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
“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 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