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another MRI....help with interpretation
I received my MRI report from July 1. This is my fourth MRI since March of '07. I will list some of the important parts of previous MRIs and then the most recent. They are worded different.
March 12, 2007:
A 5 x 16 mm oval area of nonuniform enhancement located at the left cerebellar peduncle, w/o mass effect or surrounding edema. No evidence of other enhancing lesions and no evidence of lesions at the corpus collosum.
Several very small rounded foci along both cerebral convexities w/ signal characteristics corresponding to CSF, likely representing prominent CSF spaces.
IMPRESSION:
diagnostic considerations include multiple sclerosis. Infection and neoplasm are also considerations with other etiologies not excluded.
(had one done in June 07, showed inprovement of lesion, not enhanced and no other lesions seen. Cannot find that report)
The next two were both done on 3T MRI machines
Jan 08
A 0.75-cm focal area of abnormal T2 prolongation is present in the left lateral pons near its junction w/ the middle cerebellar peduncle near the trigeminal nerve root entry zone. No focal signal abnormality or abnormal postcontrast enhancement is present in the trigeminal nerve, either in the prepontine cistern, the Meckel cave, or at the skull base.
A tiny focus of T2 prolongation is present in the left anterior deep frontal white matter. No other focal areas of abnormal T2 prolongation are noted. No other focal area of enhancement are present.
Last week's MRI--July 1 08
IMPRESSION:
1. Comparison is made to a precious 3T MRI of the brain (1/4/08). There has been no interval change since the previous examination. There has been no interval increase in the size or number of a few small foci of increased signal intensity deep to the anterior insular cortex on both sides. ( what and where is this??) The small foci are nonspecific. On the current study, no lesions are identified in the immediate periependymal region, at the level of the corpus callosum, brainstem or cerebellar hemispheres.
2. No abnormal foci of gadolinim enhancement are identified anywhere within the brain parenchyma on post-contrast transaxial 1.3 mm slices obtained from a 3D volume data set.
3. Diffusion weighted images fail to reveal any focal or segmental areas of restricted diffusion. There is no MRI evidence for ongoing ischemia. BOLD susceptibility weighted images fail to reveal any abnormal areas of hemosiderin deposition or abnormal calcifications w/in the brain parenchyma.
(sinuses were fine)
Some of these wordings are just different. I guess it is sounding good. But do I still have the lesion in the cerebellar peduncle and in the frontal lobe? Are there other small ones noted? If so where are they located?
Anything you can offer me I would appreciate!
Thanks, Julie
March 12, 2007:
A 5 x 16 mm oval area of nonuniform enhancement located at the left cerebellar peduncle, w/o mass effect or surrounding edema. No evidence of other enhancing lesions and no evidence of lesions at the corpus collosum.
Several very small rounded foci along both cerebral convexities w/ signal characteristics corresponding to CSF, likely representing prominent CSF spaces.
IMPRESSION:
diagnostic considerations include multiple sclerosis. Infection and neoplasm are also considerations with other etiologies not excluded.
(had one done in June 07, showed inprovement of lesion, not enhanced and no other lesions seen. Cannot find that report)
The next two were both done on 3T MRI machines
Jan 08
A 0.75-cm focal area of abnormal T2 prolongation is present in the left lateral pons near its junction w/ the middle cerebellar peduncle near the trigeminal nerve root entry zone. No focal signal abnormality or abnormal postcontrast enhancement is present in the trigeminal nerve, either in the prepontine cistern, the Meckel cave, or at the skull base.
A tiny focus of T2 prolongation is present in the left anterior deep frontal white matter. No other focal areas of abnormal T2 prolongation are noted. No other focal area of enhancement are present.
Last week's MRI--July 1 08
IMPRESSION:
1. Comparison is made to a precious 3T MRI of the brain (1/4/08). There has been no interval change since the previous examination. There has been no interval increase in the size or number of a few small foci of increased signal intensity deep to the anterior insular cortex on both sides. ( what and where is this??) The small foci are nonspecific. On the current study, no lesions are identified in the immediate periependymal region, at the level of the corpus callosum, brainstem or cerebellar hemispheres.
2. No abnormal foci of gadolinim enhancement are identified anywhere within the brain parenchyma on post-contrast transaxial 1.3 mm slices obtained from a 3D volume data set.
3. Diffusion weighted images fail to reveal any focal or segmental areas of restricted diffusion. There is no MRI evidence for ongoing ischemia. BOLD susceptibility weighted images fail to reveal any abnormal areas of hemosiderin deposition or abnormal calcifications w/in the brain parenchyma.
(sinuses were fine)
Some of these wordings are just different. I guess it is sounding good. But do I still have the lesion in the cerebellar peduncle and in the frontal lobe? Are there other small ones noted? If so where are they located?
Anything you can offer me I would appreciate!
Thanks, Julie
Hi, there, sorry to be so tardy, but NO ONE told me I had been summoned!! lol, I sometimes avoid MRI interpretation because I don't often feel confident in what they are saying.
I can say that it appears that the lesion at the pons/cerebellar junction which was large 5x16mm and enhanced, later was 7.5mm seems to be gone from the most recent MRI. So it sounds like you did have a new lesion which healed.
Apparently there are still little spots of T2 hyperintensity. The interpretations vary in what they focused on so it is hard to say.
It does say that they looked especially for signs that there had been a stroke - "diffusion restriction" and "hemosiderin deposits" (would be left behind by pooled blood) - and none were found, so that is good evidence ruling out stroke.
So, if does seem that this is an overall improvement in the MRI. This is good, but does not at all rule out MS as your neuro likely explained. I think your plan to have one more MRI in a year or if there are more symptoms makes sense.
About the rapidly fluttering sensation in your ear. I have had this, and at the time was seeing one of the foremost vertigo docs in the world. He explained that this feeling/sound of an insect fluttering in the ear was often a rapid twitching/spasming of the muscle that helps move the eardrum, the "tensor tympani" or one of the other tiny muscles in the ear. ANY kind of irritation in the ear, from infection, to allergies, can cause this. If it happens when you laie down at night, then this is when it is irritated. It's annoying but not harmful.
Sorry I was so tardy.
Quix
I can say that it appears that the lesion at the pons/cerebellar junction which was large 5x16mm and enhanced, later was 7.5mm seems to be gone from the most recent MRI. So it sounds like you did have a new lesion which healed.
Apparently there are still little spots of T2 hyperintensity. The interpretations vary in what they focused on so it is hard to say.
It does say that they looked especially for signs that there had been a stroke - "diffusion restriction" and "hemosiderin deposits" (would be left behind by pooled blood) - and none were found, so that is good evidence ruling out stroke.
So, if does seem that this is an overall improvement in the MRI. This is good, but does not at all rule out MS as your neuro likely explained. I think your plan to have one more MRI in a year or if there are more symptoms makes sense.
About the rapidly fluttering sensation in your ear. I have had this, and at the time was seeing one of the foremost vertigo docs in the world. He explained that this feeling/sound of an insect fluttering in the ear was often a rapid twitching/spasming of the muscle that helps move the eardrum, the "tensor tympani" or one of the other tiny muscles in the ear. ANY kind of irritation in the ear, from infection, to allergies, can cause this. If it happens when you laie down at night, then this is when it is irritated. It's annoying but not harmful.
Sorry I was so tardy.
Quix
Sorry I didn't recognize you from earlier posts. It's hard to keep track of everyone. Hopefully Quix is feeling well and will comment soon. We are so lucky to have her! And you!
Feel well and hang in there,
Zilla*
Feel well and hang in there,
Zilla*
Thanks momzilla!
Sweet of you to at least attempt to help me! It is very confusing. None of these were done at the same facilities. First two were done locally, where I live, and the third at UCSF and the other was done in Los Gatos (in order to save us some money...still a 3T machine, but much cheaper than UCSF!) It was nice of the doctor to think of us in that way!!! This last one just seems to have terms that the others don't!! I am still hoping for Quix's wisdom to come wandering over here!! :-)
As far as what brought me here.... If this MRI and the results of my evoked potentials are good, I will not have any other test for another year, providing I am symptom free. In a year I will have another MRI. If that is also good, the dr. will release me with no MS diagnosis. BUT...you can click on my profile and go all the way back to my very first post to see what it is that actually brought me here. Some strange things that I've never got answers for and some things I've never reported...like things fluttering noise in my ear when I lay my head on my pillow at night. ?? what is that??? Sounds like a bug or butterfly trapped in my ear!!!
Anyway, thanks for trying! I don't post much, but read a lot!!!!
Julie
Sweet of you to at least attempt to help me! It is very confusing. None of these were done at the same facilities. First two were done locally, where I live, and the third at UCSF and the other was done in Los Gatos (in order to save us some money...still a 3T machine, but much cheaper than UCSF!) It was nice of the doctor to think of us in that way!!! This last one just seems to have terms that the others don't!! I am still hoping for Quix's wisdom to come wandering over here!! :-)
As far as what brought me here.... If this MRI and the results of my evoked potentials are good, I will not have any other test for another year, providing I am symptom free. In a year I will have another MRI. If that is also good, the dr. will release me with no MS diagnosis. BUT...you can click on my profile and go all the way back to my very first post to see what it is that actually brought me here. Some strange things that I've never got answers for and some things I've never reported...like things fluttering noise in my ear when I lay my head on my pillow at night. ?? what is that??? Sounds like a bug or butterfly trapped in my ear!!!
Anyway, thanks for trying! I don't post much, but read a lot!!!!
Julie
Hi, Julie, and welcome!!
These reports are confusing to me in that they don't go back and refer to the foci found in the previous studies. Or do they? I wish I could help more, but I'm afraid I don't know how to navigate the brain like Quix can. She's our resident physician, whom you'll meet soon, or may know if you've lurked here for any time...
If these studies were all done at the same faciltiy, it could be that the radiologist was just commenting on changes from the previous ones, not noting everything s/he saw. OR, it could be s/he did comment, and I just don't know all the alternative names for brain regions to recognize it. This is where Quix will be helpful. WHile certainly no one here can interpret MRIs for you, Quix can tell you what the radiologist is saying in the report.
I'm sorry you've found yourself on a journey to diagnosis. It can be very frustrating. We'd love to help you navigate through the journey, and be of comfort. Can you tell us your story, what made you seek out a doc who ordered an MRI for you? What kinds of symptoms do you have? When did they begin?
Feel well and take care!
Momzilla*
These reports are confusing to me in that they don't go back and refer to the foci found in the previous studies. Or do they? I wish I could help more, but I'm afraid I don't know how to navigate the brain like Quix can. She's our resident physician, whom you'll meet soon, or may know if you've lurked here for any time...
If these studies were all done at the same faciltiy, it could be that the radiologist was just commenting on changes from the previous ones, not noting everything s/he saw. OR, it could be s/he did comment, and I just don't know all the alternative names for brain regions to recognize it. This is where Quix will be helpful. WHile certainly no one here can interpret MRIs for you, Quix can tell you what the radiologist is saying in the report.
I'm sorry you've found yourself on a journey to diagnosis. It can be very frustrating. We'd love to help you navigate through the journey, and be of comfort. Can you tell us your story, what made you seek out a doc who ordered an MRI for you? What kinds of symptoms do you have? When did they begin?
Feel well and take care!
Momzilla*
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