Help reading the MRI report

[aankit1030]

Hello,
I recently got my MRI done for the brain. I need help interpreting my report. I wanted to know if this could be Multiple Sclerosis.


FINDINGS:

On the axial T2 FLAIR images there are occasional subcortical white matter hyperintensities in the centrum semiovale ovale and these are best seen on axial images numbers 13 through 18 of series 6. These are old rounded and measure approximately 1 mm. These are nonspecific and could represent incidental gliosis. Migraine related white matter change could also cause these findings. These are not typical for demyelination.

Axial T2 weighted imaging shows normal visualization of the basal ganglia and thalami. The midbrain, pons and medulla are normal. The cerebellum is normal.

The paranasal sinuses are clear. The posterior nasopharynx is normal. The parapharyngeal fat is nondisplaced.

The sagittal T1 weighted imaging shows no cerebellar tonsillar ectopia.

Axial diffusion images are negative for acute intracellular edema.

The ventricular and sulcal pattern is normal..

There is no hemorrhage, mass effect nor midline shift. There are no intra-axial or extra-axial fluid collections identified.

There is a normal flow void in the basilar and in the carotid arteries.    

IMPRESSION: Occasional subcortical white matter hyperintensities in the centrum semiovale ovale probably incidental gliosis. Migraine related white matter change could also cause these findings. These are not typical for demyelination.

[supermum_ms]

Hi and welcome,

In the findings section of your report it provides you with specific lesion information..."These are old rounded and measure approximately 1 mm. These are nonspecific and could represent incidental gliosis. Migraine related white matter change could also cause these findings. These are not typical for demyelination."

A few 'tiny' (less than 3mm in size) round shaped white matter lesions only located in the subcortical area are very common findings and because of the shape, size and singular common location it would generally indicate these findings are highly unlikely to be demyelinating lesions, which are the specific type of lesions suggestive-consistent with MS.

Your MRI report also states within the conclusions section that your MRI only showed "Occasional subcortical white matter hyperintensities in the centrum semiovale ovale probably incidental gliosis. Migraine related white matter change could also cause these findings. These are not typical for demyelination."

IF MS was one of the potential causation's you were being assessed for, what ever symptoms, neurologically abnormal clinical signs you have etc, it looks like your brain MRI evidence alone would be placing a condition like MS very low down on your potential causes list, so it's very possible what you've experienced is not related to a neurological condition like MS and one of it's mimics.

I hope that helps.....JJ

[supermum_ms]

sorry typo, it should read....so it's very possible what you've experienced is not related to a neurological condition like MS and it is one of MS's many mimics instead.

[aankit1030]

Thanks for providing more details to this. I wanted to mention I have few symptoms such as tremors, pins and needles, spasms. Please advisde why the radiologist said these are not typical for demyelination.

[supermum_ms]

"In the findings section of your report it provides you with specific lesion information..."These are old rounded and measure approximately 1 mm. These are nonspecific and could represent incidental gliosis. Migraine related white matter change could also cause these findings. These are not typical for demyelination."

A few 'tiny' (less than 3mm in size) round shaped white matter lesions only located in the subcortical area are very common findings and because of the shape, size and singular common location it would generally indicate these findings are highly unlikely to be demyelinating lesions, which are the specific type of lesions suggestive-consistent with MS. "

IF you are asking "why the radiologist said these are not typical for demyelination" when you didn't actually have a brain MRI to even look for MS, and the radiologist just mentioning 'demyelination' is confusing or worrying you...

Radiologists generally examine patients MRI scans and report any normal and abnormal findings they see,  Radiologists typically use structured reporting or contextual reporting templates, which are basically standardised text blocks for the different types of things commonly found on an MRI that he/she can pick and choose to put into an individuals report.

"These are nonspecific and could represent incidental gliosis. Migraine related white matter change could also cause these findings. These are not typical for demyelination."  is likely to be the standardised text block the radiologist uses for non specific white matter hypersensitivities (WMH).

Non specific means that the WMH’s are not specific to any disorder but in order to establish clinical significance, the findings need to be correlated with a your clinical history and neurological examination. Symptoms are not the same as 'clinical' objective signs of neurological abnormality eg Clonus, Babinski sign, hyperreflexia etc

Unfortunately the types of symptoms you've mentioned could literally be caused by many different things, having the occasional tiny 1 mm sized lesion in only the subcortical area would usually be an unlikely explanation for any abnormal clinical signs, so what ever is causing you these issues is probably not being caused by a brain related abnormality.

I hope that helps......JJ