Re: LEISIONS on MRI films Without CONTRAST!

Posted By CCF NEUROSURGERY MD on August 19, 1997 at 10:17:32:

In Reply to: LEISIONS on MRI films Without CONTRAST! posted by Kelly  on August 19, 1997 at 07:01:15:







: Let me begin with, I have had two MRI's within the last 12 months and both were done
WITHOUT any CONTRAST. However, each actual report says the MRI's were perfromed with
contrast. I would have remembered if I was injected with anything. Each MRI report says
GLADIUM was used.
My point, is that the LEISIONS described on the MRI results are typically brought out; only by
contrast. Which if CONTRAST wasn't used (AND IT WASN'T) does that make them more
serious?
And becasue ONLY CERTAIN LESIONS are onlyu seen with the use of CONTRAST, their
might be hidden LESIONS being missed.
Despite the above, the MILITARY NEUROLOGIST says MRI results are normal.
Yet, seen an ENT DOCTOR about the GROWTH cited by the MRI and he's said it appears
between the ETHMOID and ORBIT part of the BRAIN!
TECHNIQUE: T1 weighted sagittal images of the head were followed by proton spin density and
T2 weighted axial and coronal images of the head.
The ventricular system and subarchnoid spaces are normal. There is no evidence for intraaxial or
extraxial hemmorrhage, fluid collection or mass effect. There aree are five subcortical white matter
punctate foci of abnormally high signal in the left frontal lobes and two punctate foci of abnormally
increased signal in the subcortical white matter of the right frontal lobe. These foci are of uncertain
significance and may reflect a residual of previous trauma, resulting from a demyelinating process,
or possibly reflect averaging with adjacent cortical gray matter. Foci of abnormal signal are only
definitely identified on coronal images.
There is a minimal mocusal thickening in the base of the left maxillary sinus. The remaining
paranasal sinuses are well aerated. There is normal flow void within the corotid basilar and
vertebral arteries.
IMPRESSION: Several punctate foci of abnormally high signal in the subcortical white matter of
the frontal lobes bilaterally. The foci are of uncertain significance and may be related to previous
trauma or possibly a demyelinating process. Clinical correlation is advised.



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Dear Kelly,
What is described in your MRI report are nonspecific changes in the brain
that may be associated with a history of trauma, demyelinating disease or
what is called small vessel disease.  These findings may be of little
clinical significance.  From the report there is no mention of a tumor,
so the information the ENT doctor gave you may not be accurate.
It is not clear what may be your medical condition.  Why were the MRI's
ordered?  The findings on MRI need to be read in the light of your
medical history and present symptoms, if any.
Your best bet is to return to the physician who ordered the MRI's and ask
for a clear explanation of what the findings are.  If you cannot get a
satisfactory answer you may choose to get a second opinion.  If this is the
case, you should get copies of your MRI's and medical files and seek the
opinion of another neurologist.  He or she should be able to assist you.
You have legitimate questions about the findings on MRI and deserve
clear, understandable answers to those questions.
Good luck.