Here's a New One for Me - My Brain MRI...

[anon07072023]

I’ve been diagnosed with MS since 2010. For the first time, this brain MRI report says that my white matter lesions could be compatible with atypical distribution for demyelination. He also noted that my lesions are of doubtful clinical significance. Then said that chronic microvascular ischemic change is a differential diagnosis. And in the bottom part of the report under Impressions, it said that I had stable appearance of white matter disease. And it would be compatible but not diagnositic of multiple sclerosis. It is a mildly atypical distribution of demylination. Rule out vasculopathy as a cause.

I have a new neuro and since I transferred to her, she said she wanted to start from scratch by getting a complete round of new MRIs – brain, c-spine, t-spine. Previous MRIs of my spine showed a lesion between T9-T10. I’ve looked up microvascular ischemic changes and it says it’s seen in people with high blood pressure, high cholesterol, and diabetes. I’m the opposite of all 3 of those. ???? I’m just wondering now what this new neuro is going to say, once she sees the report. I wonder if she’ll keep my MS diagnosis or go down a different path.

Thanks,
Kelly

[anon07072023]

Maybe - since they have to put the clinical findings together with the imaging.

[kwarendorf]

I think it's important to remember that radiologists look at images in a vacuum. They are not diagnosticians. The see, they say. It may be that for this radiologist vasculitis/ischemia are the horses they think of when they hear hoof beats, and MS is the zebra :-)

Kyle

[anon07072023]

Thanks Corrie. Not sure what she'll do. I wonder if they'll run any type of coagulation tests on me. Aneurysms and strokes do run in my family.  

[Corriel]

Hi Kelly, what an odd report from the radiologist! When I had my MRI, vasculitis was mentioned and my family doc was still on his stroke theory. Like you, I did not have issues with BP, cholesterol or diabetes.

When I saw my neuro, he was quick to tell me that the lesions in no way looked ischemic but to rule out a deep vessel stroke, he ordered a bunch of coagulation tests to rule it out definitely.

I hope your new neuro looks at your history of symptoms and not exclusively at the new test results.  I do not get it when the experts start questioning things as serious as a dx. It isn't like you wanted a second opinion.

Good luck and keep us posted,
Corrie