Deciphering MRI report

[ANonnyMouse73]

I realised that I posted this in the wrong area of MedHelp the other day so am replicating here in the hope someone can put this in laymens terms for me:

"Multiple small FLAIR/T2 hyperintensities in the frontoparietal subcortical and deep white matter. A small similar focus is also seen in the left parieto-occipital subcortical white matter. Chronic ischaemia of the of the small vessel type would be considered unusual at this age."

Can anyone decipher this MRI report for me? The Neuro forwarded her report direct to my GP, who didn't tell me what it said, just that MS is the most likely dx and I've been referred to another neuro who is (I think?) a MS specialist (no idea how soon the appt is - will have to wait to go through the public system).  I'll be asking the new Neuro what this report actually says, but can anyone enlighten me in the meantime?

Thanks in advance,

Bec

[COBOB]

That looks like a T2 sequence that you posted.  That does not look like an MS back hole.  MS black holes are pretty hard to find on the images and they are seen in the T1 sequences.  You will not see the typical MS black hole on T2, PSE, or FLAIR images.

Bob

[Lulu54]

L'hermittes is the name for the shocks.  

I look at my pics every once in a while just to help me remember how little I know about the brain and mri's.  LOL

The symptoms you describe sound suspiciously like MS and you are right in wanting to know so you can get on with living and not worrying about what is wrong.

good luck with this next step.
Lulu

[supermum_ms]

I hate to tell you this but you just mentioned at least one red flag, migraines! I've heard a few stories of people dx with migraine to explain the lesions and if they dont get headaches they're then told they have silent migraines, no way to get around that lollie pop logic lol.

It sounds like you have a neuro who is actually thinking, electric shocks when you bend your head down has a name, which for the life of me isn't coming to mind but it starts with an L. What you have said do fit in with MS, even the just had a baby, MS often rears its ugly head a few months after giving birth, the immune system is protecting the baby and once its out, the host (you) goes into an MS relapse or even presents with a bang for the first time.

The CC is best seen on the side view, its the squashed looking kidney shape in the middle of your brain. If you have something going on there, it looks whitish around that area, the middle shape is normally dark, its the edges where the lesions turn up. I hope i've made sense of that. Its not actually a good idea to try and work out your own scans, even the radiologists screw it up, so with out the training its difficult knowing what area the lesions really are, though not many could resist looking, i couldn't.

Cheers.......JJ

PS maybe you swallowed a puppy and thats why your cholesterol is high, sure would explain that scan lol.

[ANonnyMouse73]

Looking at another series of slices I count 17 lesions. (Just for giggles Q ;) ) I'm going to print them out and play connect the dots while I wait for my appt.

[ANonnyMouse73]

Woo hoo! Another Aussie! (ALthough I'm actualy a kiwi.... shhhhhhh!)

I'm turning 37 in a few days so I expect that's why it says I'm too young for it to be ISVD?

I actually have the CD of my MRI images here as well as the films and looking at it just one series of "slices" counted 12 noticeable white spots of varying size all over the place on both sides, and one weird looking black hole with a white ring around it, but nothing in the CC (although obviously I have no idea what I'm really looking for).

Funny thing - one of the slices looks EXACTLY like a very sad puppy, complete with tears! Too cute! Oh, and there's a pair of perfectly shaped dolphins in my sinus cavity! LOL

I only have a few minor MS sx and after reading up on what everyone else experiences as part of their MS I'm starting to wonder exactly why my GP said it's MS (or at least, she said this was what the first neuro said). She got the report from the neuro, called me to make an appt, sat me down and said the neuro said it was MS, then she explained to me what MS was, said there are drugs to help but that I can hold off on those for now since my few sx are bearable and I'm breastfeeding still.

SO it kind of feels like I've been diagnosed based purely on patches of numbness, electric shocks when I move a certain way, and tiredness (which isn't anything like the fatigue mentioned by other people with MS, except for the odd time where I feel I'm walking through mud all of a sudden but I recover from that after only a short rest, and it's usually when I've been out shopping for too long anyway).

Oh, and the lesions of course.

I have had periods in the last decade where I get nasty nasty headaches that last 24 hours each, so maybe that could explain the lesions? They weren't migraines with aura or nausea ec, just throbbing headaches. I also have rather high cholesterol considering my age, diet, and physique, so that could explain some of the lesions as well I think?

AAARRGH! On the one hand I'd like to hurry up and find out if their dx of MS was certain so I can just get on with life and see what it throws at me, but on the other hand I've scared myself silly reading the description of symptoms described by other forum members because if I do have MS then those sx could very well be mine one day, so I'm now trying to think of other possible reasons for the lesions and sx.

I suppose it's wishful thinking that it could be purely coincidental that I have lesions AND numb patches, shocks etc, and it's all perfectly benign and easily explainable.

If you got this far into my ramblings, well done! It's all just a bit of a rant and I know no one can give me answers but the neurologist  I'm just VERY impatient to find out for certain what the heck is going on!

Bec

[supermum_ms]

Hello fellow Ozzie,

The first thing is that they found lesions in your brain, the second is that they are inconsistent with your age group, which then leads me to a question, How old are you? At this stage they may not generate a dx of MS, in truth you dont know what the neuro is going to make of them. Another Bris Ozzie didn't get her dx until she moved out of state, told by the Bris doc's there wasn't lesions in the corpus callum (sp), so not MS but they were there.

I live in Melb, consistent sx of MS and so far no other explanation, the report from my MRI states 'Chronic ischemic small vessel disease inconsistent with age' it doesn't actually name the areas just states deep white matter and periventricle though mentions not finding anything in the corpus callum, it appear that if the cc is involved then MS is a slam dunk dx over here. In the conclusion it states 'chronic ischemic small vessel disease' anyway, lol MS is the most common conclusion for T2 lesions, symptoms and the 20-50 age group, even in OZ. BTW ISVD is suppose to mean the lesions are silent so doesn't cause problems, and to be consistent with age you need to be over 65 (or there abouts).

My heads up started a long time ago, always little odd things that went away, until with a bang in 2003 I was introduced to fatigue, adding sx but the first MRI was only done last year and by that time i was walking like a string puppet, with too many other issues to go into lol. I was 45 at the time and even though i'm mimicing MS my lesions and clinical signs are not being counted because of the ISVD conclusion which i'm way too young to have anyway. lol

The first neuro i saw said i only had a few irrelevant bleeds (which is ISVD) but i have the scans on disc and there are way more than a few lesions, I stopped counting after 10 because there was at least 'a few' T2 hyperintese in almost every picture, no way for me to know if i'm counting the same ones more than once. The second neuro didn't have the scans to look for himself, he just read the report and then dismissed all the clinical signs because they didn't fit in with that report, he also stated a few loopy MS myths, ooh i'm in a fish bowl lol!

You could ask the hospital radiology dept for a copy of your MRI so you can give it to the MS neurologist, I had a scribled note requesting a copy, with the neuro's stamp on it, they didn't look at it, or bat an eye, just handed it over and it cost me nothing but time, it was just that easy.

Anyway, i hope you get answers soon!!!!!

Cheers........JJ

[COBOB]

If I'm reading the Rad's report correctly, he is say there are lesions in the deep white matter on the frontal sides and left rear side in the white matter.  Sounds like there are too many of them and too spread out for them to say "migraine" and the Radiologist feels you are too young to say diffuse lack of blood flow/oxygen to the brain.  So the radiologist doesn't have a suspected cause for the lesions and has left it up to the neurologist.  I think you are correct and the general neurologist has sent this to someone who specializes in MS.

Bob