MRI report

[Joiedecour]

Ok, got report. Will see Neuro mid January. Here is some of it:
Indications: multiple sclerosis, optic neuritis
Not sure where multiple sclerosis came from since not in order form he gave me.
Here are impressions:
1. Stable appearance of the mild white matter abnormality without evidence for new lesions or abnormal enhancement.
2. Symmetrical appearance of the optic nerves without significant intrinsic abnormalities.
Other comments of interest in report: "A few white matter lesions are again noted on the FLAIR sequence primarily in the parietal white matter. This is a stable finding. There is no evidence of intracranial hemorrhage or acute ischemia.
What is new in this report is this use of two words: "abnormal" and "lesions."

So I do not know what to think. Since the report says no change, I think I stay in limbo. However, prior MRI report said no change and yet Neuro noted change. And there are sagittal images this time showing white spots which are not on prior sagittal images. But I am not a neuroradiologist - far from it!

Is the use of abnormal or lesion significant ? Any and all thoughts very welcome

[Joiedecour]

K thanks! Think it's fixed. Sorry about that aspentoo

[immisceo]

Check your settings. It's likely that you have it set so that only people you've friended on the site can see your photos or that only you can see your photos. This is how I have mine set up, otherwise anyone can see my images.

That being said, no one will really be able to give you reliable or constructive feedback on MRI images. It takes years of training for a reason!

[aspen2]

Did that -- title says in bold "photos (5)" but then in box, says "no photos".  And nothing when I click.  I've tried in a Windows laptop and an iPhone.

[Joiedecour]

Hey there, MRI pics are under my profile in photos - click on my name and then go to photos

[aspen2]

Where did you post them?

[immisceo]

There is no reason your doctor should stop treating your symptoms. If they seem reluctant, I'd find a new doctor. Absolutely keep your appointment. It is your chance to ask any questions face to face. This is valuable time! Write them down ahead of time, since it's easy to forget in the moment. If you do not understand or feel confused, your doctor has an obligation to clarify. I consider that part of their duty of care. Ask them straight up about inconsistencies and where this leaves you going forward.

[Joiedecour]

I know we don't like self-readings of mris, but I put a few saggital images up. One is 2014, admittedly a T1 (they did not do T2 saggital in 2014), and shows nothing, the others are from 2015 and are T2s, and show something. I posted them just to show there is something behind my confusion lol. I have lots of axial too with similar things on them but it is the saggital that confuses me.

[Joiedecour]

So doc left message and said MRI stable, reading off report and saying so nothing to suggest this has become ms. I am sure he has not looked at films yet since it was very clear he was reading and I have had this before when I get all clear on phone and then he changes mind at appt. I am not sure what happens now. Do I still go to my appointment, will I still get access to symptoms meds eg fatigue meds? Is this a good rule-out that there is no change over a year? Is it worth getting a second read on mris? The 4 reports are by 2 different radiologists and range from 'one focal hyperintensity' to what is above.' I don't understand, I am confused, and a bit apprehensive to be kicked to the curb when I have had repeat bouts of symptoms and still no explanation. I can easily accept this is not ms nor will it be but it doesn't make sense to me. Maybe you guys need to talk some sense into me. I am listening

[Joiedecour]

Thank you, Immi

[immisceo]

Some of the frustration in the diagnostic process comes from the wording used by the radiologists. It's always good to keep in mind that they are paid to report on what they see, in the context of why the MRI was ordered. Anything else that's stated is really outside their remit. Also, they'll vary in the vocabulary they use to describe the exact same thing. One person's 'foci' is another's 'lesions'. One person's 'not expected in individual this age' is another's 'abnormal'.

The neurologists diagnose. It's not the radiologist's job. So if someone has "Meets McDonald criteria (2010) for ms" written on their MRI report by the radiologist, it's really a radiologist going a bit beyond their specialty. Phrases like "enhancing lesions consistent with currently active demyelination process" or  "periventricular lesion count increased since previous MRI" is a more professional way to put it. But they're human like the rest of us, I suppose.

Either way, I hope your next visit with your neurologist is a productive one and that you're able to focus on the holidays in the mean time. Easier said than done, I know, but we all deserve a break from health stresses.

[Joiedecour]

Thanks Alex and Aspentoo. I hope January appt will allow him to send me off as dismissed and ruled out. Trying to keep my head space there. It is easier than wondering. It is shocking to me that you have statement on meeting McDo criteria and you are not dx'd, A. We need that diagnostic test asap.

[HVAC]

This is an on the fence report. It could go either way. What is important is if you have had new symptoms since the last MRI. I had a MS specialist look at a MRI report and say it is probably not MS. Six months later he looked at the same MRI and was with me looking at the same report two times. The second time he said this is for sure MS. Go figure. Since then I had an abnormal LP.

Alex

[aspen2]

For me, the use of the words abnormal or lesion were not significant to my neurologist.  Neither were the words "Meets McDonald criteria (2010) for ms".  (He disagreed because he felt the lesions were too small to be considered ms plaque, even though they were in 2/4 of the correct areas)  It will depend on your neurologist.

I will guess that you will stay in limbo.  However, as you said, your neuro may spot something significant, so  .... well ... have a wonderful Christmas, try not to worry about it, and welcome to the "January ms neuro appointment club :P".