not understanding~MRI results

[avangela]

MRI
BRAIN MRI - 04/22/2014
The MRI examination of the brain demonstrates the ventricles, cisternal spaces and cortical sulci to be
appropriate for the patient’s stated age. There is no midline shift or extra axial collection. There are patchy
somewhat confluent foci of increased signal within the periventricular white matter which are nonspecific and may
represent the sequela of small vessel ischemic disease in this patient. The corpus callosum and pericallosal
regions are unremarkable. The diffusion weighted images demonstrate no acute ischemia. There is normal
vascular flow voids. The visualized paranasal sinuses are clear. The mastoids are well aerated.
Impression:
Mild small vessel ischemic disease without evidence for acute ischemia or abnormal enhancement.
BRAIN MRI with and without gadolinium - 04/25/2013 . INTERPRETATION: MRI brain with and without contrast.
History speech difficulty, MS. Contrast gadolinium 16 cc; 4 cc discarded. Comparison 02/06/2008. There is no
mass effect on cortical edema or hydrocephalus. There is normal physiologic enhancement. White matter signal
is preserved. There is no evidence of acute infarct or previous parenchymal hemorrhage. The orbital and sellar
contents are normal. IMPRESSION: Normal brain
BRAIN MRI 4/25/2013
INDEPENDENT REVIEW
There is abnormal increased signal noted in the periventricular areas from the IVth up through the lateral
ventricle. There are two areas of abnormal signal noted at the head of the caudate on the right and an area of
abnormal signal noted in the adjacent subcortical white matter. The signal abnormalities are seen on the T2
weighted images but more noticeably on the FLAIR sequence.

[jensequitur]

I've read my MRI reports over and over, and I've gotten used to the 'lingo' used in these reports.

The regular radiologist thought it was ischemic damage, but the independent review thought it was MS. From my experience, this report sounds more like MS.

"There is abnormal increased signal noted in the periventricular areas from the IVth up through the lateral
ventricle. There are two areas of abnormal signal noted at the head of the caudate on the right and an area of
abnormal signal noted in the adjacent subcortical white matter. The signal abnormalities are seen on the T2
weighted images but more noticeably on the FLAIR sequence."

What this means is that the radiologist sees more white spots around the periventricular areas (near the ventricles in the brain.) There are also two white spots at the head of the caudate and one in the subcortical white matter nearby.

Whether they're white spots caused by MS damage or ischemic damage from mini-strokes, it can cause cognitive problems.

I'm not sure why the regular radiologist thought one thing and the independent review thought another, but this happens all the time. It really depends on what the doctor is used to seeing on the MRIs he reviews.

[avangela]

HI
thank you for your reply, I have been to 3 sat with my neurologist and
1 SAID CLINICAL MS
2 one said MS
3 Said MS
  
The resone  why iam asking its been 10 years
and when i get the report it says normal MRI

THE NERO IM WITH KNOW FOR THE LAST 2 YEARS SAT ME DOWN
AND SHOWED ME THE LESION ON THE MRI....why aren't the radiologist doctors seeing it

I appreciate any advise or input....thank you

[kwarendorf]

Hi Welcome to the group.

We are not doctors and can't evaluate your MRI findings as your neurologist can. Nothing I read sounded like the typcal "Impressions" section in which the radiologists gives an opinion as to what might be the cause of any findings. There was noting in my reading that leapt out and said MS. Rather, the one possiible cuase I saw was small vessel ischemic disease. This relates to blood vessels rather than the central nervous system.

Are you meeting with your neurologist to discuss the MRI?

Kyle