Quix, please help with my 3 Tesla mri results

[monotreme]

Hi Quix, I had a 3 T brain MRI  last Friday done at Johns Hopkins hospital which was ordered by my new NJ neuro.  Baltimore is the closest place that has the 3 T machine.  Anyway, here are the results:  Brain parenchyma shows mild generalized volume loss with dilatation of sulci and ventricles.  Multiple scattered T2 flair hyperintensity is noted in the periventricular and subcortical white matter.  There is prominent T2 flair hyperintense lesion noted on axial slice 28 perpendicular to the body of the lateral ventricle in the left posterior parietal region.  Ventricles and sulci are normal in size, shape and position.  No abnormal fluid collection.    Impression is : parenchymal volume loss.  and Nonspecific scattered T2 flair hyperintensity in the white matter, probably chronic small vessel ischemic changes.
  Ok, here is the additional complication. I called natl Institute of health last week because I saw they were looking for people with neurological problems but no diagnosis.  The doctor called today after reviewing my brain mri and other reports and he said it is obvious I have something wrong in the brain.  he said I have alot of black spaces where there should be brain tissue.  he thinks I have normal pressure hydrocephalus and the black spaces are filled with fluid.  he said it is cured by doing spinal taps.  I told him I had a LP the other week and it didn't help.  Quix, aren't these the black holes you can get in MS???    What do you think of the brain mri report from Hopkins?  I am so confused and upset because I keep getting worse memory loss and more spasms in my legs.  Thank you for your time.  I hope your eyes are doing better......Craig

[monotreme]

Thanks for your kind words Quix.  I wasn't offended.  You amaze me by what you can do for me and everyone on this forum.  I really like this site.  My wife the nurse said the other day that of all people she has met as a nurse, all of you, suffering from MS and limbo-land, are the nicest group of people we ever could have met!!  ....Craig

[Quixotic1]

A couple things.  Another place to look for the 3T machines is in the privately-owned, free-standing "Imaging Centers."  One of those is where I got mine done.  They'll do anything.  Mine was pricey and out of my Medicare plan network so I had to pay a copay of 10% ($500).  Well worth it for me.

Second, on a post yesterday, I mentioned some of the men who have joined us and neglected your name, you who have been our most consistent support and frequent poster.  I am so, so sorry.  It's weird, because I think about you and what you're going through all the time.  I truly hope I didn't hurt your feelings.  I was just writing on the fly, but the oversight wasn't intended.  Quix

Yvette, you're probably right, I missed a whole bunch of people.  I'll look for your posts. Q

[monotreme]

Hi Yvette.  My neuro's name is Richard Rosenberg and he is in Morristown NJ.  He did not tell me to go to Hopkins.  He gave me the MRI order and told me to go wherever I wanted.  I went to Hopkins because that is the nearest 3 T  MRI  I could find.  I live in DE.  The ride was well worth it.  Good Luck...Craig  ...p.s. I grew up in North Jersey and still have family there.  My wife grew up in South Jersey.

[monotreme]

I think the 3T MRI had much better resolution.  When I put the 3T cd in one computer and the 1.5 T cd into another computer in the same room, the difference was amazing.  You could see so much more of the brain!!  The problem is the availability of these better machines.  For example, the university hospitals in Phila only use 3T for inpatients and Hopkins only uses the 3T on inpatients and brain MRI for outpatients.  I wish they were more easily accessible because I would love the 3T to do a spine MRI for me.  maybe NIH will.  I hope the neuro in NIH or at least the one in NJ will acknowledge MS.  My fear is that they will write it off and NIH will start testing me to the max for something else.  To be continued....Craig

[vizslagal]

I'll bump my recent posts for you. They probably got lost on the 2nd or 3rd page while you were feeling poorly and pushed quickly with all the new people joining and posting questions for you.  I hope you are feeling better, btw.

Yvette

[Quixotic1]

I should add:  The black hole will happen when any insult from a stroke or infection or MS destroys an area of brain.  The cells die and are eventually reabsorbed, to be filled with CSF.  If there are enough of them the brain can't support it's original structure and "collapses" or settles or compacts around them to show "atrophy."  So the black hole spaces do not have to be MS.  As you go through this, DO NOT rely on my gut feeling.  I never studied on MRIs and the field is too technical for me to learn much now.

However, it does seem like the 3T machine was superior for your case.  Do you agree?  I ask for the reaffirmation because I really want to make sure my info here is good and sound.   And, if it is MS the "spine" images on the 3T might give the conclusive answer like it did for me.

Hi, Yvette - Always glad to see you.  Do you generally read along?  What's happening with you?

Quix

[Quixotic1]

Radiologists would be eaten alive if they make "diagnoses" for diseases that require "clinical correlation" - knowledge of the patient's history and exam.  Their job is to describe the image the best and most complete way possible, way possible including ALL the negatives and the pertinent normals.

I CANNOT wait to hear what your new neuro says.  On my notes I wrote, "BINGO! - MS"  We'll see if I'm right.  I have to say that a neurologist from the NIH has it over on me at least 1000 times over.

Quix

[vizslagal]

How interesting that your neuro sent you down to Balimore for the 3 T MRI.  Had you had one done before in NJ that he wan't better resolution?  Just curious I live in NJ too.  What neurologist refered you?

Yvette

[monotreme]

Thank you Quix.  I really do appreciate your time and expertise.  I am still in shock and disbelief, like this is on TV and I am watching someone else go through this disease, not me.  I called Hopkins and got the report which just got typed today so my new neuro doesn't have it yet.   I will call the office and fax my copy to them.   Why don't radiologists diagnose things when they read a MRI?  Sometimes it seems like they are just "sight officers"..Thanks again....Craig  

[Quixotic1]

Oh my, you really do know that this is not my specialty, don't you.  What I say cannot be relied on in this situation, but when I read your report, I thought this would be your clincher to the MS diagnosis.  If, indded this is the picture of normal pressure hydrocephalus, the small amount of fluid they did in the diagnostic LP might not be enough to give you relief.  I just don't know.  I don't think normal pressure hydrocephalus would cause little areas of drop-out (black holes), but I really don't know.  And your old neuro said the atrophy was normal!!! Idiot.  This needs to be thrown in his face.

Lynn may be able to answer about the way your brain is loing volume.  

The lesions are in the areas most commonly affected by MS AND the one larger lesion is apparently elongated (ovoid?) and is "perpendicular to the ventricle."  This is the classic location and orientation of the MS plaque.  What is your new neuro saying????

Did the doc from the NIH know your clinical history and physical exam?

However, HERE is your "smoking gun!"  I've been telling you you aren't normal!!

Quix