MRI Results

[jessie438]

Hi!

Can anyone explain what this MRI report means:

History:  Follow up focal areas of white matter hyperintensity.

Procedure:   Scanning is performed on the GE Signa 3.OT scanner.  T1 axial pre-and postcontrast, postcontrast fat-sat coronal and MP-RAGE sequences with three-plane reconstruction are processed.  10cc of Omniscan was administered intravenously.

Comparison:  Recent MR brain without contrast

Findings:  The reported two focal areas of white matter hyperintensity involving the right frontal lobe are not visualized on the T1-weighted postcontrast images, but there seems to be some marginal enhancement on the T1 post contrast fat sat coronal sequence image #8 involving the larger of the two plaques.  The smaller right frontal lobe white matter lesion does not enhance.

IMPRESSION:

The larger 8x4mm right frontal lobe white matter lesion seems to exhibit marginal enhancement.  This is suspicious of evolving demyelinating disease with one being more chronic than the other.  A follow up exam in 3 months is requested to reevaluate these finding to document resolution of enhancement.


Thank you

Jess

[jessie438]

Yes, that does help, thank you!  Unfortunately, the neurologist I saw didn't have much to say and treated me like I was making up my symptoms.  My symptoms came before the MRI and are the reason my doctor ordered the MRI.  The neurologist ordered a nerve conduction test which was normal except for mild carpel tunnel.  My problems are in my left leg though, not so much my hands.  

Can migraines cause the same kinds of lesions?  

Jess

[kwarendorf]

Hi Jess -

Radiologists are not diagnosticians and are world famous for their ability to hedge their bets :-) In your case it is the " either MS or ischemic in nature" comment that continues his/her membership in the club :-)

It's not their job to reach conclusions, just to report the actual findings from the MRI. It's your neurologist that is the one to make the choice of ischemia or demyelination.

Ischemia is related to blood vessels and blood flow. If the blood vessels in the brain become obstructed or damaged the result can damage that is similar in appearance to demyelinating lesions.

Hope this helps,

Kyle

[crowther]

my young daughters mri stated a oval shaped subcortical focus of high signal on the t2 axial sequence in the right frontal matter.

small field of view CISS images confirmed that this is a prominent perivascular space . But a neurologist has not even looked into this.

As my child has numerous symptoms that are so close to MS that I am worried scared.

[jessie438]

Thank you so much for your informative answer!  I pretty much got the run around from the neurologist.  The radiologist told my doctor that he felt it was either MS or ischemic in nature.  I'm not completely clear on what ischemic is and I don't know how it would relate to my symptoms.  My doctor has ordered another MRI within the next two weeks so hopefully that will give me some answers.

Jess

[Quixotic1]

Well, here goes

History:  Another look at localized areas in the white matter (as opposed to the gray matter) which should up as bright areas on a previous MRI

Procedure:  This was done on a GE 3.0 Tesla scanner (good strength).  A whole series of different electromagnetic pulses were used and a whole series of miracles happened which the computer turned into a new series of pictures.  Contrast material was used.

Comparison:  A previous MRI which was not done with contrast.

Findings:  There were two bright areas (lesions) seen on the earlier scan in the right frontal lobe which were not seen on just one of the magnetic pulse sequences after the contrast was given.  However,  after a different magnetic pulse pattern both prior lesions were seen.  The larger of the two appears to have enhancement (even brighter image) after the contrast.  The smaller spot does not enhance.

IMPRESSION

The right frontal lobe continues to have two lesions.  The smaller one looks the same, but the larger one show enhancement, which indicates new inflammation and newly, expanded activity.  This all looks like ongoing and growing demyelinating disease (code word usually for MS)  with the smaller lesions looking just chronic (old and unchanging).  The neuroradiologist recommends another MRI with contrast in three months to see whether the new inflammation has settle down.

Jess, you might want to read the Health Page on "How MRIs Show Lesions In MS"

http://www.medhelp.org/health_pages/Multiple-Sclerosis/How-MRIs-Show-Lesions-in-MS/show/23?cid=36

Hope this helps.

Quix