Understanding the MRI report

[abbey03dj04]

My husband is 25 years old and has had several MRI's to see if he has MS. We are still in the process of finding out if he has it it. I am trying to understand what the MRI found. Help.

"There is a single small focal area of increased signal in the white matter adjacent to the frontal horn of the left lateral ventricle on FLAIR and T2 weighted imaging. This area measures about 7 mm."

After this MRI report we had a MRI with contrast done. It was even more confusing to me.

"Thin imaging through the frontal lobes again demonstrate the low T1 signal adjacent to the frontal horn of the left lateral ventricle, which does not enhance following IV contrast."

Both reports say the findings are non- specific. Is this finding a lesion? We have tried discussing this with our doctor and are currently awaiting an appointment to discuss all test results.

[Lulu54]

hi Abbey,
while you are waiting to see this doctor , do yourself the favor of taking some time to learn more about MS and prepare a list of things you want to talk about.

Rarely do we get to cover our entire list of questions - depending on the amound of time you have for the appointment, you may get just a few questions tackled.

We have great health pages here, including one about how to prep for your neurology appointment -  

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Doctor-Visit-PREP---Be-Prepared/show/156?cid=36

I'm not sure if you understand that a lesion in the context of MS is totally different that we think of as other lesions.  In MS, it is a scarring and not a growth.  Most people - including me- didn't get that at first and hearing that I had lesions was pretty frightening.  It took me a while to slow down and understand that this is a diagnosis that can't be rushed.  

The fact that your report says the spot does NOT enhance just means that it is not new.  MS lesions enhance with contrast is they are less than 40 days old.  It is a marker used to show separation in time in making the diagnosis.

I hope something in here makes sense - I feel like I'm confusing myself right now.

welcome again to the forum here - we are available to answer any and all of your questions.

be well, lulu

[abbey03dj04]

Thanks! I so feel the same way! I plan on mentioning to the doctor how her staff is acting. It is childish. Your note gave a big smile!!

[LisaJF]

Any doctor's office secretary answering the telephone annoyed at the "patients" who call in concern of their OWN health should be f'n fired!

I swear I would report that person to the doctor himself.  He is well aware the company that he keeps around him (secretaries and the like) represents him and his practice.  I'd complain -- but that's me.  How dare his office treat you with disdain as if YOU are the pain in the @$$.

If their attitude did NOT change, I would go elsewhere.  This is your husband, this is HIS LIFE, this is YOUR LIFE.  Take the #$&#!'ing time since you're getting paid for this!

I wish you the best of luck as well as your husband.

God bless!

Lisa

[abbey03dj04]

Thanks. We are trying to find a new doc, but are having trouble getting one to take us. I am going to call our insurance provider. I have not thought of telling them.

[COBOB]

Sorry for the treatment you are getting.  You and your husband have to deal with the problem 24 x 7 and you are paying the bill.  They work for you and you need to remind them of that.  If you don't like the service, find another doc.  Also call your health insurance provider.  They really hate complaints from the subscribers.  

Not a nice thing to say, but the squeaky wheel gets the grease.  

Bob

[abbey03dj04]

Thanks for answering my question! I have tried to call ask the doc, but the staff always seems so annoyed that I call. I am going to ask about this specifically at our next visit. I really appreciate the info the more I know the better decisions me and my husband can make!

[COBOB]

It seems they saw a 7mm lesion on T2 and post contrast, there was a small T1 signal in that lesion.  That would indicate an "active lesion" or what you sometimes see referred to as a GAD Enhancing lesion.  T1 signal after contrast administration is "enhancement."

Bob

[abbey03dj04]

Thanks for answering my question! I know have some new info to look into to help my husband. I am going to add your suggestion to my list of questions for our doc appointment.

[abbey03dj04]

Thank you so much for answering! You gave me more info than I have been to get from my doc. We have appointment soon and the staff haven't been able to really answer my questions. Now maybe I'll know what they are talking about! LOL

[jensequitur]

The 'single small area of increased signal' is what they call a lesion.  An MRI of the lumbar spine will not show lesion activity.  At the lumbar, the spinal cord becomes what they call the cauda equina - a bundle of nerves.  

Spinal lesions are indicated when there's problems with the limbs - trouble walking, numbness, weakness, loss of muscle control in the hands, etc.  If there's any abnormal sensation when the neck is bent, that's called L'Hermitte's sign - it indicates a lesion in the neck.

Anyway, what I would recommend is an MRI of the thoracic and cervical spine.

[PandorasBox91]

Hi there,

I am by no means on expert on the brain and MS but here is what I know. When an MRI is performed to look for signs of MS, they look for "plaques" which are dense white areas on the MRI scan. The "white matter adjacent to the frontal horn of the lateral left ventricle" is a region in the brain, white matter is composed of many nerve fibres and the lateral left ventricle is where cerebrospinal fluid is made. This is a common area for MS plaques to show up, along with the spine and optic nerves form the eye.
This is not conclusive of MS, but the doctor will obviously know much more than I do. Hope this helped a bit anyway.

[abbey03dj04]

We are waiting for spinal tap results to come in before they will see us again. They did an MRI lumbar spine without contrast. I am assuming that is not the same as what you mentioned. We have had 3 MRIs, an EEG, an VEP, and a ton of blood work. Just trying to understand things so I can ask questions for next visit. Thanks for responding.

[Wobbly]

Hi there, sorry can't help with the answer as it's Non Specific and the Neuro will have to answer for you.  When is your appt?  Hope you get some answers soon.  Did they do a C Spine MRI as well?

take care
wobbly