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CT CAP Aorta ***

COMPARISON: CT abdomen/pelvis dated [].

INDICATION: 83-year-old male with hypertension and lower back pain.

TECHNIQUE: Multiple transverse helical CT images were obtained through the chest and abdomen after timed administration of IV contrast in the arterial phase. Reconstructed coronal and sagittal MIP images and reformatted 5 mm axial images were obtained.

FINDINGS: A normal branching three-vessel arch is demonstrated without evidence of thoracic aortic aneurysm or intraluminal filling defect to suggest dissection or other acute aortic injury. The ascending aorta measures approximately 2.5 cm in largest diameter. No abdominal aortic dissection is present. Diffuse atherosclerotic vascular calcifications are seen along the entire length of the aorta as well as its major branches without evidence of significant flow-limiting stenosis. Calcified atheromatous plaque is seen at bilateral renal artery ostia which may cause mild renal artery stenosis. Calcified plaque is also seen at the takeoff of the celiac trunk and superior mesenteric arteries without significant stenosis. No perforating ulcer or intramural hematoma is demonstrated.
The visualized pulmonary parenchyma is without evidence of acute interstitial or airspace disease. Lung apices are not completely seen. There is mild bilateral dependent atelectasis. The heart, pleura, and diaphragms are normal. There is no evidence of mediastinal, hilar, or axillary lymphadenopathy.
Symmetric bilateral perinephric fat stranding is seen without evidence of obstruction. No solid renal masses seen. Visualized portions of the liver demonstrate no abnormalities. There is mild enlargement of the medial limb of the right adrenal gland measuring approximately 14 mm which may represent a small adenoma. However this is incompletely evaluated. The visualized portions of the pancreas and spleen are normal. There are no findings to suggest mesenteric ischemia. No abdominal or retroperitoneal lymphadenopathy is present. Incidental note is made of a small fat containing umbilical hernia.
Mild multilevel degenerative changes of the thoracolumbar spine are present with multiple Schmorl's nodes, disc height loss and endplate osteophytes. Mild narrowing of the right L4-L5 neural foramina is present secondary to endplate and facet arthropathy. There is no evidence of spinal canal stenosis.

1. No evidence of thoracic or abdominal aortic dissection or acute abnormality to account for the patient's symptoms.
2. Diffuse moderate atherosclerotic vascular disease involving the entire aorta and its major branches including the great vessels and abdominal visceral arteries without evidence of significant flow-limiting stenosis.
3. Enlarged medial limb of the left adrenal gland. This is a nonspecific finding which may represent a lipid poor adenoma. If persistent clinical concern consider dedicated CT or MRI evaluation of the adrenals.
4. Moderate multilevel thoracolumbar spondylosis and degenerative disc disease with no evidence of spinal canal stenosis from T3 through L4-L5.