Non-Contrast CT Perfusion Template

Radiology Report  
  
Patient Name: John Doe  
Patient ID: 123456  
Date of Examination: October 15, 2023  
Referring Physician: Dr. Smith  
Examination: MRI of the Lumbar Spine  
  
Clinical Indication:  
The patient presents with chronic lower back pain and intermittent numbness in the right leg. The symptoms have persisted for over six months, with no significant relief from physical therapy or medication.  
  
Technique:  
MRI of the lumbar spine was performed using standard protocol sequences, including T1-weighted, T2-weighted, and STIR images in sagittal and axial planes.  
  
Findings:  
- Alignment: Normal alignment of the lumbar spine is observed.  
- Vertebral Bodies: No evidence of fracture or significant degenerative changes.  
- Intervertebral Discs:  
  - L4-L5: Mild disc bulge with no significant spinal canal stenosis.  
  - L5-S1: Moderate disc herniation with impingement on the right S1 nerve root.  
- Spinal Canal and Neural Foramina:  
  - No significant spinal canal stenosis at any level.  
  - Mild narrowing of the right neural foramen at L5-S1 due to disc herniation.  
- Paraspinal Soft Tissues: Unremarkable.  
  
Impression:  
1. Moderate disc herniation at L5-S1 with impingement on the right S1 nerve root, correlating with the patient's symptoms of right leg numbness.  
2. Mild disc bulge at L4-L5 without significant spinal canal stenosis.  
  
Recommendations:  
Consider referral to a spine specialist for further evaluation and management, including potential surgical consultation if symptoms persist or worsen.  
  
Radiologist: Dr. Emily Johnson  
Date of Report: October 16, 2023