Sagittal T1 of the whole spine and selected axial T2 weighted images through cervical and lumbar spine: Sagittal and axial are directions. In the spine, sagittal means lengthways (parallel to the spine) and axial means across (perpendicular to the spine). T1 and T2 are types of scan. T1 is rubbish for MS lesions because it doesn’t show up demyelination / inflammation, but is really good for structural detail. T2 is good for spotting lesions. They did a lengthways T1 scan of your whole spine and they did T2 scans of your neck and the bottom of your spine. (I have to wonder why they didn’t do a T2 scan of your thoracic spine? i.e. the middle of your spine.)
Within the cervical spine the craniocervical junction is appropriately sited: where the neck meets the head is normal.
There is an area of abnormal T2 high signal seen within the ventral aspect of the inferior pons which would be consistent with an area of inflammatory demyelination: there is a white spot in the front of the lower part of the pons which looks like it’s demyelination (in other words, there is a lesion on the pons). The pons is in the brain stem (the part of the brain that joins up with the spinal cord). It is important for many basic functions including sleep, breathing, swallowing, etc. Some of the “cranial nerves” finish in the pons so depending on the lesion, it could cause things like TN too.
There are also subtle areas of abnormal T2 signal noted within the left middle cerebellar peduncle and also within the cerebellar hemisphere: there are pale white spots in the left middle section of the bit that joins the cerebellum to the brain stem and some pale spots in the cerebellum itself. To explain the cerebellum: the brain has three main parts: the brain stem (already described), the cerebrum (the big part of the brain, lying at the top, and that everyone thinks of as the brain) and cerebellum. The cerebellum is the roundish bit that lies under the back end of the cerebrum, behind the brain stem. It is important for smooth movement control. The left side controls the left side of the body and the right the right, so lesions on the left side of your cerebellum would affect the left side of your body.
There is a possible subtle area T2 high signal noted within the cerical cord substance at the level of the C5 vertebral body and also within the left side of the cord substance at the level of the T5 vertebral body: there are possible lesions in the cervical cord and the thoracic cord (ah! they did scan your thoracic spine :-)). C5 is lower neck - roughly where your neck meets your back. It’s linked to the arms. T5 is lower down, about where the top of your shoulder blades are. It’s important for chest muscles. So lesions in these two areas would probably cause problems with your arms and the hug.
There is a possible small area of signal change within the rght side of the cord substance at the level of the T9 vertebral body: T9 is lower down still; lower than a bra strap. It’s important for stomach muscles.
There is no significant abnormality seen within lumbar spine: the bottom part of your spine is fine (that’s below your waist roughly).
Conclusion: There are some subtle areas of abnormal signal change seen within the cervical and thoracic core substance. Posterior fossa structures there are some signal changes within pons and cerebellium: You have some subtle changes in your neck and upper back, plus lesions in your pons and cerebellum.
One other thing to know: the spinal cord is like a motorway with no exits: a traffic jam/accident interferes with traffic going in the same direction, so, e.g., a lesion at T5 may also affect what’s going on lower down (but not higher up). If the lesion is big enough, it will also cause a slow down on the other carriageway too.
Hth.
Karen x
