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Understanding my fiancee's MRI report

Hi there:

My fiancee’s currently going through the MS diagnosis process. Thus far we’ve seen a neurologist who referred us for an MRI scan, and on the basis of the results of that, the neurolost then said that he’d move forward on the basis of a probable diangosis of MS, although he seemed to suggest it wasn’t completely clear, and also referred her for evoked potential studies. (Haven’t had the results of those back yet).

Seeing the specialist MS nurse we managed to get a hold of the radiologists report on the MRI, which is confusing us somewhat becaus it seems kind of equivocal. I’ll write out what it says below:

"MRI SCAN OF BRAIN BY PROTOCOL:

There are multiple foci of high T2 signal with a periventricular distribution best demonstrated on axial FLAIR image 14. DWI shows T2 shine-through but no restricted diffusion. Gradient echo imaging shows no previous haemorrhage. The remainder of the brain is noirmal with no mass nor hydrocephalus.

CONCLUSION:

In a patient of this age with this clinical picture, the high T2 signal lesions would be consistent with a clinical diagnosis of MS. However no lesion is seen at a charcteristic site for MS and there is a wider differential diagnosis."

I’ve read rizzo’s excellent post here: http://www.mssociety.org.uk/forum/new-diagnosis-and-diagnosis/brief-beginners-guide-brain-and-mri which helps me to understand a lot of this, but at the end I’m still a bit confused.

I had understodd that periventricular lesions are a characteristic location for MS, so why does it say “no lesion is seen at a characteristic site for MS”. Where it says a “wider differential diagnosis”, what other conidtions could be the cause of the lesions? What does the lack of restricted diffusion in the DWI mean?

Any help would be super appreciated.

PS: We’re based in Northampton, we’d love to hear from any other Northampton based people with MS who’re out there. I’ve even stared a facebook group just for Northampton people with MS: http://www.facebook.com/groups/208476645970069/ If that’s you please feel free to join :slight_smile: