{"orderName":"MRI Complete Spine W/WO Contrast Prot","key":"WP-2465ex5ywOH4oNWoe73FR6Vg-3D-3D-24pgrFkx-2B7yORwpS7Og54GJfbbkfNCkAYbrQ9LQfkoJio-3D","results":[{"name":"MRI Complete Spine W/WO Contrast Prot","key":"WP-2465ex5ywOH4oNWoe73FR6Vg-3D-3D-24pgrFkx-2B7yORwpS7Og54GJfbbkfNCkAYbrQ9LQfkoJio-3D","showName":false,"showDetails":true,"orderMetadata":{"orderProviderName":"Mackenzie Kerbelis, PA-C","readingProviderName":"Javier Quintana, MD","resultTimestampDisplay":"May 06, 2022 6:43 PM","prioritizedInstantISO":"2022-05-06T17:41:13-04:00","prioritizedInstantDisplay":"May 06, 2022","latestUpdateInstantISO":"2022-05-06T18:45:31","collectionTimestampsDisplay":"May 06, 2022 5:54 PM","deviceReadTimestampDisplay":"May 06, 2022 6:43 PM","studyDateTimestampDisplay":"May 06, 2022 5:41 PM","specimensDisplay":"","resultStatus":"Final","resultType":"IMAGING","read":"Read","associatedDiagnoses":[]},"fdiLink":{"redirectUrl":"/Extensibility/Redirection/FdiRedirection?fdi=WP-24JPNtVy-2BjqVWiy3upHa-2BJiA-3D-3D-24zQyqJfIfsbX59K85RJN9oR94TwmdszkA3MfM5p3xdXc-3D&ord=WP-2465ex5ywOH4oNWoe73FR6Vg-3D-3D-24pgrFkx-2B7yORwpS7Og54GJfbbkfNCkAYbrQ9LQfkoJio-3D","shouldOpenInNewWindow":true},"resultComponents":[],"studyResult":{"narrative":{"isRTF":false,"hasContent":true,"contentAsString":"Exam(s):\r\nMRI COMPLETE SPINE W/WO CONTRAST: 5/6/2022 17:41\r\n","contentAsHtml":"","signingInstantTimestamp":"12/12/2025 4:20 PM"},"impression":{"isRTF":false,"hasContent":true,"contentAsString":"IMPRESSION:\r\nMild degree of symmetric ventral signal change within the conus medullaris with faint associated enhancement. Although enhancement pattern is somewhat early for infarct, in light of the history, findings suggest ischemia/infarct. Other inflammatory, \r\ninfectious, demyelinating processes less likely but would correlate clinically. \r\n\r\nQuestion tiny focal defect within the tectorial membrane.\r\n\r\nLarge degree of edema within the upper posterior cervical soft tissues including within the interspinous regions and surrounding the ligamentum nuchae. There may be some thinning of this ligament. \r\n\r\nThin appearing fluid collection within the superficial subcutaneous tissues of the low back from about T11 through the lumbosacral region. This may be posttraumatic hematoma/seroma. Infection less likely given the history.\r\n\r\nTiny degree of fat within a nonexpanded filum terminale in normal position of the conus. This is favored to be within anatomic range.\r\n\r\nFavor prominent epidural fat in the thoracic region rather than epidural fluid.\r\n\r\nRather extensive subcutaneous edema throughout the chest, abdomen, and pelvis in this posttraumatic patient.\r\n\r\nAscites with mesenteric edema.\r\n\r\nSmall bilateral pleural effusions right greater than left with associated atelectasis and/or airspace disease.\r\n\r\nPlease refer to the MRI of the brain.\r\n\r\nIndication:\r\nPost abdominal crush injury. Asymmetric reflexes in lower extremities. reflexes present on left, not on right. please evalute >72 hours post-cardiac arrest. Please evaluate, post crush injury \r\n\r\n\r\nComparison Study Date:\r\nCT, 5/2/2022\r\n\r\nTechnique:\r\nMultiplanar multisequence imaging of the total spine was performed with and without contrast.\r\n\r\nFindings:\r\n\r\nThere is a large degree of subcutaneous edema identified overlying the neck, back, abdomen, pelvis and visualized soft tissues of the arms. There is edematous changes within some of the pelvic musculature more so on the left. This is partially imaged. \r\nWithin the subcutaneous tissues of the low back from about the T11 through the lumbosacral region is a thin fluid collection probably demonstrated in a small amount of rim enhancement. This spans approximately 12 x 0.7 x 3.8 cm.\r\n\r\nSome ascites is questioned. Dependent lung changes are suspected. Small bilateral pleural effusions are seen. The patient is right vertebral artery dominant.\r\n\r\nThere is fluid noted in the nasopharynx, oropharynx and probably within the upper esophagus. Presacral fluid is noted.\r\n\r\nThere is sphenoid sinus opacity. Some degree of gyriform/leptomeningeal enhancement is questioned supratentorially but incompletely imaged. Please refer the MRI of the brain.\r\n\r\nSlight straightening of the normal cervical lordosis. \r\n\r\nQuestion a tiny focal defect to the tectorial membrane for instance series 7 image 8 and possibly 9. In general, the clival dens alignment is probably maintained with some fluid signal suspected at the clival dens interspace. The posterior longitudinal \r\nligament and ligamentum flavum otherwise appear maintained. There is abnormal edema identified posterior to the spinous processes within the interspinous regions in the cervical area as well. Edema is seen surrounding the ligamentum nuchae possibly with \r\nsome thinning more cephaladly. Some edematous changes are also seen focally in the interspinous regions from about T4-T8 with more superficial edema.\r\n\r\nThe vertebral bodies appear maintained in height and alignment. Intervertebral disc spaces are grossly well preserved. Marrow signal is preserved.\r\n\r\nThere is a mild degree of paraspinal soft tissues noted at the L4-L5 level.\r\n\r\nThere is favored to be generous epidural fat within the thoracic region rather than epidural fluid.\r\n\r\nDespite some respiratory motion artifact, there appears to be some symmetric signal change within the dorsal medulla. Otherwise, the cervical and thoracic cord are probably normal in signal intensity. There is some linear symmetric ventral high signal \r\nwithin the conus for instance series 15 image 4. On the postcontrast images, there is rather faint enhancement of the conus medullaris also suspected in this area.\r\n\r\nConus medullaris tapers normally otherwise and terminates at the L1 level. Cauda equina is unremarkable with a tiny degree of fat suspected within a nonexpanded filum maximally measuring just under 1 mm. This is favored to be still within anatomic range.\r\n\r\n\r\nImages and interpretation personally reviewed by: Javier Quintana, MD","contentAsHtml":"","signingInstantTimestamp":"12/12/2025 4:20 PM"},"combinedRTFNarrativeImpression":{"isRTF":false,"hasContent":false,"contentAsString":"","contentAsHtml":"","signingInstantTimestamp":"12/12/2025 4:20 PM"},"addenda":[],"isFullResultText":false,"transcriptions":[],"ecgDiagnosis":[],"hasStudyContent":true},"shouldHideHistoricalData":true,"resultNote":{"isRTF":false,"hasContent":false,"contentAsString":"","contentAsHtml":"","signingInstantTimestamp":"12/12/2025 4:20 PM"},"hiddenProxies":"","reportDetails":{"isDownloadablePDFReport":false,"reportID":"","openRemotely":false,"reportContext":"","reportVars":{"ordId":"WP-2465ex5ywOH4oNWoe73FR6Vg-3D-3D-24pgrFkx-2B7yORwpS7Og54GJfbbkfNCkAYbrQ9LQfkoJio-3D","ordDat":"WP-24zntCvvZqKtO75w32vM-2B1gw-3D-3D-249fezNtjTVLpQWLq21M6WD-2BaKrYyWLykaXwY55Bpgi3g-3D"}},"scans":[],"imageStudies":[],"indicators":[],"geneticProfileLink":"/app/genetic-profile","shareEverywhereLogin":false,"showProviderNotReviewed":false,"providerComments":[],"resultLetter":{"isRTF":false,"hasContent":false,"contentAsString":"","contentAsHtml":"","signingInstantTimestamp":"12/12/2025 4:20 PM"},"warningType":"","warningMessage":"","variants":[],"tooManyVariants":false,"hasComment":false,"hasAllDetails":true,"isAbnormal":false,"baseSingleMessageUrl":"/app/communication-center/conversation?id=","fullMultipleMessagesUrl":"/app/communication-center?filterType=testResults&filterKey=WP-2465ex5ywOH4oNWoe73FR6Vg-3D-3D-24pgrFkx-2B7yORwpS7Og54GJfbbkfNCkAYbrQ9LQfkoJio-3D","relatedConversationIds":[]}],"orderLimitReached":false,"ordersDeduplicated":false,"isEnhancedAskAQuestionActive":false,"hideEncInfo":false}