MRI Interpretation

[tracieblitch]

I had a MRI of my brain re-read by another radiologist and I need help understanding his findings before I see my doctor next week....this is the result/change that was noted from the first reading which was showing everything normal which I questioned.

"I called Dr. XXXXXX with this result change.  I beleive that the most likely etiology for this enhancement, especialy considering its somewhat linear appearance, is that of a very small venous anomaly.  Secondary considerations include a small focus of demyelination or ischemia.  Recommendation is for a follow up in 30-60 days for any change to this legion.

I am not getting any answers from my doctor on this, and I am going to Mayo clinic next week to look into this further....I just need to know and understand what the description of the "anomaly" is so that I can ask the right questions about what a venous anomaly would be as weel as understand what demyelination or ischemia is?  Thank you!

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Venous anomalies are common findings on MRIs, typically found incidentally. These vascular anomalies can be of several types: capillary telangiectasia, venous angioma, cavernoma, arteriovenous malformation, etc. Many times these anomalies do not cause symptoms. If asymptomatic, they are typically monitored with serial scans.

An example of a demyelinating process is multiple sclerosis. Demyelination is typically in the differential of many radiological reads, especially if the enhancement is in certain areas of the brain.

Ischemia is also known as stroke. It is an area where there has been decreased blood supply.

All of these are typically in the differential of radiological reads. They must be taken in the clinical context.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[tracieblitch]

Thank you for your input...I wonder also if the follow up scans should be completed by the same radiologist...the follow up scans that were performed to check for any changes were performed at other locations, just curious if this is a good way to track any changes since it was noted that they did want to look again in another few months for changes...the other scan that was performed did not show anything at all that was noted on the first scan...I am not trusting since I have been passed around quite a bit and many things have been missed in diagnosing my problems, just curious.  Thank you

[tracieblitch]

Thank you for your response, the reason I am so cautious with this is that I am still having symptoms of memory loss, cognitive thinking issues, depression and anxiety....that is why I just want to make sure I am cover all bases and repeating MRIs if needed just in case this is something that is starting small and becoming larger....I have been experiencing these symptoms since June 2010 and they have progressively been getting worse and I am unable to work since August( I was A wealth Manager at BAC/Merrill Lynch).  I also experienced Blind Loop Syndrome that no one discovered until I went to Mayo Clinic, so many months went by with vitamin deficiency issues too along with the other symptoms which I also understand could all be related....thank you for your time explaining the MRI.