Questions about my 3MRI How many lesions do I Have.

He everyone,  I just love this cool weather we are having in the Midwest.


I think this is the best MRI report to date,  this is first MRI done at the the University Hospital.
And just when I thought I learned so much,  I still need help with the report- I don't see the Dr for a couple of weeks.

                     Here's my questions,

How many lesions are present? I know none of them enhanced  but are new lesions since the last report.
Location-location-location  are the the lesions in the classic location?
Does the size of lesions matter? Or what's considered a larger lesion?


Ok  here's the the highlights from the report--   sorry  if i have any typo's

Findings- Brain  W/WO  constrast


Image 3 of series 11  demonstrates a 4 mm hyperintence lesion in the periventriclar white matter along the superolateral aspect of the body lateral ventricle and a similar 6 mm lesion in the corresponding location alon the superolateral aspect of the body of left lateral ventricle, these lesion demostrate associated T1 hypointensity- and are unchanged  when compared to the prior MRI.  

The same image demostrates a punctate lesion in the posterior of left corona radiata, that finding wasn't present on the the prior MRI.  Image 12 of the same series demostrated no change in 3 mm lesion further posteriorly and inferiorly along the lateral aspect of the body of the lateral ventricle..  No change in 2 mm T2 Flair hyperintense of the right capsule and the anterior portion of the right external capsule..   it goes  on how other things appear normal.



Impression,  

When compared to the MRI no changes in three T2 Flair hyperintense lesions in the periventricular white matter
adjacent to the lateral ventricles .  there no change in a lesion in the right frontal lobe white matter near the junction of the anterior limb of right interanal capsule and the anterior portion of the right external capsule,  a punctate lesion in the posterior left corona radiate was not seen on the prior MRI-

Spine
1.  Equivocal 1 mm focus of hyperintense signal in the midline dorsal aspect of the spinal cord at the C6-7  level seen on the axial MEDIC images

2. A 2.5 m hyperintense lesion in the right side of the spinal cord at the the level of the superior endplate of C5


OK,,   I have two spinal cord lesions,  only I knew of only one before and it appears that I have more brain lesions and none enhanced,,


Thoughts anyone?
  F/U visit with the Ms Dr  next,   prior to my visit he wanted me to read up on DMD'S


Thanks
Johnniebear

[COBOB]

Sounds like 5 measurable and 1 pinpoint in the brain that were called out.  Two of them seem to have corresponding "black holes" (gliosis) on the T1sequences.

Sorry.  Just a quick look.

Bob

[jensequitur]

Personally, I think the lesion location is more important than the number of lesions.  Spinal lesions cause specific problems.  For example, I have a lesion at T10 that makes both knees numb and buzzy, and makes the right leg weak.  I also have an unspecified number of lesions up above, in the 'upper thoracic' region.  That's what causes my esophageal spasm.

But most importantly, the MRI is not there to find all the lesions, or all the damage.  There's lots of invisible damage that the MRI won't catch.  Don't let the neurologist tell you that because it's not on the MRI, you don't have that symptom.  It's only a diagnostic tool to help the neurologist figure out that you have MS.  Granted, it'll catch the very large problems - the corpus callosum damage, the lesion in my cerebellum, the frontal lobe lesion, the spinal lesions - but there's lots of problems I have that can't be tracked to a specific lesion.  It's rather like trying to figure out if a house is on fire by finding the burned timbers.

[sllowe]

Report states you have:

4 mm hyper lesion in the periventriclar white matter
6 mm lesion in the corresponding location

(I'm confused where they mention the 6mm corresponding lesion demonsrates T1 because they say "these" leading one to believe they are both T1.

T2's are usually referred as hyper, and T1s are hypo (sometimes called black holes like Bob says) and the 4mm they are saying is hyper, not hypo so their reference to "these" throws me off a bit.

Are they T1s or T2s? Maybe Bob would like to add his thoughts further on that. The wording is off.

Regardless, they are not new as indicated on the summary.

The new is the "punctuate" they refer to.

No change in your 3 mm lesion or your 2 mm lesion

Overall, Johnnie, I think you interp'd your report well! You have old and unchanged, and 1 new. The only thing I'm not sure of ref. the spine is if they are new. Where is the comparison to the old? From what you mention you only knew of 1.  

I'm glad you are reading up on your DMDs. Lets hope they stop this in it's tracks. You leaning any particular way?  How are you with needles?

Hope this helps!
-Shell

[johnniebear]

I had old 1.5T MRI  of the spine.. So they were able to compare to.. When I popped the CD in the Mac I could see how much clearer the imagers are on the 3T--  even tho I didn't know to look for-

Injecting -  15  years ago I self  injected  Inimttex
(miss spelled I'm guessing)  so thought of injecting daily isn't a concern ..

The rest of report about my spine talks about the bulge & herminated  disks at C4, C5 C6 C7.
All near the spine lesions..

Thx for your time
John

[sllowe]

Your welcome, anytime.
Those herniations are the worst. Have them too.
What day next week you go?
-shell

[johnniebear]

Quick question ,  are the lesions in the classic area for MS?  Other than the spine lesions..


Thx

John

[sllowe]

Don't forget MS lesions can be atypical. Your report states posterior of left corona radiata, and periventriclar white matter. My opinion is yes, but I'm no expert.

Here's doc Q's HP:

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

-shell

[johnniebear]

I see the MS DR  late next Monday in Chicago .

We are so pleased with ... What a waste of time the other regular  neurology  Dr's  were.

Johnniebear

[COBOB]

The way I read it, there are left and right frontal lobe hyperintensities on the T2 sequences that have corresponding T1 hypointensities.  That means gliosis or axon loss.  

It is possible to have a T1 hyperintensity that matches a T2 hyperintensity, but that is usually after contrast and that would identify an "active" lesion (GAD enhancement.)

Bob

[johnniebear]

Thanks everyone for your thoughts & concerns.

This why we have the best forum on the Web..



Johnniebear