Black Holes in MRI?

[luvsummer]

Can someone tell me how I might be able to identify if there are black holes on my MRI brain scan?  I had one done this past Wednesday and I see black spots, but of course, I do not know what I'm looking at, lol.

I'm trying to learn how to post a few of the films on my profile as I see others have done.  That might take awhile!

I hope everyone is having a good day.

Luvsummer

[COBOB]

It might be better to google: " gliosis "
Black holes are T1 sequence hypointensities.  They don't really get repaired, but they do scar over.

Bob

[sllowe]

Hi Angelina!

This is one of our HPs that Doc  Quix prepped and it includes a couple paragraphs on the T1s.
Hope it helps:

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Lesions-Lesions-Lesions/show/762?cid=36

-Shell

[angelina420]

I will look into that, thanks.

[jensequitur]

Hey, Angelina - try googling 'hypointense' and see what you get.  

Basically a black hole is an area of the brain that has permanent axonal damage.  However, the brain can recover from the damage - other parts of the brain will step up to compensate.

[angelina420]

I have been searching online for black holes in MRI's and this is just about the only posting I have found. My dad was diagnosed with Glioblastoma Multiforme stage 4 back in August of 2010. He recently had a MRI that also showed a black hole. When he asked the doctor what it was, all she said was "I am not sure, I think it is healing". This response really left my dad disappointed and unsure of things even more then he was from the beginning. Not about the fact that she said it was healing, but just the fact that she said it so unclear.......

[Quixotic1]

Everybody - I have to agree with Lulu that it is human nature to want to diagnose our own MRIs and see our own lesions.  HOWEVER, and it is a big however, it takes years to master the reading of brain MRIs.  The neuroanatomy is so complex.  You cannot just look for bright and dark spots.  And for any spot you find you have to look at all the slices just before and after it, to make sure something isn't part of a different structure.  Then you have to be aware of all the variations of normal on top of that.

I don't recommend really trying to pinpoint these thing on a serious basis, nor asking other unqualified people for their opinions, either.  We either scare ourselves or get the completely wrong idea of what is there.  For example, I will not read my own nor will I read anyone else's MRI.  And I had a full year of neuroanatomy.

Just be aware if you do it, that you are just doing it for giggles and you will likely form all the wrong conclusions.

Quix

[Lulu54]

Hypo means the spot is darker than the surrounding area, versus hyperintensity which is brighter.

We all look at our MRI's much too much - it's human nature.  But keep in mind that those radiologists and neurologists trained for years to understand what those pictures are telling them.

Us amateurs tend to read too much into what we see and then also miss what the experts spot immediately.  Be sure to get a copy of the radiologist's report to help you understand what you are seeing.  But don't expect too much because they tend to be vague as well.

There are several good sources of mri images that can help you a bit - either of these will be of interest to you,,,,

http://www.radiologyassistant.nl/en/4556dea65db62#p4594f74ccbf19

http://www.scribd.com/doc/8817608/MRI-Atlas-of-MS-Lesions

The atlas is awkward to maneuver through, but it 184 pages of great information and pictures.

I do have hypointense lesions - my neuro and others talk about these areas healing and the black holes going away.  I still don't understand how that is possible and they were still there on my last mri.

be well, Lulu

[luvsummer]

Bob,
This info is a big help since the files are labled T1, T2, Flair, etc.

Now, I am going to have to look up the word hypointense, lol.  

I hope you are feeling better than your post stated a few days ago.

Luvsummer

[luvsummer]

Ahhh, same time I got mine back.  

I wish you the best on this journey and hope you get all the answers you need soon.  Thank you all over the place for helping me out!

Luvsummer

[ANonnyMouse73]

I wish I could answer your questions! I'm a complete newbie to all this as well and only got my MRI's back two days ago and the black spot may or may not have been mentioned in the report - I'm having trouble deciphering the gobbledegook! I just noticed that it looked out of place amongst the other bits, and was also different to all the other lesions, which showed up white. The pale ring around it wasn't added... it's just how it came out on the MRI. I've only seen one pic with a similar looking black spot and that was in someone who had a tiny piece of brain tissue removed for biopsy.

I'll be asking my neuro about it when I can get an appt so if you like I'll try to pop back here and tell you what they said about the black hole.

[COBOB]

You have to look specifically at the T1 sequences for "Black holes."  They are little dark hypo-intense areas.  You will not se they on T2 or FLAIR sequences.

Bob

[luvsummer]

Thank you so much!  You can't get a better description than that!  I'm sorry you have to have one though.  I'm not seeing anything that looks like that on my scans.  Is the paler ring around the hole something the radiologist added for identification?  Or is that part of the disease?

Are the black holes always on the edge of the brain?  The black places I  have seen on my films are more toward the center of the brain.

Thank you for your help.

[ANonnyMouse73]

http://www.medhelp.org/user_photos/show/168547 Here it is. Look at the top in the middle.

[ANonnyMouse73]

I have a black hole on one of my brain MRI.... it looks a little like a target with a paler ring around it. I'll see if I can link to a pic of it.