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11119474 tn?1428702170

MRI Images

Hi everyone.  I just picked up the MRI Images from my brain and cervical spine studies, in
preparation of the MS Specialist appointment coming up in 3 weeks.  I posted a few on my profile if
anyone would like to take a peek, and tell me if they look typical of MS lesions.  The radiologist
says yes, but the general neuro won't call it.  Thanks!
16 Responses
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5509293 tn?1428531475
Hey there, I am going to be watching responses here with a lot of interest. I think it's significant when you have both brain and spine hyperintensities. The spinal ones are especially significant, since there isn't a whole lot else from what I understand that causes those. What was the impression on the radiology report?
Everyone will tell you not  to read your own mris, and that's probably wise. From my own reading on all of this, your brain hyperintensities do not seem typical of MS - in terms of where they are - I have some in the same places, same shape, size, and more of them, and I am told repeatedly that they relate to age (42 at time of first mris), migraines (I don't have them), random things, and that they are totally non-specific.
I hope that helps some. Have you had mris before? Is there an increase in hyperintensities if you have had them before? 3 weeks is going to be a long wait for you!!
Helpful - 0
5509293 tn?1428531475
another thought....you might want to photoshop your images so that your name, etc doesn't appear, since this is all public...not sure if you were aware that info was there.....
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11119474 tn?1428702170
Thanks for your response!  Never even thought about photo-shopping out my name.  I'll do that in the future. No - not trying to read my own MRI's... I can read blueprints, but not these.  :)   Anyway, yes, I've had 7 MRI's in a 14 month time frame trying to get to the bottom of my neurological issues.  I'll just give you the impressions/findings from the latest ones.

Brain: Findings:  The ventricles are normal in size shape and position.  The diffusion-weighted images show no recent infarcts.  FLAIR sequences an T2-weighted show a few scattered focal areas of increased signal involving the periventricular white matter.  

For example, there is a 5 mm lesion within the right frontal lobe on image # 15 series 6.  There are additional bilateral lesions but none of these lesions enhance with contrast.  Apparently, there were two focal areas of enhancement within the cervical cord on the  MRI of the cervical spine dated 08/04/14.  There were no extracerebral fluid collections and no mass or mass effect.

Impression:  There are a few scattered focal areas of increased signal withing the periventricular white matter which are non specific, but would support the diagnosis of multiple sclerosis.  However, there was no contrast enhancement.  No evidence of a mass.  The remainder of the sudy was within normal limits.

Cervical Findings:  As on the previous study, there are abnormal foci of high signal intensity in the cervical spinal cord at the C4 and C5 levels with associated abnormal enhancement on the postcontrast images. The findings are consistent with actively enhancing multiple sclerosis plaques. No abnormal expansion of the cervical spinal cord is seen.

The signal abnormalities lie in the dorsolateral aspect of the cervical spinal cord, typical of multiple scerosis plaques.There is no new focus of abnormal high signal intensity and no abnormal enhancementis seen elsewhere in the spinal cord.  The craniocervical junction is normal.  No syrinx is detected in the spinal cord.

As on the previous study there are mild degenerative disc changes at the C2-3, C3-4, C4-5, C5-6, and C6-7 levels, unchanged.  No central spinal stonsis is seen but there appers to be mild neural foramen stenosis at the C3-4 level on the left and C4-5 and C5-6 levels on the right.

Impression: 1.  Actively enhancing multiple sclerosis plaques are again seen in the spinal cord, not significantly changed since August 4, 2014.  2. Mild degenerative changes are present in the cervical spine with mild neural foramen stenosis bilaterally as described above.

Apologizing in advance for any typing errors!

Thanks,
~Linda

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5509293 tn?1428531475
Linda, looks like a slam dunk dx to me.
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11119474 tn?1428702170
Thanks.  :(   Of course, I do not WANT a definitive dx of MS... but it's just been so frustrating going thru all of these tests and MRI's, and I just want to feel better. It has been an almost 4 month wait to get into the MS Specialist at Vanderbilt, while symptoms continue... some getting worse.  When I started this journey months ago, I had no idea that it would take this long to get answers.
Just like everyone else, I guessed that whatever it was could be figured out in an office visit or two with a neurologist.  

Thanks for your help.  

Hugs,
~Linda
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11119474 tn?1428702170
Oh, an on the subject of non-specific age related lesions, maybe mine (or some of mine) are.  Today happens to be my 58th birthday, so I'm certainly old enough for them.  
Helpful - 0
5509293 tn?1428531475
Hey, happy birthday!! Hope you have been able to celebrate and have some fun in spite of all this. I hope you don't get bad news at your appt but sometimes I can imagine very well that it's better to have bad news than not knowing and fearing getting worse without treatment. I really hope you get the answers you need so you can move forward. Happy, happy, I'll go eat some cake on your behalf : )
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11119474 tn?1428702170
Enloy your cake as I did mine!  Thanks.  LOL!
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1831849 tn?1383228392
Happy Birthday :-)

As to yuor MRI, I'm not a radiologist but it sire doesn't sound as if your results exclude MS.

Kyle
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11119474 tn?1428702170
Thank you, Kyle.  :)
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9745005 tn?1410044366
Happy belated Birthday!  I hope this year brings you answers and relief, and joy and happiness!

Karen
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11119474 tn?1428702170
Thank you Karen!  :)
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Avatar universal
A belated happy birthday from me!

Here's some food for thought: Some people, certainly not all, do get 'abnormal signal' results on brain MRIs due to age, this being more likely the older one is. Often this is due to microvascular ischemia, or tiny bleeds, most likely from high blood pressure.  However, and this is a big however, such lesions do not cause symptoms. They are found in people who do not have MS but who have had brain MRIs for some other reason.

Also, spinal lesions have few causes other than MS.

So if your current neuro sees you because you are having neurological kinds of symptoms, he examines you and orders MRIs which turn out to be abnormal, I hope he isn't now blaming this on age, or waffling if things aren't precisely textbook. No doctor should suspect a problem for various reasons, test and find evidence of that problem, and then shrug his shoulders.

ess
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11119474 tn?1428702170
Thank you for the Birthday wishes, ess.

My General Neuro has done all of the barrage of testing and MRI's to try to come up with an answer. I've been tested from head to toe to rule any other possibilties out. She has not waffled about the lesions likely being age related.  In fact that has never come up in conversation with her.  I only brought that up because of Joidecour's original response.

I do not have, and have never had high blood pressure.  I think my general neuro just won't confirm a diagnosis because the lumbar puncture showed no obands, therefore I'm being sent to Vanderbilt in Nashville.

The symptoms that I saw the neuro for in the first place were for very uncomfortable numbness from the hip level down, right side arm & leg Lhermitte's, back pain, loss of balance, abnormal gait, leg fatigue, extreme cold in my feet, incontinence, absent sexual sensation, generally tired, and mild cognitive issues.  I clinically failed all sections of the office exam relating to gait, balance and coordination.

Over the passed several months I've been tested for just about all other possibilities, all with negative results.  In November, I did get a 3 day course of IVSM and that made a dramatiac difference in my symptoms... maybe reduced by 50%. But over the last few days, I feel on the downhill slide again. The numbness was quite uncomfortable when I went shopping at Wal-mart today.  I don't know how long the Solumedrol is supposed to help, and it's now been three months since the infusions.

So, like I said.... I've been waiting for months to see the MS Specialist, and that happens on Feb. 24th, so we will see.

Meanwhile, I am alive and unwell in limboland.  LOL!

~Linda
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Avatar universal
I did miss this--thanks for pointing it out.

Haven't checked back, and I'm sure there's been discussion, but your current doctor should know that obands are not diagnostic for MS. Although apparently the huge majority, 85 or 90%, do get this result, it seems that on this forum the number is far smaller. I'm one who did not have an LP indicating MS, though that was in '06, much earlier in the game for me. My Hopkins doctors, whom I saw subsequently and whom I still see, have given me the diagnosis regardless, and though I had an easy LP with no negatives, I'm sure not about to rock that boat!

And just by the way, my own early brain MRIs were abnormal from the start. This was blamed on ischemia, despite the fact that I too have never had hypertension.The radiologists took one look at my age, ancient in terms of MS diagnosis, and pretty much dismissed me. Of course, all they knew about me was my age and sex. The several wimpy neuros I'd seen theretofore just went along with that. A specialist is always best.

ess
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11119474 tn?1428702170
Thanks, ess.  Well, I don't know about my current neurologist.  After the LP she jubilantly said... It is good - you DON'T have MS or a spinal tumor. But - I don't know what is wrong, so I will send you to Vanderbilt."  But her assistant, always refers to the likelihood that I do, whenever I talk to her, but says the Specialist will need to figure it out.  Geez!  

The last time I saw her... in early November, she ordered the solumedrol to see if that helped and it certainly did.  But like I said in my other post, the symptoms are getting bad again.

I don't know ... maybe I need to find a new general neuro after seeing the MS specialist at the end of the month.  
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