I know it's hard to wait, but your neurologist is the best person to interpret your scans for you. For example, even though the radiologist notes that you have findings that are consistent with MS, that doesn't mean it is MS.
I am sorry for all you have been going through. Limbo is so hard! There are others here who are more knowledgable than I am about MRIs, so maybe they can give you more insights.
Keep us posted on your follow up appointment.
Hi and welcome to our little MS community,
MRI speak is a pain, they're not that easy to interpret and most of the time they confuse lay people more than shed enough light on exactly what's going on.....MRI's are only one diagnostic piece of the diagnostic puzzle when it comes to diagnosing MS, you don't mention what your symptoms are but your symptom type and pattern, abnormal neurological signs etc are all important clues on whether neurological conditions like MS are possible or not.
To me your brain MRI isn't particularly screaming MS of 20 years, you do have an undisclosed number of non specific periventricular lesions, which is one of the specified Mcdonald diagnostic criteria locations. MS would be on your potential causes list because of that lesion location but within your MRI report it mentions you have a history of chronic anemia, and small vessel ischemic brain lesions are associated with some types of anemia, so it's possible that these MRI finding are more vascular than demyelination.
Your spinal MRI apparently wasn't very good, it definitely does happen more often with spinal MRI's but first time i've seen a patients habit of swallowing as a reason for poor quality scans......the part about the "Subtle, amorphous regions of abnormal signal are present in the cord at the C4 level at the C5-C6 disc level" is as clear as mud, my interpretation is that the radiologist can't clearly determine if there are multiple cord lesions or not.
Amorphous basically means the radiologist saw vague unclear shape or form, so it's not clear enough to say what this is but from the similar type of wording throughout ie "potentially related to the patient's multiple sclerosis" he/she has the impression that your brain and spinal MRI's are from an already MS diagnosed patient and he/she is assuming spinal cord lesions...
'IF' these amorphous regions do end up being determined too be spinal cord lesions, when combined with the periventricular brain lesions, you would theoretically have the MRI evidence to meet the Mcdonald diagnostic criteria for MS but keep in mind it's possible with unclear scans for this to be a system error and not really there.....
My lay persons interpretation is that you 'may or may not' have MRI evidence that would be suggestive or consistent with MS....your brain MRI is clear but there wouldn't be enough with just your brain MRI to put MS at the top of your potential causation list, your spinal MRI will likely need to be redone to have clearer images of these amorphous regions and determine if it is consistent with MS or not. Please keep in mind that there is a lot more to dxing MS than just a persons MRI evidence and seeing an MS specialising neurologist in a few months would be in your best interest at this stage!
Hope that helps........JJ
Even when it seems like the MRI is a shoe in to a general radiologist (I met McDonald Criteria in 2013 within a few months of my first relapse), it is completely up to the ms neurologist.
Mine felt my lesions were too small and non-specific despite meeting dessimination in space. When I had an increased lesion count over a year, they were subcortical lesions which are not particular to ms.
So despite meeting criteria, and a bunch of relapses, my diagnosis took 3 years. I actually was tentatively diagnosed December 2015, then my LP was clear and he promptly ruled out ms again (unfortunately he had already ruled everything else on the planet out).
Took another year and in input from other specialists before he finally dxed me.
The amorphous region on your spinal cord might be considered a lesion, in which case that would possibly move an ms diagnosis. OR your neurologist would suggest it's an artifact, which it very well could be.
It's a long and frustrating wait, for sure. So sorry you're going through this, KDD :(.
The Mcdonald criteria is basically the MRI diagnostic evidence you need to meet the criteria to be diagnosed with MS, there are 4 specific lesion locations and you need at least 2 out of the 4 locations, so theoretically IF you have both periventricular and spinal cord lesions this would be 2 out of the 4 and meet the Mcdonald criteria...
Having a preexisting dx of optic neuritis (ON) would be evidence of a prior attack, having ON and an MRI with brain lesions actually increases your risk of developing MS. You mention experiencing "a feeling of some type of chest pain kind of like a spasm like my chest is being squeezed really hard....it wasn't heart related" you could be describing the 'MS Hug', this is a tight banding or squeesing type of feeling that partially or fully surrounds the torso.
The Hug is often caused by the intercostal muscles between your ribs spasming, these intercostal muscles naturally expand and contract whilst breething, but when they spasm or lock down in their contracted phase your rib cage is unable to do what it's suppose to do, hence the tight restricted feeling.....both the MS hug and neurogenic bladder/bowel dysfunction are associated with spinal cord lesions, so it's definitely possible that those amorphous areas are actually spinal cord lesions.
I definitely think you need to see an MS specialising neuro, make sure you have the reports from the urologist and ophthalmologist with you when you get another opinion in regards to MS but please keep in mind that there are similar neurological conditions to RRMS that will still need to be considered if you have bilateral ON and do have multiple spinal cord lesions.
Your close to knowing what's going on, please hang in there and let us know what happens but in the mean time if you need any questions answered please just ask away, no topic is off the table here...
Hope that helps........JJ