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I need help with my MRI results
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I need help with my MRI results

Hi, I am hoping that someone can give me some information on my MRi with and without contrast. In June of this year I had an MRI and I just had another one yesterday and I am a little confused by the results. In June the MRI read:
Findings: Sagittal T1-weighted images demonstrates the corpus callosum, brainstem and cerebellum to be intact. No abnormality increased signal indentified to suggest hemorrhage.
The diffusion: weighted images demonstrate no evidence of acute ischemia. On the flair images, minimal nonspecific 3mm regions of increased signal in the frontal subcortical white matter. No abnormal increased signal identified in the immediate periventricular regions, brainstem or pons to suggest a demyelinating process at this time.
Axial T-2 weighted images demonstrate normal flow-voids in the internal carotid arteries and basilar artery.
Mild ethmoid and right maxillary sinus focal mucosal thickening.
Impression: No evidence of acute ischemia, mass effect, or abnormal intracranial enhancement.
Tiny non specific 3mm regions of increased signal on the flair images in the frontal lobe subcortical white matter bilaterally. These are nonspecific –possibly from prior remote trauma. No lesions in typical periventricular or brainstem locations are identified to suggest a demyelinating process at this time.

Repeat MRI
The repeat MRI was compared to the previous one and the findings were:
The sulci, cisterns and ventricles remain normal. There is no extra-axial fluid collection or intracranial hemorrhage. No mass, mass effect or midline shift. No restricted diffusion or sign of acute ischemic change.
Nodularity callososeptal interface again noted. Corpus callosum again demonstrates normal thickness. Multiple foci of nonenhancing T2weighted and flair hyperintensity again noted within the centrum semivale, periventricular and subcortical white matter. There is no significant interval change within the foci of signal abnormality. No new foci are noted. These foci of signal abnormality enhancement again, these foci of signal abnormality concerning for demyelination such as multiple sclerosis.
There is no abnormal enhancement. The cerebellopontine angles remain normal. The intracranial vascular flow-voids remain normal. Overall stable exam.
Impression: Stable exam. No acute intracranial disease.
Stable multiple foci of nonenhancing T2 weighted and flair hyperintensity again noted within supratentorial white matter. Nodularity callososeptal interface.  Again these findings are concerning for demyelination, such as multiple sclerosis.
I would really appreciate any information that someone can give me. I am confused as to why demyelination is a concern now if there were no changes. Also, could one of the MRI’s been incorrect? If I am reading this correctly the first MRI states that white matter is only found in subcortical not periventricular and now it is saying multiple foci noted within centrum semiovale, periventricular, and subcortical but no significant changes.
Over the last several years the only problems that I had were fatigue and problems with my stomach, which did not show anything on the colonoscopy and the stomach issues would come and go. The fatigue it has never went away and continues to get worse. Then this year things began to get worse, the fatigue, tremors in my hands constantly, swelling in the lower part of my legs when running or on long walks occasional dizziness. In September, I started having trouble breathing and that happens on a weekly basis now, it may last a couple of days or just one day. The dizzy spells have become a problem now. One week I may have 3 different spells when sitting or standing and then the next week it will happen every time I stand or sit and my feet have been going numb pretty frequently and it will last anywhere from 10 minutes to an hour. It feels like pins poking me and right arm has been tingling in one particular spot.
With all of these issues that I have had over the last couple of months, then shouldn’t there be more abnormal changes to the MRI if it is really MS? I have had extensive blood work done multiple times and it always come back fine.

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Hello and welcome to the forum.  I can see what you are saying - the 1st MRI report says that you didn't have any increased signal in the periventricular areas, but then the 2nd MRI says that you do have increased signal in the periventricular areas - yet it's noted that it's unchanged.  How can it be unchanged when that right there is a change?  

I take it that you're seeing a neurologist already, and they are the ones who have ordered these MRIs for you.  It's good that they have ordered extensive blood work for you.  MS is a disease where they really need to rule out other things before they want to look directly at MS for a diagnosis.  Your symptoms don't necessarily scream out MS to me - but I guess everyone is different.  

Good luck with everything.  Maybe if you have an appt set-up with your doctor, then they will be able to tell you what all of this means.

Don't trust radiology reports.

My first 3 MRIs all reported normal but neuro doc saw white matter lesions and increased spinal cord signal but because the reports were negative he decided to wait and see.  Then I got a lot worse and lost some reflexes and had some reflexes become too fast, I got hypertonicity in my legs and lost my balance completely.  LP was abnormal so MRI repeated again.  End result no 4 .........white matter lesions and increased signal all of spinal cord, active demyelination..... But....the report said...same as previous MRIs.....what the???

I went back to the radiology office and gave them some very explicit feedback on what I thought of the reporting radiologist and his lack of competence.
I have a 10 mm abnormality and the radiologist kept switching what side of the brain it's on.  I only have one...

Bring any conflicting language up with your neuro and ask him pointedly if he/she has reviewed the MRI him/herself.  They need to.

As for questions I am in the dark.  I think some of the confusion occurs b/c the radiologist uses scripted responses and sometimes doesn't edit out the extra text that doesn't apply.

I need to clarify what I meant to say in my earlier post.  My communication skills aren't what they usd to be....that's my excuse and I'm sticking to it.

What I meant to say is the first 3 MRIs were reported as normal the 4th one was reported as having a number of abnormalities itbalso said they were the same abnormalities as on the previous MRIs just more extensive.

Thank you for your responses. I do have an appt scheduled in February. This will be my 3rd nuerologists hopefully this one works out better then. the last two. I had to go round and round with them over my sleep disorder that was discovered in late May.
I am just ready to find out something up until the first of June I was pretty healthy. I have been to the doctor more in the last 6 months than I have in the last 10 yrs. I turned 30 and fell apart.
All of the testing was brought on by me passing out at work and not breathing. My primary dr sent me to a cardiologist and he ran some test everything came back fine and that dr referred me to a neurologist. On my first office visit there, the exam showed weakness on the entire right side, my right eye was dropping and my coordination was off. They have tested for corpral tunnel, seizures, strokes, lupus, cancer and they have done a lumbar puncture and so far the MRI is the only thing that has come back abnormal.

Hopefully I can find out something on my next visit.
I second the - "don't trust radiology reports."

My initial MRI supposedly had no lesions/hyperintensities in my brain (according to the radiologist).  Then I took my MRIs to an MS Ctr and the neuro there showed me 6 lesions & 3 T1 black holes that they missed in my brain from my MRI scans. And an extra lesion in my spine that they missed.  I've had several MRIs since then and they miss getting all of my lesions each time.

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