T2 (T2W - Fast Spin Echo [FSE] Turbo Spin Echo [TSE] and Spin Echo [SE]and T2* - Gradient Echo) are the sequences that most often detect "demyelinating lesions". T1 scans show gliosis and enhancement post GAD if there is a breech in the Blood Brain Barrier. Proton Density (Rho-Sequence) is a study that shows the relative density of hydrogen protons by magnetization transfer (shows demyelination in the spine well.) There are also FLAIR (FLuid Attenuated Inversion Recovery) and STIR (Short Tau Inversion Recovery Sequences that can show demyelination.)
The problem is that the MRI is only part of the story. It is another lab test. I sometimes think doctors put way too much faith in just the MRI. Just because you can't see something, doesn't mean that it is not there. MRI demonstrates macroscopic damage. Nerves and their myelin covering are microscopic structures. Even on a T1, when you see a "black hole," that demonstrates a cluster of numerous astrocytes making up as scar as the result of damage to axon in the CNS.
Looking at MRIs is not just comparing images, but knowing the background medical story. This is not like is a bone broken or not (even though some of those can be tough to see.)The MRI library at USUHS is a good example. The images have to be viewed with the medical history history and physical exam findings to make a "clinical picture."
(Disclosure: I was one of the authors of the Request for Proposal that became the DoD DINPACS (Digital Imaging Network Picture Archive and Communications System that was a primary source for many of these images.)
I love your choices and they made me laugh.. We already have access to the MRI Atlas with its almost 200 pages of images. Why reinvent the wheel? Just wondering.
I dunno. I'm nosey and curious. I downloaded the manual and it's really good, but it only has one short chapter on the spine and it doesn't show what "normal" looks like for the sake of comparison. (Or, in other words, what could be mistaken for abnormal.)
Plus, I just want my damn report so I can get it, take it to a neurologist and move on with my life. All I have now is the pictures and an obsessive nature. :-/
Neurological Time seems to move even slower than Geological Time. Hurry up and wait ... and wait ... and wait ...
It seems to be the nature of the beast.
what is the MRI Atlas you are speaking of? Is it in the health pages? I didnt see it (But I often have a hard time finding things that are right under my nose! lol) Thank you :p
I just found another great resource (link below). Figure 3.5 on p.22 looks almost exactly like the bright(ish) area of my c-spine, which is in the same place (C2-C3) referenced in the original scan's report as a possible artifact.
Your too funny, lol
But, my choice isn't there. My pick would be no (not that it wouldn't have it's use elsewhere) only because we're a patient to patient forum, and no official, or unofficial neurorads here.
But, never say never! Maybe we'll get one and have em' categorize our CNSs like tomorrow!
Thanks, Shell, but I can assure you I am not funny. My mom and sister tell me frequently. :-P
I understand. I wasn't really thinking of the image library as a diagnostic tool, but more of a database of reference images. I think the idea came from another online community I used to belong to, Wet Canvas, which was a forum just like this. There was a reference image library through which people shared their photos rights free so that others could use them for paintings, etc. Seems like if a community of people who have MS and get MRIs pretty regularly did that, after a while, it might turn out to be a useful central source of images and findings that maybe doctors or researchers could access, etc.
Anyway. With that stated, I posted another picture: http://www.medhelp.org/user_photos/show/219715?personal_page_id=2193369
At first I thought the lighter spots in my MRI looked just like the ones from the manual, but then I noticed that the photos in the manual show the spinal fluid as the same brightness as the spots, whereas on mine, the fluid is much, much brighter.
I have lesions on my brain and spinal cord. The ones on my spine aren't bright white they are like you said light and dark spots...not bright white like the several on my brain. Hopefully you don't have it though...IT *****!