MRA/MRI result - second opinion

[chessplaya2010]

Hello Guys,

I went to see a neurologist after having a repeated episode of headaches, he ordered MRI/MRA of my brain.  The results came back normal and I was given a CD w/ my images.  A few days later I decided to look over my images out of curiosity.  And found these 6 images that caught my attention.  Anyone could point out the oddity/abnormality in these six images.  My neurologist said he did not know what it was as he went by the Radiologist report so he sent my MRI/MRA to the head of Neuroradiology in his hospital.  They said it's an image defect or otherwise known in the field as an artifact.

I'm currently symptom free but I could not get over the fact that the radiologist did not point out the "image defect" on his report.  And when I inquired my Neurologist about whether he should've or whether the guidelines on reporting state that a Radiologist must notate image defects on MRI/MRAs, he said he did not know as he wasn't a Radiologist.  

Do you guys think I should be OK w/ just getting the feedback from the head of Neuroradiology ? or should I get a second opinion ?  FYI.. after insisting on more explanation my Neurologist got very irritated and told me to find another Neurologist as I would not be fine until I heard it from another professional.

[chessplaya2010]

I appreciate your feedback and i'm glad you found the root cause to your issue. I'm in the process of seeking a second opinion, the only issue is Neurologists are not expert in reading films.. that's the job of a Radiologist, so when I seek second opinions from Radiologist, nobody will look at my films unless I give them an order from doctor.  My neurologist also got agitated w/ me and even told me that he felt it was insulting that I was questioning his judgment, I got upset also and haven't reached out to him and do not feel like asking him to write the order.  Unfortunately, I also do not have a primary care physician as i'm a healthy individual overall, rarely get sick enough to require medial attention.  So i'm in the process of finding an MD that will write the order to have a Radiologist look at  my films and confirm that the abnormality is indeed an "artifact" (image defect).  Ultimately, I believe I will need to go for a second MRI to see if it truly comes back clean w/o the artifact.  It's a struggle and second opinions are not covered  by insurance to top it off.

[bellancody]

Sorry your are going through what you are. I'm new here, and not sure if what I'm saying is beneficial or not. In my honest opinion, although it is being send to the head office, I'd still get a second opinion. My experience wasn't like yours, however, I have seen neuro for migraines 4-5 days a week. Results from testings, mri, ct, Xrays were normal. The first neuro said all was ok and don't know why I'm getting so many migraines. I questioned his ability to show me the results, and he got agitated. Got really rude and unprofessional.   I left the office and immediately contacted my insurance to file a official complaint. I got a second opinion from a APN, and was told there is slight abnormalities in white lesion matter. Was put on medication to help reduce migraines. It helped some. She was extremely passionate and said sorry countless times the experience I've had with colleague. He is now no longer at that office, due to so many complaints of being unprofessional. I began having migraines more and more, and so she referred me to ortho, after testing and imaging, the culprit was my spinal canal was severely compressed due to herniated disc. Had a ACDF Fusion with ROI spacer. Migraines have dimished. I do still get mild headaches, that are managable. My ortho sent me to have another mri of not only brain, but cervical. The abnormalities of white lesion matter has gotten better, and fusion started to heal. Sorry this is long. Bottomline, I'd definitely get a second opinion. There is no excuse for that physician to be like that, not when they are suppose to be passionate and care for patients. That's just my opinion.  Good luck to you and hope everything works out for the best. :)

[caregiver222]

Get Dr. Jerome Groopman's book titled "a second opinion". He has a website and, addressing this issue, recommends that a second opinion be obtained on every MRI/MRA image report. There vare two weays of reviewing the images, and he points out that mostly the faster method is used, which causes many problems to be missed.