MRI Follow Up Results

I had my 6 mos follow up last week and have been bugging my neuro for the results.  Well of course the nurse that likes me there is on vaca this week and I'm in solely the neuro's hands and was told 'when she gets a minute, she will call you'.  Yeah well, I'm not waiting for her, I went to the hospital and picked up my MRI (on CD - cool) and report. 

As always, I'm wishin' I didn't because it doesn't sound like peaches and cream...  Here it is and I'm wondering if this means that I have 2 active lesions now, please let me know your thoughts..

1. On FLAIR and T2 weighted images several scattered high signal intensity foci are seen within cerebral hermispheric white matter and superior basal ganlionic regions. These regions of increased signal intensity are nonspecific.

2. The cerebellar tonsils may be minimally low-lying, possibly indicating mild cerebellar tonsillar ectopia.  No hydrocephalus.

COMPARISON: Two of the high-signal intensity foci on FLAIR and T2 weighted images within cerebral hemispheric white matter in the superior basal ganlionic regions are more conspicuous than previously seen.  When compared to the prior study, there has been minimal change. 

OK - to me... it looks as though I now have 2 active lesions and they are slightly larger than 6 mos ago.  The tonsil thing is extremely blowing my mind because I had my tonsils out when I was 10!

Am I reading this correctly or am I off my rocker? ;o)  I'm counting the days till I see the MS specialist, only 20 more days....

Denda said...
Hi everyone -

I had my 6 mos follow up last week and have been bugging my neuro for the results.  Well of course the nurse that likes me there is on vaca this week and I'm in solely the neuro's hands and was told 'when she gets a minute, she will call you'.  Yeah well, I'm not waiting for her, I went to the hospital and picked up my MRI (on CD - cool) and report. 

As always, I'm wishin' I didn't because it doesn't sound like peaches and cream...  Here it is and I'm wondering if this means that I have 2 active lesions now, please let me know your thoughts..

1. On FLAIR and T2 weighted images several scattered high signal intensity foci are seen within cerebral hermispheric white matter and superior basal ganlionic regions. These regions of increased signal intensity are nonspecific.

2. The cerebellar tonsils may be minimally low-lying, possibly indicating mild cerebellar tonsillar ectopia.  No hydrocephalus.

COMPARISON: Two of the high-signal intensity foci on FLAIR and T2 weighted images within cerebral hemispheric white matter in the superior basal ganlionic regions are more conspicuous than previously seen.  When compared to the prior study, there has been minimal change. 

OK - to me... it looks as though I now have 2 active lesions and they are slightly larger than 6 mos ago.  The tonsil thing is extremely blowing my mind because I had my tonsils out when I was 10!

Am I reading this correctly or am I off my rocker? ;o)  I'm counting the days till I see the MS specialist, only 20 more days....

Yet another example of where a little knowledge is a dangerous thing.

Cerebellar tonsils have NOTHING to do with the tonsils in your throat. They are an area of the BRAIN that happens to resemble tonsils, thus the name.

Here is a web site that talks about the most common disease associated with a problem with cerebellar tonsils:

http://www.co-cure.org/chiari.htm

NOTE: YOU DON'T HAVE CHIARI. Note the words, "...minimally", and "mild".  A radiologist presenting a report on MRI's has to report everything that might fall a bit outside the range of "normal", so this is noted. It likely means nothing.

As for the "foci" -- note the words, "nonspecific" -- meaning not indicative specifically of any disease mechanism (like MS); and "when compared to the prior study...MINIMAL CHANGE" (my emphasis).  Nothing much different than your last MRI, in other words.

This is WHY nobody should try to interpret their medical reports without having some medical training, and without sitting down with the doctor to ASK these questions.

I'd read this and think that there is minimal change from last time, no real areas of concern, and let's watch and wait.

But that's just me.

Denda said...
Thanks Uppity, I did figure that out by my second post about the tonsils thing. I'm not worried about the tonsil thing at all... I'm not worried about the 'minimal change'...

I am worried about the active lesions now, when on my last MRI I had no active lesions so the possibility of IF this is MS it could be dormant (if that's the right word for it) and I'm just having some symptoms/sensory issues. I only wrote what I didn't understand on here, which is not the whole report. Here's the whole paragraph..

On FLAIR and T2 weighted images several scattered high signal intensity foci are seen within cerebral hermispheric white matter and superior basal ganlionic regions. These regions of increased signal intensity are nonspecific. The main consideration is demyelination/multiple sclerosis in a patient of this age. Additional, all be it less likely, considerations include foci of small vessel ischemia, migraine related disorders and previous trauma. Please correlate clinically.

From the previous report (Nov 2006) FINDINGS: The study does demostrated several slightly less than 1 cm sized foci of abnormal hyperintense T2 signal scattered throughout deep white matter of both cerebral hemispheres including a few adjacent to the atria of lateral ventricles. These are nonspecific findings and can be caused by any insult brain including trauma, infection, demyelimination, factors predisposing to microvascular angiopathy and other. Clinical correlation is necessary.

Another variable in here is that each MRI was read by a different radiologist, although they are in the same 'radiologist group'. I don't know if that helps at all.

So again, trauma has been ruled out, infection ruled out, migraine ruled out. Spinal tap = normal, hormones = normal, thyroid = normal, all CSF infections = negative. I don't think I've had a stroke.

So, I guess what I'm looking for now is if anyone's doctor dx'd them once they saw that they had active lesions? Or if someone's lesions are active, was that the corner to turn to get put on medicine? I'm not wanting to be on meds, but wondering what everyone elses experiences are.

Oh and thanks for the link, Uppity.. That's a much better site than what I found, much medical research jargon and what not.  This site is much easier to understand!

One can have a stroke, by the way, without knowing it.  I hope the doctor tests you thoroughly to rule that out, just in case it is the cause of your problems.  It is possible to diagnose on the findings of "active lesions", but usually they're in areas of the brain specific to MS, not in other areas, like your MRI indicates.  Anyway. I hope your doctor finds an answer for you, soon.

Hang in there Denda! Boy, waiting with partial information and the ability to “google” can drive a person crazy (at least it makes me pretty batty and I’ve been in this situation several times, right now included). Anyway, unfortunately I don’t know enough to help you with interpreting your MRI report, but I just wanted to say “I feel your pain” (er…worry and frustration) and I hope you get some answers really soon.

Sunny

Oh! I forgot to add.. the reason for the long visit was because she started going over the possibility of getting on a MS med.  She suggested copaxone, rebif or possibly tysarbi.  That was a tad surreal.