disc protrusion appears to be present centrally of 5 mm with bilateral lateral recess stenosis and possible contact of the descending nerve roots within each lateral recess. Minimal bilateral neural foraminal narrowing is noted. Mild central canal narrowing is noted to 10 mm.
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