Need help understanding

[garikari]

I have has viral meningitis 3 times now. I have RA and have some symptoms of MS.  I recently had an MRI in the hospital during a stay.  I need help understanding....do any of these issues show a need to discuss further testing for MS or other issue?  Here are the results.



Examination: MRI BRAIN WO/W CONTRAST. 03/30/2016 19:53.

Clinical Information: Concern about encephalitis. Patient with
meningitis, complaining of headaches and nausea..

Technique: Sagittal T1-weighted images are obtained. Axial diffusion
imaging and ADC mapping is obtained. Axial T2, FLAIR, and Swan imaging
is obtained. Axial T1-weighted images are obtained prior to and after
the intravenous administration of 5 cc of Gadavist. Post contrast
coronal images are obtained along with axial MPR imaging..

Field strength: 1.5 Tesla MRI machine.

Comparison: Comparison is made with a prior MRI dated 7/16/2013..

Findings: Sagittal T1-weighted images demonstrate a patent cerebral
aqueduct. Cerebellar tonsils are in normal position. The pituitary
gland is normal in size.

On diffusion imaging, there is no restricted diffusion to suggest an
acute infarct. T2 images show preserved midline. The sulcal spaces are
normal in size, as are the ventricles. The quadrigeminal plate cistern
is well seen. The fourth ventricle is midline.

On FLAIR imaging, there continue to be multiple foci of increased T2
FLAIR signal involving subcortical, central, and periventricular white
matter tracts. The pattern is unchanged from the prior study. None of
these white matter lesions shows pathologic enhancement following
contrast.

The brainstem shows normal intensity as does the cerebellum.

On Swan imaging, there is no hemorrhagic change or hemosiderin
deposition within the brain.

T2 images show flow voids in both vertebral arteries and in the
basilar artery. There are flow voids in the intracranial internal
carotid arteries which bifurcate normally into A1 and M1 branches.

The orbits structures appear symmetric. There is mucosal thickening in
the inferior aspects of both maxillary sinuses and along ethmoidal
septations..


Impression:
1. NO ACUTE INTRACRANIAL ABNORMALITIES VISUALIZED. NO EVIDENCE OF
ACUTE INFARCTION, ACUTE HEMORRHAGIC CHANGE IN THE BRAIN, OR MASS
LESIONS IN THE BRAIN.
2. STABLE FOCI OF INCREASED T2 FLAIR SIGNAL THROUGHOUT THE
SUPRATENTORIAL WHITE MATTER TRACTS. THE PATTERN IS UNCHANGED FROM THE
PRIOR STUDY AND NONE OF THESE LESIONS SHOWS PATHOLOGIC ENHANCEMENT.
THERE ARE NO FINDINGS ON THE FLAIR SEQUENCE SUGGESTIVE OF
ENCEPHALITIS.
3. NO PATHOLOGIC ENHANCEMENT WITHIN THE BRAIN PARENCHYMA OR INVOLVING
THE MENINGES.
4. MUCOSAL THICKENING IN THE PARANASAL SINUSES..

[HVAC]

I think Ess is right.

Alex

[essdipity]

Hi. I think this report shows normal results with one exception, #2 under Impressions. You apparently have many lesions of some sort in the areas of the brain most associated with MS.The radiologist compared this part with MRI findings of several years ago, and believes there to be no changes. No lesions enhanced when contrast was introduced.

Usually a radiologist will speculate about the cause of such lesions, based on his or her experience and training. Yours didn't, but that's okay, as a radiologist is not a diagnostician. I think you should see a neurologist with expertise in MS and who can read the images for himself or herself. You also need a thorough neurological exam and various rule-out tests, including blood work. Then the doctor will be in a better position to tell you what those lesions mean. Your symptoms will certainly figure into this as well.

Good luck and keep us posted.