Have to comment on the name you have choosen...gonefishin. I know that I have gone fishin' to try and find answers to the symptoms I have had. The information, experiences and other peoples questions are and have been most helpful. I think searching for the answers yourself will help you understand this disease and the process more than any thing else will. I hope you find your answer, and I hope it isn't abreviated MS.
Dear Gonefishin:
Sorry that your having symptoms and wondering thoughts about the results of the MRI. MS is not based on MRI findings alone. If the symptoms are not waxing and waning with time intervals of recovery, no one would call MRI lesions MS. In fact, some of the new criteria that is being bantered about would not make you a candidate for MS based on your MRI even if your doubled your lesions and make them of various time points. The paper by Paty, is a study trying to unify the research criteria for evaluating MS patients. It is not trying to make a case for MS diagnosis by MRI. One needs to consider where the lesions are located. There are small ovid areas of hyperintensity on T2 that are Virchow Robin spaces and have in the past, been called hyperintense areas by radiologists. Certainly, periventriular location is predominant in MS, but it depends where periventricularly the lesions are seen. In MS the lesions follow the small to medium venules in a finger-like pattern. I did not get the feeling that was the description of your lesions.
Hyperintensity is a term used when the MRI signal is shorten on T1 or T2. Enhancement means that there has been breakdown of the blood brain barrier and now some of the contrast material gets into the brain tissue.
I would side with the neurologist and his/her assessment. Unfortunately we all get these hyperintense areas in our brains as we age. There is not been any association with dementia or demyelinating disease noted.
Sincerely,
CCF Neuro MD