Doctor advice request MRI scan

[Les259]

The MRI from 2008 is reading as follow:
Axial sagittal pre and post contrast enhanced T1and T2 -weighted scans of dorsal spine were performed.
Verterbral alignment is normal. Verterbral body heights and disc spaces are preserved all levels. A thin central syrinx is redemonstrated in the mid and upper dorsal spine. No cord expansionor associated enhancing spinal mass.
It is not changed significantly in size since the previous study. No new abnormality is identified.
Conclusion
Narrow central cord syrinx noted between T3 -T9. No enhancement or associated mass. No significant interval change with previous scan.

2009 MRI.
No fracture or destructive bone lesion . No large disc hernitation identified. No evidence of canal stenosis. No obvious
prevertebral or paravertebral soft tissue mass. Best demonstrated on transaxial immaging is a minor syrinx versus prominent central canal which involves the mid to lower thoracic cord. The sagittal imaging was largerly degraded by CSF pulsation artefact. The region of the conus is intact.
Conclusion
Suspicious for a syrinx extending from approximately T5-T9 although this could also represent a prominent central canal only. Sagittal imaging is somewhat degraded by CSF pulsation artefact. There is no evidence of focal disc herniation, canal stenosis or intramedullary tumour.
There has been no significant change since prior MRI.
The question is ,
No large disc hernitation identified . -  can this mean that there is a small one? this is confusing
Is this a syrinx? if there is no significant change how it is possible that the syrinx is now visible on the level of T5-T9
versus T3-T9 on previous two scans, does it mean that it is getting smaller or there was a problem with MRI.
What does it mean - Sagittal imaging somewhat degraded by CSF pulsation artefact?

I would appreciate if a Doctor could shed some more light on this report.

[Jamie880]

All discs degenerate as we age.  Significant areas of chronic inflamation will degenerate quicker than normal aging.  When a disc degenerates or flattens out to the point that it extends beyond the parameter of the joint itself it is called bulging.  Almost everyone over 50 has some "bulging discs".  Many times they are asymptomatic; however, just because they are not causing pain does not mean they are not impacting your nervous system. If the nerve being irritated is for function, like your pancreas, adreanals or gallbladder, you may not associate the symptom with stress on the nervous system.  The radiologist takes your age and average disc height into account when he makes his comments.  One thing I recently learned is that not all radiologists read x-rays the same.  I have significant degeneration in my neck and a syrinx from T7-T9.  One radiologist only noted the syrinx and difinitively stated it is located from t7-t9.  A chiropractic radiologist noted compression fractures or developmental wedging from t7-t9 and the syrinx is "best seen" from t7-t9.  Today I am having a lumbar MRI and a dexa scan.  A dexa scan will show if there actually are compression fractures or if the syrinx is causing the bone to erode.  I urge everyone with a syrinx to demand these tests.  Compression fractures can cause exaggerated curves and scoliosis, both devastating to syringomyelia and chiari.  Get another opinion on your x-rays, get 3 or 4!!  You will begin to see things in a brighter light.  If your insurance company won't pay for additional readings, don't be afraid to call a radiologists office directly and negotiate a cash fee.  Many Docs will jump at the chance to read something like this and one actually gave me his written opinion for free!

[Shane99]

I agree with Selma; MRI reading isn't an exact science - the radiologist looked at both MRI's and his best guess is it's a possible small syrinx, something they will continue to monitor, but as of now, nothing to be concerned about.

And by saying "No large disc hernitation identified" he's not saying you have a small one either - he doesn't see anything worth be concerned about there either - minor disc herniations occur often and fix themselves often. Until it becomes an issue, don't worry about it.

Your best bet, as Selma said; if you are having pains in your back, or numbness anywhere, is to send it to a Chairi/Syringomyelia specialist.

[selmaS]

Hi, unfortunatly there r no drs that participate in this forum as of yet.

I am not sure, but it sounds like the one image  was unclear bcuz of the movement of the CSF.

I could be completely wrong...but again that is my take on it.And to ur question is a syrinx...it appears the radiologist could not be sure on that either. Prominent central canal is a pre cursor to a syrinx and bcuz of the csf mudding up the pictures .

I would suggest u try to send a copy of both MRI's and the reports to a chiari specialist as they also treat syrinx's.

I do hope another member that may know a bit more will chime in.

"selma"