Tiny spots in the boxes are on 3 or 4 slices in a row, but slightly off in each slice. ? Anyone?
Tiny spots in the boxes are on 3 or 4 slices in a row, but slightly off in each slice. ? Anyone?
Comments (6)
Avatar universal
jdhecaj, Apr 06, 2009
I'm totally shooting from the hip and I don't see the boxes well, I'm not medically trained I just read a lot so I am throwing this out as a possibility for you to investigate further. Could they be "Virchow-Robins Spaces"?

http://www.medhelp.org/posts/Multiple-Sclerosis-MS/Virchow-Robins-spaces-in-early-MS/show/743614

Although I don't think it is in early MS.  You read about them.

They are also shown in this website....in the lower 1/3 of the page.

Virchow Robin spaces
Key finding: Bright on T2WI and dark on FLAIR.


Virchow Robin spaces

First look at the images on the left and describe the lesions.
Then continue.

On the T2W image there are multiple high intensity lesions in the basal ganglia.
On the FLAIR image these lesions are dark, so they follow the intensity of CSF on all sequences (they were hypointense ion the T1WI).
This signal intensity in combination with the location is typical for VR spaces.

FLAIR image


Virchow Robin spaces are CSF spaces around penetrating leptomeningeal vessels.
They are typically located in basal ganglia, around atria, near the anterior commissure and in the middle of the brainstem.
On MR they follow the signal intensity of CSF on all sequences.
They are dark on FLAIR and PD unlike other WMLs.
Usually they are small except around the anterior commissure, where perivascular spaces can be larger.

On the image on the left we see both very wide VR spaces aswell as confluent hyperintense lesions in the WM.
This case nicely illustrates the difference between VR spaces and WMLs.
This is an extreme case and this condition is known as état criblé.
VR spaces enlarge with age and hypertension as a result of atrophy of surrounding structures.
Avatar universal
jdhecaj, Apr 06, 2009
http://www.radiologyassistant.nl/en/4556dea65db62#p4594f74ccbf19

http://www.medhelp.org/posts/Multiple-Sclerosis-MS/Virchow-Robins-spaces-in-early-MS/show/743614
751951 tn?1406632863
PastorDan, Apr 09, 2009
Looks like a good possible explanation.  Thanks.
847433 tn?1243009652
missy142, Apr 18, 2009
May ask Pastor, what the radiologist report states?  Wouldnt this give you some explanation of what they may be?

mary
751951 tn?1406632863
PastorDan, Apr 19, 2009
Thanks, missy, but the radiologist wrote no more than absolutely necessary, in fact.  These small spots weren't mentioned at all.  If they are actually VR spaces as jdhecaj suggests, they likely wouldn' merit mention, because those sound as though they'd be essentially meaningless.
847433 tn?1243009652
missy142, Apr 22, 2009
Dear Pastor Dan,
Im Missy142  (mary), kind of new here and I heard the news about your wife.  My deepest condolences to you and your family.  My brother is a youth pastor and based on how deep his faith is, Im sure you are equally devoted and this is what will get you through, one day at a time.

Blessings,
mary
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