MRI Results-Can anyone explain in laymen's terms?

[barbdwyer]

Can anyone explain what this means in terms I can understand?  My neurologist wanted to compare this new MRI to a former one from this year to see if the spots (plaques) he saw increased or not (?), suspecting possible MS.  I think him, as well as several other neurosurgeons just don't know what else to do for me regarding my Chiari Malformation and Syringomyelia, so he's thinking along the lines of something he actually has knowledge about, which is MS.  I don't have MS, I know I don't.  Still, I'd like to know what this means before my appointment in three weeks.  I need to make a decision on whether I need to go for yet another opinion.  I'm hoping I can finally find someone who will help me (or at least admit that they can't).

Thanks!

HISTORY: Chiari malformation postoperative. Comparison with 03/18/2010


TECHNIQUE: T1-T2, diffusion and postgadolinium MR head.


The cerebellar tonsils descend to the C1 level with mild mass effect
associated. The ventricles and cortical sulci are within normal limits.
Several nonspecific punctate foci of increased T2 signal are again
present in the white matter. Associated increased T2 signal is present
in the medial frontal cortex. Note is also made of CSF slit like
structure in the dorsal spinal cord at the craniocervical junction.


Following gadolinium administration there is an unremarkable enhancement
pattern. Findings are stable compared to prior study.


CONCLUSION: Stable postoperative findings following Chiari I surgery.

[barbdwyer]

Thank you Bob and everyone!

I am glad to have an idea of what the findings are.  It looks like it has not changed since my last brain MRI, which may be good.  I have other issues with Chiari Malformation and Syringomyelia and I don't think the docs quite know what to do with me.  They don't know what these lesions mean, but since this is a sign of MS, I believe my neurologist wanted to rule it out.

Thanks again, I feel I will be more confident now when I go see him later this month.

[COBOB]

This is where MS Diagnosis gets complicated and some neurologists get messed up.  If you have 2 lesions with Dawson finger characteristics in the white matter near the ventricles on you fist MRI, and no attacks, it's not diagnostically MS.  You have an attack 1 month later (say loss of feeling in your left leg.)  All other causes are ruled out.  Then they can diagnose CIS (Clinically Isolated Syndrome.) Things get better and 6 months later, you get Optic Neuritis.  Now they can diagnose MS. Left leg is a different "space" than Optic Nerve (Second Cranial Nerve.)  6 months later is "dissemination in time.  The Neuro dosn't need to repeat the MRI, though it might be recommended,  Positive MRIs support the clinical diagnosis.  You can have MS with a clean MRI.  Negative MRIs do not rule out MS.

Bob

[BOK2Bjan]

Bob explained everything well - I thought I'd just add that the important finding is that there is no change from the previous MRI.  MS is a diagnosis that is only made if lesions are found in the white matter indicative of a demyelinating process in at least two different places at a minimum of two different times.  It tells the Dr. that the destruction of myelin is taking place over time and in different places.  That's the pattern that fits the disease.  The report sounded like your brain hasn't changed since the surgery, which would support your opinion. ("again found . . . ")  I don't know, however, what the history is of the lesions that were seen on both occasions.  Could be they need to be watched over time - don't know with the info you've given.  I wish you the best - hang in there.  Doctors definitely don't have all the answers!

Jan

[Deb61]

The thing that stands out are the several nonspecific punctate foci in the white matter.  These are lesions.  You also have a lesion in the frontal cortext.  

There's several things I don't understand, too (I'm not a doctor).  I didn't know that the brain had "tonsils".  I also have no idea what the CSF(cerebral spinal fluid) slit-like structure is.  My first take is that there's a slit in the sac holding the CSF at the top of your neck, but I am more than likely far off.  

It sounds like a positive MRI to me for lesions, but the radiologist doesn't specify if the lesions are demyelinating or not (nonspecific).  

Hopefully someone with more knowledge will chime in here.

Deb