3T MRI results in!

[jensequitur]

Well, I got my 3T MRI results.

(Brain) Findings:  There are no previous studies available for comparison.  There are a few scattered punctate areas of signal abnormality within the supratentorial white matter, located in a classic distribution for demyelinating disease.  The single most conspicuous focus is in the right frontal lobe in a classic periventricular distribution.  There is also some minor involvement of the corpus callosum.  The overall degree of plaque burden is quite mild.  There is however an area of demyelination within the ventral aspect of the pons to the right of midline, and also a subtle lesion within the left side of the medulla.  There is also a minor demyelination within the right inferior portion of the middle cerebellar peduncle.  There is no pathological enhancement to indicate active demylination.

(Tspine) Findings: There are no previous studies available for comparison.  Evaluation of the thoracic canal shows no evidence for spinal stenosis.  Visualized best on the STIR sequence in the lower thoracic cord there is an area of abnormality consistent with a vocal area of demyelination.  This lesion is approximately 13 mm in length and is situated within the midaspect of the thoracic cord.  There are similar subtle lesions predominately dorsally located within the upper cord, which are much less conspicuous.  There is no pathological contrast enhancement.  There is no evidece of any significant extra-axial disease.  There are mild degenerative changes in the thoracic spine.  The dominant lesion is located at the T10-T11 level.  No other significant findings.

To be honest, I'm not surprised.  I've looked at these probably more often than the radiologist, although I'm less sure about what I'm looking at!  With my leg weakness, numbness, loss of temperature sensitivity, and slight atrophy of the right leg, it all points to damage in the dorsal column of the spine.  The extreme knee weakness has been a puzzler.  That nerve is from the lumbar, (I think it's L3) and it shouldn't be affected by cord damage at T11.  But...  I have read that the lumbar nerves can involve T11-T12, so maybe that's it.

I am curious to know what the neuro says about the lesion in the pons.  I've had shortness of breath on and off for no explainable reason....  Now I'm off to google 'ventral pons' and see what they say.

[jensequitur]

Yeah, me too.  He's on vacation this week!  I had to call and get my results from the nurse... luckily she was able to fax them to me.

[steph74]

Wow!  Glad you got the results.  I hope they help your process with your neuro.  They seem very clear and detailed.

[jensequitur]

My only real MRI was done in 2007, on a 1.5T machine - the ones from the .7T machine are pretty much useless.  And it was just brain, anyway.  I would have liked to have given them the films from 2007 - if I had known, I'd have brought them with me!  Ah, well.

[PastorDan]

Sounds like a pretty detailed and careful report.

Question: Did they really not have any previous studies to compare?  I've forgotten your specifics.  I've had radiologists say that they had nothing prior to compare, when the prior study was just down the hall in a file drawer.  In fact, one had access to it at his PC, but his report still said that there were no previous studies to compare.

Last MRI I had, I took them copies of everything I could copy, and made the tech promise to make the radiologist aware of them.  Turned out that this tech & that radiologist never meet; they swap everything back and forth via e-mail.  She e-mailed everything I had in electronic form, and he actually commented on the lack of change from one to the next.

I'm still jealous that you got a 3T, though!

[jensequitur]

Yeah, I've been googling ventral pons, and all I get is information on the pons itself.  I guess they don't know what bit does what - no surprise there!

The medulla oblongata damage is probably what has caused my breathing difficulties.  There is a inspiration/expiration center in the pons that controls breathing, too.  

I think that's why they always say not to worry about the location of lesions.  If you have clinical signs of damage in a certain area, then your neurologist should take that as evidence  that there's something there.

Unfortunately mine is more focused on the MRI than on the clinical signs...  but now we have both.  So there. ;-)

[jensequitur]

Hah, no, it was supposed to be 'focal.'  I've been doing that all day - transposing letters, misspelling words...

[essdipity]

Well, Jen, I'm glad you have these to review with your neuro. The brain part sounds pretty straightforward. I'm a bit confused about the T-spine one. Does it really say 'vocal' area of demyelination?

A 13mm lesion is pretty darned big, and could cause a lot. Did you have a cervical MRI done too? I'll be interested in hearing about all of this, and in particular, what your pons is telling you. Good luck.

ess

[Lulu54]

Was that the radiologist's report?  I'm impressed that there was so much detail.  

And I am especially impressed at how well you can map lesions to locations..  Happy googling!

be well, Lulu