quick ? is the radiologists report the final say?

[mrsturbo]

Does the neuro read the mri itself or does he base his findings on the radiologists report?

[immisceo]

Radiologists do not ever diagnose. Their job and specialty is to report what they see in an image and list the differential diagnoses accordingly. The report is then used by the relevant specialist (who sees they patient in person and is aware of their entire clinical picture) to help narrow down what's likely going on. They will then diagnose, choose wait-and-see, or refer the patient on to a different specialist.

Did the report say "is consistent with"? This isn't the same as diagnosing. Did you speak to the radiologist in person? (This usually doesn't happen). I can imagine your panic, as PML is kind of a big deal, but it's also extremely rare. Hopefully you have some more concrete answers soon.

[Rosemary50]

What was your actual diagnosis from your neurologist?  My husband is going through the same thing, radiologist diagnosed him with PML, neurologist disagrees, my husband and all of us are a wreck..he is having blood work for JC virus and spinal tap next week...thanks, Rosemary

[Quixotic1]

I would like to answer Wanna's question about the PCP's and the MRI.  In general the PCP has so much to learn and keep in mind that they do not go for the additional three years training to read all the rasiology stuff they order, chest xrays, upper GIs, gall bladder ultrasounds, MRIs of everything imaginable.

The generalist (internist, family practitioner, gen'l pediatrician) rarely is super-skilled in reading MRIs or most diagnostic imaging except the really common things from their field  (eg. I always read my own chest x-rays).  That is why we have radiologists.  I also don't believe that most generalists should be working up MS, except for the initial stuff.  That is why we have neurologists.  In the old days one doctor could get a handle on all the info.  It is completely impossible now.

IMNSHO

Quix

[mrsturbo]

Thanks for your responses.  I just didn't trust the radiologist since my test was done late afternoon and the rad had already gone home.  He looked at my test, and allllll the tests done the same day as mine, and had reports completed on them all the next morning by 10 am.  My mri was only of the head, but there were over 260 pictures taken.  That's alot to read, mine and everyone else's, in such a short time.

[Want to feel well!!!]

The same holds true with my PCP...she goes by the rad report, but every specialist I have been to likes to see the CD's and see the report.  I'm wondering if it is common practice for a PCP to go rely on the reports only.  I would think it would seem reasonable in the case of a PCP to just use the reports, but specialists should be able to make their own determination by seeing the "films."

Wanna :o)

[santana8]

When I had my first MRI of the  brain with and without contrast, the neuro-radiologist thought that I had something called PML which is fatal usually within a year. My neuro said that he knew that I didn't have this. I asked then why would the radiologist say that it looks like this?  He said that is why he is a radiologist and not a neurologist, He looks at pictures only and I treat the patients! Then he smiled and patted me on the shoulder and said, don't worry, you don't have that. He ran a polyomerce chain reaction test on my spinal fluid , which included a test for this, also a HIV test , because PML is usually found in immunosepresant patients. Both the PML and HIV came back negative, Thank God! My neuro was right about this even before the test was done. I spent three weeks worried to death about what this radiologist said, and the final and correct answer came from my neurologist! So in my case I would say that the neuro  knew best!

Santana

[Jason732]

My Neurologist looks at the MRI films and then reads the report, but my regular Dr. only reads the report. Thank goodness he's not the one addressing my symptoms or I'd have been diagnosed with a brain cloud already ;). Anyway, I agree with the others when it comes to finding a good neurologist that is willing to hear what the radiologist has to say, but at the same time wants to draw their own conclusions about what they see on your films.

[essdipity]

You're right. But the thing is, the radiologist doesn't know us from the man in the moon. There might be a few words on the MRI order, like 'use MS protocol,' or 'right leg numbness,' or something like that, but that's all.

The neuro is the one who is supposed to put it all together. THEY'VE done the exam and performed all the rule-out tests. And they're supposed to be able to read MRIs. This one gets me right where I live, because a former neuro either didn't bother or didn't know how to interpret my MRIs, and because of that I have suffered a great deal, possibly unnecessarily.

ess

[wingnut19]

Let's not forget the Neuro's that totally discount the radiologists report, also...

I mean, shouldn't there be a happy medium??

:)

Tammy

[essdipity]

Then you havve a good neuro!   They are all too few.

ess

[6-paq]

My neuro always reads the MRI himself.  I'm always looking over his shoulder.  ;-)

He will point out the areas in question and look for other possible lesions that the radiologist may have missed.

[Quixotic1]

Hi, again.  I believe that any self-respecting neurologist should read his own MRI images.  They have the most information about the patient and can put findings into perspective.  Any neurologist that relies solely on the radiologist is suspect (in terms of competence) in my opinion.

We have seen this very thing many times on the forum.  The neuro's that just go by the rad. report have also shown that they are not up-to-date in other areas also.

Quix

[Want to feel well!!!]

It's been my experience that my neuro and/or any specialists like to see the actual MRIs/X-Rays/CTs etc. themselves as well as read the radiologist reports.