MRI Report

[OMGWHATNow2]

Hi Quix if you're out there somewhere. I have been trying to figure out this MRI summary. So here it is if anyone has a clue what it means.

Technique: Axial T1-weighted spin echo, axial T2 weighted fast spin echo, azial and sagittal T2 weighted FLAIR, axial diffusion weighted and post gadolinium axial T1 weighted spin echo images of the brain were obtained.

Findings: There is no acute infarct, intracranial hemorrhage, fluid collection, abnormal edema, mass efect, or midline shift. The ventricles and sulci are normal in size. Nonspecific minimal periventricular T2 hyperintensity along the margins of the body of the right lateral ventricle, unchanged. Stable nonspecific punctate focus of T2 hyperintensity in the left corona radiata, image 25. There is no mass or pathologic enhancement. The orbits are grossly unremarkable. New tiny mucus retentin cyse right maxillary sinus. Prominent Virchow-Robin spaces bilaterally basal ganglia as before. There is minimal ethmoid sinus mucsoal thickening. The mastoid air cells are clear. The osseous structures are unremarkable.

Impression:
No acute infarct
Nonspecific minimal periventrical T2 hyperintensity along the margins of the body of the right lateral ventricle, unchanged.
Stable nonspefic punctate focus of T2 hyperintensity in the left corona radiata.
No mass or pathological enhancement

Thanks anyone who can help

[jensequitur]

Meh...  Maybe it's time to take a break from doctors!  I do think you have something going on, but like most people in limbo, there isn't enough evidence there to show what's wrong.  

Continue to keep track of your symptoms, and if you start feeling bad again, call him back up!

[OMGWHATNow2]

Welp, so much for that. All labs and tests came back normal. Low Vit D. When I asked again about the MRI suddenly it was "it's unchanged". The week before I saw him I started to feel better and still do. Not sure what is going on but I am DONE. I give up. I don't have the energy anymore. Besides, if the labs are fine I MUST be fine, right?

[Lulu54]

The rheumy sounds like a good call to see him- it appears you are making progress.  As Jen said, hang in there.  You might be getting close to answers.  -Lu

[jensequitur]

HAng in there, chica - sounds like you're on a track to diagnosis.  Good luck!

[OMGWHATNow2]

Hey wanted to let you know what is happening. I went to the new rheumatologist a week ago. Having CT lungs, pulmonary function test and xray of chest tomorrow for breathing difficulty. He did blood work at the office as well as some simple xrays. I go back to him next Tuesday for the results. He spent three hours with me- and not once did he suggest I was crazy. He held up that MRI and said to the guy with him "huh- look at that" and then suggested a neurologist next time. Soooo- I feel like I'm getting somewhere. They do a lot of clinical trials- maybe it makes them more experienced. He said "We're going to go with the Sjogren's for now". So I'll let you know!!!!

[OMGWHATNow2]

They;re trying to make me insane. I think I found a good rheumatology practice from a drug rep friend. I'll be callling them tomorrow to schedule. They do a lot of research as well. Thanks for your comment.

[essdipity]

The psychiatrist isn't trained in reading MRIs. Besides, he wasn't even looking at the films, but at a radiology report, which does say there are abnormalities. This guy is over-reaching, to say the least.

I agree it's time to shop elsewhere.

ess

[OMGWHATNow2]

He also said I seem like I'm looing for something to be wrong. Maybe he's just an *** too and I don't want to work with him anymore. I'm just making up all this crap for fun I guess.

[OMGWHATNow2]

I had the psychiatrist look at the report. He said there is nothing wrong with it. Also said that hyperintensity doesn't mean lesion. What??????????????

[Quixotic1]

hyperintensity=lesion

[OMGWHATNow2]

OMG you guys are saving me sooo much time. Thank you for your help!!!!

[jensequitur]

"Nonspecific minimal periventricular T2 hyperintensity along the margins of the body of the right lateral ventricle, unchanged. Stable nonspecific punctate focus of T2 hyperintensity in the left corona radiata, image 25."

This means that one of the ventricles has some white along its edge, and you have a small lesion in the left corona radiata.

[OMGWHATNow2]

Which part says the lesions? I need to argue my point

[OMGWHATNow2]

It does help. I searched for hours. The last MRI was 9/23/9. They want another one in six months again. I'm going to stop at the PCP and get the first report tomorrow so I can compare them. The lesions could be causing the neuro symptoms right? The lesions could be caused by the Sjogren's? This brain stuff is confusing.

[Quixotic1]

Basically this MRI reports two small T2 lesions in places where MS - and other things - can cause lesions.  At your age, these likely will be called "normal for age", but in my opinion, unless the cause of a lesion is very clear, any "consistent" lesion must be kept in mind in the presence of neurologic symptoms.  That is where so many neuros fall down.

This report calls these lesions stable or unchanged.  When was the previous MRI?  It is uncknown how long an MRI in MS may remain stable.  As I do not believe in MS following "rules", it would seem that it can remain stable for a long time - many years.  I suppose as the years turn into decades, the likelihood of MS drops.  We have posed this question to an MS expert via Lulu, but have not received an answer.  I know that mine were stable for two years, but only "changed" when they used a higher power MRI.

Others on the forum with MS have reported unchanged MRIs for much longer.

The Virchow-Robin spaces are where blood vessels pierce the linings of the brain.  It is commonly held that prominent VR spaces are a normal variant.  However, I have suspicions that these may have some meaning.  I may be wrong.  Here is my thinking:

In the elderly as brain atophy become obvious the Virchow-Robin spaces become prominent, so in the older age groups that finding is considered a sign of brain atrophy.

I have found at least one study that noted that in people with MS, there was a much hihger incidence of prominent or enlarged VR spaces - presumably from the earlier atrophy that is known to occur in MS brains.  The study recommended large scale follow-up of this finding and I have never seen that it was done.  I have also not seen that the correlation has been disproven.

So, I have a nagging suspicion that prominent VR spaces might be a soft indicator of MS.  However, no other neurologist has agreed with me.  I carry little weight in the Neurologic/Radiologic fields, alas.

Does this help?

Quix