MRI results...having difficulty understanding.

[Tayybayygreen518]

PROCEDURE: MRI BRAIN WWO CONTRAST, 7/9/2015 9:37 AM
ACCESSION NUMBER(S): AFM15001556106
LOCATION: SAAF

COMPARISON: Noncontrast head CT 12/2/12, brain MRI 9/25/12

CLINICAL INDICATION: MRI Brain with and without gad in 25 year
old female patient with MS post partum 7 mos not on any therapy.
Compare with previous MRI..

TECHNIQUE:
1.5T MRI of the brain was obtained with the following sequences:
Sagittal T1-weighted, axial DWI and ADC, axial GRE, 3 plane
FLAIR, and axial T2-weighted.
3 plane T1-weighted postcontrast.

Contrast: 9.5 mL Gadavist was administered intravenously.
Complications: None.

FINDINGS:
Brain: Grossly stable signal abnormalities in the bilateral
periatrial, posterior temporal periventricular, and bifrontal
subcortical white matter compatible with demyelinating disease.
There are new plaques in the right middle cerebellar peduncle
extending into the right cerebellum, right periatrial white
matter (image 27 series 10, and image 30 series 5), and left
frontal white matter (image 17 series 8). There is enhancement
within the right periatrial, left frontal white matter (images
34-35 series 13), and right cerebellar/middle cerebellar peduncle
lesions consistent with active demyelination. There is also small
linear enhancement in the left frontoparietal, although this may
represent an incidental developmental venous anomaly (image 14
series 11 and image 5 series 12).

No acute infarct or intracranial hemorrhage. No significant mass
effect, midline shift, or hydrocephalus.

Intracranial Flow Voids: Within normal limits.

Craniocervical Junction: Normal position of the cerebellar
tonsils.

Orbits: Visualized portions are within normal limits.

Paranasal Sinuses and Oto-mastoids: No significant mucosal
thickening or opacification.

Osseous Structures: No abnormal marrow signal.

IMPRESSION:
New/worsening enhancing plaques in the right periatrial white
matter, left frontal white matter and right middle cerebellar
peduncle/cerebellum, suggestive of active demyelination.

Linear enhancement in the left frontoparietal region may
represent a small developmental venous anomaly, versus additional area of demyelination.

[HVAC]

You can have progression with or without symptoms. When you meet with your neurologist you can see where you want to go from here.

Alex

[aspen2]

This line, "There are new plaques in the right middle cerebellar peduncle extending into the right cerebellum, right periatrial white
matter (image 27 series 10, and image 30 series 5), and left
frontal white matter (image 17 series 8)" suggests there are new lesions, rather than old ones getting larger.

Second line: "There is enhancement within the right periatrial, left frontal white matter (images 34-35 series 13), and right cerebellar/middle cerebellar peduncle lesions consistent with active demyelination".

It's hard to say but these locations are the same lesions AREAS as mentioned in first line, just in a different order.    It could be that the new lesions are the ones enhancing.  Hard to say though.  Perhaps you had previous lesions in this area as well?  You will get much better information from your neurologist.

[Tayybayygreen518]

Also I had 2 pregnancies back to back so that's why I haven't had an MRI in a few years. She ordered this MRI since I haven't had one in awhile and I have been having memory trouble. No physical problems, I only have 2 lesions on my spine. Most are on my brain. What I don't understand is do I have NEW lesions or just previous ones getting bigger?

[Tayybayygreen518]

I have an MS diagnosis. I was diagnosed at 21. I have relapsing remitting Ms. I have been in rebif and tysabri. I was wondering what exactly these findings meant? Their location and what symptoms they would cause. Also do these findings mean that I have had progression since my last MRI?

[aspen2]

It seems you may already have an ms diagnosis,
according to the info under  "Clinical indication".  Is this the case?  And you are not being currently treated (perhaps because of your pregnancy?)

When do you see your neurologist next?   they will want to have a discussion, I'm sure, with respect to the current activity.

Was the mri done for worsening symptoms?

[essdipity]

Yes, I agree also, but remember that the MRI is only a part of the diagnostic picture. What are your symptoms, and what other testing has been done? Have you had a thorough office exam (strength, reflexes, etc) performed by a neurologist?

ess

[kwarendorf]

Hi TBG-

Unfortunately I agree with JJ. These are text book MS findings. There are lesions (plaques) in more than one location and of different ages, indicating activity at least 2 different points in time. The radiologist attributes the lesions to demyelination. MS os a demyelinating disease.

Did a neurologist order the 2012 MRI's?

Kyle

[supermum_ms]

Hi and welcome to our little MS community,

Whilst i'm very sorry to be the person telling you this, unfortunately from my understanding, your MRI will put MS at the top of your possible list of medical explanations, because you have lesions in multiple locations suggestive/consistent with MS and additionally you also have some that enhanced with contract, which is consistent with active demyelination.

Have you seen a neurologist yet?

Hugs.......JJ