can anyone help with mri reading or im in wrong area?

Hi! I'm new here so I'd first like to say Hello! I'm happy to say that I did a search for MRI info yesterday and happened to find this site that way. It looks like a great site. From what I have read so far, you guys are so nice and helpful. I received my MRI report yesterday and have a few questions about it. Before I go posting the entire thing, along with some brief medical history, I would like to know if this is the correct place to post this type of thing? Thanks for your help in advance! Claudia

[COBOB]

Cluadia,

You can post questions here.  Most of us are just people with MS or people in Neuro Limboland, but everyone here is pretty helpful.  Per the guidelines, don't post anything with identifying information (like MRI images with your personal data on them.)

Bob

[ClaudiaCT]

Thank you for letting me know. I'm 42 years old and was diagnosed in 2001 with MS. I have a MRI once a year roughly. This one is not alarming to me but just different than all other years. The radiologist notes that "This study is somewhat limited by sagittal FLAIR images". I'm curious why they would even say that. Then one thing under findings that I'm not sure about "a focus of T2 signal alteration adjacent to the atrium of the right lateral ventricle appears more conspicuous, although this maybe related to differences in technique" what does he mean, do you think? I had the same type of mri that I usually have so not sure why technique is a problem and wonder what would have been better. Lastly, he starts talking about "no associated restricted diffusion to suggest active ischemia". They have never spoken about ischemia before, why even mention it now and although he is implying I don't have active ischemia, is he suggesting I have non- active if they is such a thing? Or is that normal to mention just like they would mention that they don't see a hemorrhage. Not sure if anyone has this written on their reports as standard protocol. I hjave never and have been going to same place for over 10 years. My dr appt was impossible to get this time so I have a long wait. Figured I would see what others thought in the meantime. Thanks, Claudia

[jensequitur]

> This study is somewhat limited by sagittal FLAIR images

It sounds like the radiologist wasn't happy with the sagittal FLAIR images they received.  

>  a focus of T2 signal alteration adjacent to the atrium of the right lateral ventricle appears more conspicuous, although this maybe related to differences in technique

Here the radiologist is commenting that the lesion appears more conspicuous - meaning larger and brighter - but he isn't sure if that's an actual difference.

>  no associated restricted diffusion to suggest active ischemia

I think he's saying that because of the lack of restricted diffusion (probably he means a lot of punctate hyperintensities) then it's probably not due to active ischemia.    Sometimes it seems like the radiologist starts from square one when they're trying to read your MRI.  Even though he has your past records to look at, he still wants to confirm that it isn't ischemic damage.

Just curious - what strength was the MRI?

[ClaudiaCT]

Thank you. That makes a lot of sense. Good question about strength...I really don't know. How do I find that out?

[jensequitur]

What I do is call the clinic and ask what the machines are - 3T, 1.5T, etc.  I was diagnosed on a 1.5T, but I usually recommend 3T.

[ClaudiaCT]

Ok, I asked and they said my MRI was done using 3T. I wonder why the radiologist was not happy with the images. Maybe the tech did not do as good a job? I have always have it done there so they could do a comparison to the last time I was there and I have never heard that remark of the study being somewhat limited. My only guess is that there are a lot less pictures this time for some reason, and esp in the area he was trying to look. Doubt my ins will want me to go back from a few more pics LOL. Guess I'll be waiting till next year!

[jensequitur]

It sounds like they are saying that... weird, huh?  The good thing is that these are done mainly for tracking - is your DMD working, are you progressing, etc.  It sounds like you're progressing a little bit, but not very quickly.

[COBOB]

If the old scans were done on a 1.5T and the new ones are on a 3T, they loose the ability to compare.  It can really upset the docs.  This is one of the issues with the 3T scanners....they images can not be compared well with the previous 1.5T scans.  The resolution is different, the signal to noise ratio is different and the frequency of the proton spin changes.

Once you move to a 3.0T you basically start over.

Bob