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dont understand my mri, can any help help?

Hi All, I have posted my symptoms on another post, this for the MRI,s, as I dont really understand it and how they are so different, each mri was done 4 months apart. MRI REVEALED : Spine - no signifanct cord compression but narrowing of the right neuroexit foraminia at level c6&c7, no lesions were mentioned
Brain mri said: high signal intensity foci in various regions of brain, in the white matter front and right lobes adjacent to the anterior horn of the right ventrical and foci of patchy high signal intensity of the right cerebral hemisphere. flair aquisition demonstrates foci apparent signal intensity located in the region of the grey and white matter overlying the right parietal occipital region…(with out contrast)

I do not really understand these findings

Second mri with contrast revealed less and only in the frontal lobes and revealed highsensitivity - no spine scan was performed and a lot of diseases have been ruled out, although im not sure which ones!! im a totally confussed and cannot see how the mri was normal considering the second one has changed mm??

I can explain it, but could you just check the wording and punctuation for me first please? It’s a little confusing in places at the moment and I don’t want to get things wrong.

Probably best to type the whole thing out exactly as it is in the report.

Karen x

Hi

Find as follows: mr brain undertaken by diffusion weighted acquisitions and gradient echo T2 acquisitions.

brain: foci of increased signal intensity is noted within the white matter of the left and right frontal region with increased signal intensitiy adjacent to the anterior horn of the right lateral ventricle. These are not associated with significant restricted diffusions. we question demyeliniation of foci. In addition increased signal intensity within the right sinus. Axial flair patchy foci increased signal within the peripheral aspect of the right cerebellar hemisphere. The foci of apparent signal intensity peripheral cerebellar is in the region of the grey and white matter overlying the right parietal occipital region. Marked as NORMAL?

Spine: reveals No severe or significant compression, but narrowing of the of the neuroexit foramina at the level of the c6 and c7. We request this procedure with contrast. No siginifcant signs of limbic encephaltilis, needs correlation with othert tests

Second MRI 4 MONTHS LATER: Hypersensitivty in left and front lobal region,NON specific, no tumors or lesions present.

My new m.s neurologist has to compare both these mri,s, as I have found out the first neuro never sent it to him?? so when he said he was not convinced it was m.s he had not seen the scan, but he was aware the first neuro said, ageing,and stress related and he reported the mri brain and spine as normal. I am currently waiting for my new neuro to compare both and file his findings. I am still waiting e blood test result for limbic e too, this was taken on 2nd August, I believe my nuerologist will compare all.

Some background info:

The brain has three main parts: the cerebrum, the big part that everyone thinks of as the brain, the cerebellum, the roundish part underneath the back of the cerebrum, and the brain stem, the bit that joins the cerebrum & cerebellum to the spinal cord.

The cerebrum has two halves, the left and right “hemispheres”. Both have four main areas, “lobes”: frontal (at the front), parietal (behind the frontal lobe and in the upper part of the cerebrum), temporal (behind the frontal lobe, at the sides of the brain, under the parietal lobe) and occipital (at the back, joining both the parietal and temporal lobes).

There are three main types of stuff, “matter”, in the brain: gray matter (where all the processing, storage, encoding, etc is done, i.e. all the “thinking”), white matter (the stuff that carries the signals between different bits of gray matter) and cerebrospinal fluid, CSF (the fluid in the brain that sort of acts like oil in an engine). CSF is stored in reservoirs called ventricles, but bathes the whole brain, pooling wherever there is a hole, just like water.

“mr brain undertaken by diffusion weighted acquisitions and gradient echo T2 acquisitions.” This just means MRI of the brain using two different types of scan. Amongst other things, the diffusion weighted scans are used to look for active lesions in MS. They do this by tracking the flow of water in the brain (it slows at active lesions). Gradient echo T2 scans are good for spotting lesions. I’m surprised that there were no T1, FLAIR or PD scans though, although this doesn’t necessarily affect the results.

“foci of increased signal intensity is noted within the white matter of the left and right frontal region” means that you had lesions in both frontal lobes.

“increased signal intensitiy adjacent to the anterior horn of the right lateral ventricle” means that you had a bright spot at the tip of the ventricle in the middle of your right hemisphere. The anterior horn is the tip at the frontal lobe end of the ventricle. Bright spots at the tips of the the lateral ventricles is often a normal result and so doesn’t mean anything in itself.

“These are not associated with significant restricted diffusions” means that these lesions/spots were not causing any problems with the water flow in your brain and so they were not active (i.e. currently forming).

“we question demyeliniation of foci.” I don’t know if this means they are suggesting that the lesions are demyelination or if they are saying that they think the neuro’s suggestion of demyelination on the MRI form is dubious.

“In addition increased signal intensity within the right sinus.” There isn’t enough detail for me to interpret this, sorry. There are multiple sinuses and it could mean something or nothing depending on which one they’re talking about :frowning:

“Axial flair patchy foci increased signal within the peripheral aspect of the right cerebellar hemisphere.” Ah ha! They did do a FLAIR scan: an axial flair means a FLAIR scan taken in slices across the brain, from ear to ear. They found patchy paler area(s) towards the outside of the right half of your cerebellum.

“The foci of apparent signal intensity peripheral cerebellar is in the region of the grey and white matter overlying the right parietal occipital region” doesn’t make sense :frowning: I’ve tried several times to work out what the radiologist meant, but it doesn’t make anatomical sense to me unless, perhaps, the radiologist meant cerebral instead of cerebellar. If he/she did, then it would mean that the patchy area is not in the cerebellum, but instead in the right hemisphere where the parietal and occipital lobes meet.

“Spine: reveals No severe or significant compression, but narrowing of the of the neuroexit foramina at the level of the c6 and c7.” The openings where the nerves travel from the spinal cord to go to the muscles are narrow in your neck (C6 and C7 are vertebrae low in the neck) - this can cause the nerves to be compressed, which can cause neurological symptoms. C stands for cervical - these nerves control the arms and hands.

“We request this procedure with contrast.” means that the radiologist thought having scans with contrast would be helpful. I don’t think the comment is specific to the spine. I think they probably thought that it would help to see if any of the brain lesions were active demyelination (but this is a guess).

“No siginifcant signs of limbic encephaltilis, needs correlation with othert tests” means that there were no obvious lesions in the limbic system which would suggest it wasn’t limbic encephalitis, but they are saying that it doesn’t rule it out and other test results should be considered.

“Hypersensitivty in left and front lobal region,NON specific” means a brighter patch(es) in both frontal lobes, but that these are not specific to any particular condition. [Lesions often have distinctive features which can point towards certain conditions. Lesions that don’t are called non-specific.]

OK, I’m not a radiologist, but I think you should have another report done on your first scan. The anatomical referencing is terrible and I honestly cannot tell from this whether your scan was normal or not! The frontal lesions could have multiple causes including B12 deficiency, mini TIAs that didn’t cause symptoms, migraine, etc, or they could be demyelination or something else. These are lesions that are often written off as “age related” - in other words, often found in adults, but no specific cause known. I am very suspicious of the cerebellum stuff - this could be normal, but I’d have to see it. The anterior horn comment could also mean nothing. If the white spot is large, then it’s important. If it’s small, then it is probably normal. So, all in all, a very unsatisfactory report!

The second scan could be a different radiologist’s opinion on the first scan, if we rule out the suspicious bits the first radiologist wrote! Impossible to say what’s really changed without seeing both scans.

So I guess you need to hope that the neuro actually knows how to read MRI. If you are in any doubt, then you should request a second opinion on both sets of scans. If the same person (preferably a neuro-radiologist) does a report on both, then you will have a much better idea of what’s going on, assuming that person is an expert of course.

Not sure that will have been terribly helpful, but I’m not sure what else I can add :frowning:

Karen x

Hi Karen,

Thanks for taking the time to relay the Mri’s to me, much much appreciated. Forgot to mention I have recently been diagnosed with hypertension, again this has only become apparent since iv took ill, and even though on blood pressure tabs, my blood pressures goes dangerously high when I have attacks, like the chronic pain or seizuire type episodes. I was unaware that M.S caused respritory problems, I initially thought it was because of the chronic fatigue. I am now wondering whether its is neurosarcidosis or some vascular prob. However, there is no indication of this at all. I had asked about cerebral vasculitis but the neuro said no and I just assumed all this had been ruled out, so im not sure whats going on. my gp has just notified my neuro of the hypertesnsion in case their connected. I am still waiting for his report on the contrasting mri, still nothing as yet, its been six bloody weeks!

xxxx

Hi Karen,

After reading your kind reply above is there any way you could give me some advice… my sister is 31 year old previously healthy and active female. In January, she struggled to talk for a period of two weeks and her speech was incredibly impaired which resulted in a number of tests being carried out.

Fat forward 9 month, she has been identified to have idiopathic dilated cardiomyopathy.

Abnormalities have now been found on her MRI of the brain - the report states the following: "Multiple course areas of high signal related to both deep white matter tracts. There is no specific lesion related to the corpus callosum or in subcortical position. There are more than incidental findings particularly in a aptient of this age and would be consistent with possible demyelination or a vasculitis. There is no seperate mass.

Now she has had an appointment with a neurologist with a full physical examination which was all fine. My sister cannot recall any period of neourological dysfunction apart from the speech episode mentioned above. The neurologist didnt feel it could be MS, and said he would expect severe headaches with CNS vasculitis so is unsure what cause be the cause.

I just want to know what do these scan results actually mean? I am so worried about her… she is due to have a spinal tap soon. But it seems to me the neurologist wasn’t sure what could be causing this. Any clarificztion on the findings of the scan would be very much appreicated.

Thanks,

Sara

Hy !Need help regarding my Brother’s brain MRI

Hi Beeni

You’ve posted your message on the end of a very old thread. Plus, you’ve not been explicit about what the problem is.

You will get more help by starting a new thread. You just hit the button marked ‘New Thread’, give it a title and then put your questions and problems in the text box.

Try to give us some detail about what your brothers symptoms are and exactly what you want to know.

Just be aware though, that we aren’t Doctors or MRI specialists. We can only tell you what’s happened in our experience.

The other thing no one here can do is to tell you whether your brother has a specific diagnosis, whether it’s MS or something else.

Sue

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