Please can I have an opinion on my MRI images please?

New diagnosis and before diagnosis
1

Hi everyone,

I had the all clear after my MRI of the brain, but being the untrusting person I am, I ordered a copy of it.

I have found white spots on my MRI that haven’t been picked up, I think.

The MRI’s for comparison are both from people with MS.

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The one that has pointers to the lesions, my brain mri is the one on the right and the on the other one my brain mri id the one on the left (without the screen data).

Any thoughts gratefully received. I’m off to the GP tomorrow. Still getting symptoms every day. Since October 2014 for this last ‘relapse’

Kind Regards,

Lisa

2

Basically, mine is the brain shaped most like an egg!

On the second image I think there are white spots at the front of my brain that mirror the other person’s (who has MS).

And on the first, I can see a white spot at the front left that the other MRI has pointed out as a lesion.

Any thoughts?

Thank you,

Lisa

3

Lisa, I couldn’t view your images for some reason - all I’m getting from those links is a succession of dots travelling along the bottom of the screen.

But I’ll be honest - I wouldn’t dream of trying to interpret anyone’s MRI results, let alone suggesting the specialist who did interpret them is wrong. I don’t have anything like the skill or experience to be able to do that.

I can’t find the lesions on my own MRI, after they were already pointed out! I don’t mean they have nice big arrows pointing to them on the images - I think even I’d be OK with that. I mean they were shown to me in the consulting room, but when I got home, I couldn’t find them at all.

So if it was left to me to do the interpreting, I’d have had the opposite problem to you: I’d be asking: “Lesions? What lesions?” - because I couldn’t see any.

I’m afraid simply having the disease doesn’t make any of us qualified interpreters of brainscans - I think you’re asking the wrong people.

If you’re seriously concerned, you’re entitled to a second opinion (from a professional, I mean) - but I think it’s extremely unlikely an untrained first-timer (sorry, no disrespect - and I’m assuming you’re untrained) has spotted something missed by all the professionals.

Tina

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Dear Tina, thank you for taking the time to reply.

There are a few reasons I don’t always trust our esteemed medical professionals…

When I was 18 months old, my Mum was told by the consultant that I couldn’t possibly have dislocated hips as I was walking so well - I had bilateral CDH and needed surgery, including having my femurs sawn in half, and still have 6 inch long scars on my thighs to prove it.

When my son was 3, I was told by our GP that he was coughing for attention. Two weeks later he was admitted to Kingston hospital with double pneumonia and still has to take steroid inhalers to control his asthma now (he’s 16).

I saw 4 endocrinologists about my thyroid issues (including one that I had to explain the difference between T4 and T3 to) until finally getting to the route of my autoimmune thyroid disease and am now on thyroxine, feeling human again.

I have shown a few friends my MRI scans and they have agreed that it does appear that something may have been missed, including a friend used to work Whitechapel hospital as a lung specialist (now retired).

The radiologist reported no abnormalities, so it may be the case that my neurologist didn’t look at the images himself. It wouldn’t surprise me as he has put my symptoms down to ‘transient irritability of the nerves’ which according to him is ‘quite common’. For 6 months? And with clear muscle testing and nerve conduction tests?

Amongst the users of the forum, I thought that many people may have become experts at interpreting their own scans and that there may even be a radiologist or two?

Kind Regards,

Lisa

5

Lisa, I am sorry that you have grown wary of the medical experts, but they’re still way more likely to be right than anyone on here! If there were any real experts on here, which I doubt, their code of professional ethics would prevent them from expressing an opinion anyway. And armchair experts are to be avoided like the pest. We’re all in the dark!

I agree with Tina. If you are concerned, you need a proper second opinion.

Alison

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I saw my GP this morning and, after seeing the images, she felt that I should either write to my current neurologist with my concerns and request a spinal MRI, or she would refer me for a second opinion.

Lisa

7

Haha, I see I’ve taken so long to type this that I’ve been overtaken by events! But I’ll post it anyway…

We used to have a regular poster who had qualifications in neurology - she did the “Brief beginner’s guide to the brain and MRI” sticky you see further up this page.

But even she was not a practising healthcare professional, but an academic. Nobody here is a neurologist or radiologist - that I know of. And if they were, I wouldn’t blame them at all for shutting up about it. They’d be inundated with queries just like yours, and there would be all sorts of professional and ethical issues about whether they could give medical opinions to strangers on the internet, and what the standing of those opinions would be - e.g. would it be OK as long as they made clear they were answering in a purely personal capacity (I suspect not)? Could they be sued if they were wrong? Does it bring the profession into disrepute to give medical opinions to people who are not your patients - especially if they conflict with those of the patient’s own doctor?

As you can see, it’s quite a minefield. I don’t know if professionals do look in here from time to time (it would be nice to think they try to get a taste of the patient’s side of life), but if they do, I’d be very, very surprised if they would stick their neck out and admit publicly to being a neurologist (or whatever) and start giving advice. There’s almost certainly something in the professional code of conduct about that.

All I can say is that if you do, in fact, have MS, it won’t just go away (as I’m sure you know), and eventually the truth will out.

As I say, I couldn’t view your pictures anyway, for some reason, but I strongly suspect I still wouldn’t be able to recognise a lesion if it was jumping up and down screaming: “I am a lesion!” Since diagnosis, I have tried to educate myself - to the extent a layperson reasonably can - about MS and the workings of the CNS. I thought it was in my interests to understand my own illness as far as possible. But I still can’t spot my own lesions! It doesn’t help that there were literally hundreds of frames, only half-a-dozen of which (allegedly!) contained a lesion, so my chances of finding them just by browsing through all the frames were about the same as finding a needle in a haystack.

Even if I - or anyone here - looked at the pictures and said: “Hmmm, you might be right”, what would that mean for you? You couldn’t use the opinion of an interested amateur in your case to the GP, could you? But I see your GP has consented to a second opinion anyway (should you want one), so probably not too relevant what anyone here thinks!

All the best with it!

Tina

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That sounds very sensible. I am glad that you have found a way to take this forward.

Alison

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I cannot comment on your scans. What I can tell you from experience working with MRI brain scan images for research is that whiteish spots are the most common form of ‘artefact’ - typically they’re from blood vessels which just happen to line up in the right way (inflamed nerve fibres tend to be swollen, i.e. ‘wet’, but so are blood vessels so they look very similar on a scan), or sometimes just a random blip in the scan data. I worked analysing brain scans for several months, and even experienced neurologists on the team who had developed the scanning techniques and worked in diagnostic research for decades sometimes couldn’t be sure about these things.

Furthermore, there’s a lot of natural variation between people and even normal people usually have one or two odd spots on a scan as they get older. So don’t worry about them or think something has been missed, it probably hasn’t.

Do stick with the process of finding out, but it does take time, and sometimes you need to keep pestering the doctors. And if your specialist dislikes you asking a question then you probably need to look for a new specialist.

Best wishes and I hope you get some helpful answers soon.

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