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  1. "\r\n        MRA HEAD W/O CONTRAST\r\n\r\n\r\nMRA CIRCLE OF WILLIS WITHOUT CONTRAST\r\n\r\n\r\n** HISTORY **:\r\nStroke symptoms\r\n\r\n\r\nTECHNIQUE: 3D time-of-flight imaging of the Circle of\r\nWillis was performed without gadolinium. 3D MIP,\r\npost-processed images were then reconstructed. Axial\r\nFLAIR and DWI sequences were also obtained.\r\n\r\n\r\nCOMPARISON:  No prior studies available.\r\n\r\n\r\n** FINDINGS **:\r\nThere is irregularity of the bilateral cavernous\r\ncarotid arteries which is favored to be related to\r\natherosclerotic disease. There is a laterally directed\r\noutpouching arising from the left cavernous ICA\r\nmeasuring approximately 2.5 mm at the base and 2 mm in\r\nheight (image 62, series 3) this. There is also an\r\ninferiorly directed outpouching arising from the right\r\ncavernous ICA directed inferiorly measuring\r\napproximately 2.5 mm at the base 3 mm from neck to dome\r\n (image 57, series 3; image 18, series 306).\r\n\r\n\r\nThe bilateral carotid termini, MCAs and ACAs\r\ndemonstrate no evidence of hemodynamically significant\r\nstenosis or aneurysm.\r\n\r\n\r\nThe bilateral intradural vertebral arteries, basilar\r\nartery and PCAs demonstrate no evidence of\r\nhemodynamically significant stenosis or aneurysm. A\r\npatent right posterior communicating artery is\r\nidentified with a relatively hypoplastic right P1\r\nsegment. This is consistent with predominantly fetal\r\norigin of the right PCA.\r\n\r\n\r\nIMPRESSION:\r\nNo evidence of hemodynamically significant stenosis\r\ninvolving the circle of Willis.\r\n\r\n\r\nIrregularity of the bilateral cavernous ICAs, likely\r\nrelated to presence of atherosclerotic calcification.\r\nThere are 2.5 mm outpouchings arising from both\r\ncavernous ICAs which are favored to represent vascular\r\nectasia. However, small aneurysms cannot be completely\r\nexcluded.\r\n\r\n\r\nElectronically Signed by: Wen (M.D.) Lin on 6/18/2017  7:36 AM\r\n\r\n      "
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