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6012171 tn?1381679620

MRI question



Hi Everybody!

I have a question about my latest MRI.  After the MRI, I had a same day appointment with my neurologist.  He said that the MRI was "stable" but he didn't elaborate beyond that.  I assumed he meant it was unchanged from the last MRI that I had about a year ago so I didn't question him on it.  But I was also surprised that it was stable because I had a really rough 3-1/2 months this summer.  Then when I read the report this morning I saw that it says I have "5 foci of signal abnormality".  I've only ever had two lesions in the right frontal lobe shown on MRI since 2011.  So what exactly is "5 foci of signal abnormality"?  Does that mean I have 3 new lesions?  I'm trying to figure out my neurologists definition of "stable" lol.

Here is the report:



EXAMINATION: MRI OF THE BRAIN WITH AND WITHOUT CONTRAST

HISTORY:   45-year-old woman with history of demyelinating disease

COMPARISON: 11/25/2014 and 10/13/2014

TECHNIQUE:
The following sequences were obtained through the brain on a 3T MR
scanner:
1. Precontrast: Sagittal T1 FSPGR; axial T1 FSPGR, DWI with ADC map,
and EPI DTI.
2. Postcontrast: Axial T2 FLAIR, T2 FSE, T1 FSPGR, T1 MEMP; sagittal
T2 FLAIR.
Coronal and sagittal reformats generated from FSPGR data.

Post processing:
1. NeuroQuant volumetric evaluation performed and color maps and data
archived on PACS.

IV Contrast: 4.8 cc Gadavist.

FINDINGS:
Parenchyma: There are stable approximately 5 foci of primarily
subcortical signal abnormality in the right frontal lobe. There are
no new areas of white matter signal abnormality.

There is no restricted diffusion. No enhancing abnormality.

The ventricles and cisterns are normal in size and configuration.
There is no significant mass effect. Central vascular flow voids are
preserved. Orbits are unremarkable. Visualized paranasal sinuses and
mastoid air cells are well aerated.

Volumetric MRI: Cortical gray matter measures 33.23% of intracranial
volume. Hippocampal volume measures 8.09 cc. Lateral ventricular
volume measures 28.22 cc.

IMPRESSION: 


1. Stable brain MRI with several areas of nonspecific right frontal
white matter signal abnormality. No new areas of white matter signal
abnormality. No enhancement or restricted diffusion..



I really appreciate any insight you all can give me on this :)

Jess
5 Responses
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5112396 tn?1378017983
I would certainly ask, but bear in mind that it could simply be down to the difference between the two radiologists who did the reports (assuming it was different people).

Yes, these are highly trained individuals but still liable to make subjective calls about what is significant enough to include in their report or not. Ditto your neurologist. He could look at both MRIs and not place a lot of weight on the radiologists' reports and make the call him/herself that things are stable. In the end, it's their opinion that carries the weight here.
Helpful - 0
14631020 tn?1436545476
If you have a copy of your reports I would certainly ask the neurologist.  Normally my neurologist looks at my MRI's himself after the radiologist interpretation.  I notice in the "findings" he says the 5 foci are stable, so he is seeing them on the older MRI.  I would ask my neuro though.
Helpful - 0
6012171 tn?1381679620
That's why I'm confused though.  All of my previous MRI reports have stated in the Impression and Findings sections that I only have two areas of signal abnormality. This most recent report states that there are "5 foci of primarily
subcortical signal abnormality in the right frontal lobe".  I am confused as to why this isn't considered a change from my previous MRI's
Helpful - 0
1831849 tn?1383228392
I agree with Shannon. Radiology Speak is a very scary language
Helpful - 0
14631020 tn?1436545476
As an xray tech, my best advice is to just read the impression.  The radiologist is saying there are no changes from your previous MRI.  The radiologist's have to rehash everything from your previous MRI, but the impression is the short form of all of that complicated radiology words..

Shannon
Helpful - 0
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