Quix and Heather MRI results

Hi there......I finally got a copy of my MRI.

The report says:solitary, nonspecific 4mm left frontal white matter lesion, which could be related to early small vessel ischemic disease, vasculitis, migraine headaches, (I have only had one in my life), past infection, and much less likely MS, since it is solitary. The appearance of the brain is otherwise unremarkable. There is left maxillary sinusitis.

Any comments or feedback would be greatly appreciated. I guess I'll have to look elseware for the cause of the pain and weakness in my legs. I do have that bulging disc at L4-5. Can it deteriorate in 11 months? I couldn't even cross my legs last night my left leg and hip hurt so bad, with pins & needles and pain in both legs. Is a 4mm lesion large or small?

Thanks for any ideas or imput, am off to work shortly, so will check back after work...11:00pm.Maggie

[Quixotic1]

Hi, Kiido, I have a comment.  Mostly it's a sharing of my own experience.  When I presented to the neurologist with right leg weakness and spasticity my MRI had a "single, lonesome, solitary lesion of 4 to 5mm deep in the frontal lobe."  The radiologist and my neurologist dismissed it as a UBO (Unidentified Bright Object) of doubtful significance due to my advanced age of 52.  I had no visiable lesions in my spine.  So that was my only lesion.  By dismissing it, I went without a diagnosis for more than 2 years.

When I finally reached a real MS Specialist he "jumped on it" and explained why.  A 4mm lesion, though not huge, is a definite lesion of real size.  The literature reports that the majority of MS lesions are at least 3mm - as opposed to being "punctate" or pinpoint sized.  The lesion was well demarcated, that is, it had very distinct borders.  It was ovoid - the classic shape of the "typical" MS lesion, and its long axis was "perpendicular to the ventricles" the "typical orientation" of an MS lesion.

The lesion you have is not in a "classic" or most common location.  That does not rule it out of being an MS lesion.  Remember that the typical pattern of MS lesions is based on the plotting of thousands of lesions from many hundreds of patients.  All together they do fall mostly into a pattern, but many also fall outside the "pattern."  If there is only one lesion it's location doesn't tell us much at all.  Rejecting it as possibly from MS shows a rigidity of thinking that will miss a lot of diagnoses.

Since then, many more lesions have appeared on my MRIs, possible due to increasing disease activity and more likely due to the fact that all of my subsequent MRIs have been on the higher power machines, the 3T.

So, from my perspective that "solitary" lesion can't be discounted.

The report of sinusitis on an MRI has to be taken with several pounds of salt.  The MRI is SO sensitive to inflammation, even old inflammation, that it WAY overcalls sinus disease.  The Gold Standard for the diagnosis of sinusitis is the CT scan.

I hope this helps a little.  Quix

[LLWB]

Yes it does help, but just keeps me in limbo-land. Oh well, I have lots of company. I asked the radiologist about the machine and she told me it was a T1.5? The really weak one. In order to get the T-3, I would have to go to Portland, 300 miles away. And now that we are in the new year, back to having to pay the deductable again. Oh joy. I see my PCP on the 17th.

Thank you for the information about the size issue. At least now I know that it's not all in my mind, it's all in my mind.LOL.

I will ask dr about the sinusitis issue, but I have had lots of problems, with my sinus that antibiotics haven't seemed to help. But I can live with those problems.

I had an MRI last Feb that saw a bulging disc at T-8 and one at L4-5. Would that MRI have show spinal lesions if they are there? I have been having a lot of back trouble, and problems with my legs.Or is the procedure for finding spinal lesions a different one? Thank you so much for your help....Maggie God Bless You

[Heather3418]

The process of finding or seeing a spinal lesion, is an MRI of the entire spine with and without contrast dye.  

The bulging disk at T-8 (the thoracic area of the spine) and disc problems at the Lumbar (lowest level of the spine) could be causing some of the symtpoms you are having with your legs.

So finding a lesion in the spine, if there is one, is the same process as the brain.

Oh, when Montel Williams annouced he had MS several years ago, he said that only ONE lesion was found on MRI.  So I have to agree with Quix on this one.  The total size of a single brain lesion is not what excludes MS.  It's the signs and symtpoms found on physical exam, relapses and remissions of symptoms, etc., that helps the doctor determine the diagnosis of MS.

In your case, if you feel that having an MRI of the brain and spinal cord on 3T would show more lesions and provide further proof to your doctor, than I would certainly travel 300 miles to have it done.   What does your "gut" tell you to do?  Listen to that "little voice" whispering in your ear.  Listen to your body and what it is telling you.

I sincerely hope that nothing less that 3T magnification of (power of the magnet) will be the MRI standard very soon.  It seems the costs of MRI's have never decreased as the technology became standard.  I know the machines costs millions, but I would have expected the cost to the patient to have gone down by now.  Now facilities purchasing the newer, more powerful MRI machines: I would still expect to see the higher prices passed onto the patient.

Heather

[Jazzyfizzle]

Hey there Maggie,

Here is the way my report reads -


Impression: Nonspecific White Matter Disease
There is a subtle area of bright irregularity involving the deep white matter of the periventricular region in the right parietal lobe. There is also a small area of increased signal on FLAIR sequences in the periventricular white matter of the frontal lobe. These could be related to old small vessel ischemic infarcts. Demyelinating disease is not totally excluded. The left side of the brain appears normal.
The ventricles are normal in size.


Mine was performed on a 1.5 T (I phoned to ask the other day). I am thinking of phoning OSU and asking if it is possible to have one done down there on that 7t or at least find one with 3t.

Jazzy