PDA

View Full Version : Shape of a MS lesion??




Jan4you
07-20-2008, 08:19 PM
I know that MS lesions have the dawson fingers look and most likely are in the periventricualar area, right?

Just wondering if you were told your lesions have a "certain" look to them? I was first told that mine were not "typical" for MS lesions. What does that mean?
The shape? OR what??

I have over (20) 3-7mm in the periventricular area and other lobes, including a newish one on the PONS.

Thanks
Jan




tonyaocala
07-20-2008, 09:26 PM
That is a good question. Yes, you are right from what I understand it is "typical" to have lesions in the periventricular area and other lobes. And I am also interested how come some doctors refer them to as "not typical". I will be watching this post closely with you for others replies ;)
Have a great week :)
I know that MS lesions have the dawson fingers look and most likely are in the periventricualar area, right?

Just wondering if you were told your lesions have a "certain" look to them? I was first told that mine were not "typical" for MS lesions. What does that mean?
The shape? OR what??

I have over (20) 3-7mm in the periventricular area and other lobes, including a newish one on the PONS.

Thanks
Jan

Bearygood
07-20-2008, 10:20 PM
My understanding is that the shape of MS lesions is usually ovoid and there are several locations besides the periventricular, but all tending to be (as my migraine specialist friend says) "deep in the white matter". So atypical would be not meeting the criteria of shape or one of these typical locations. That's my small contribution but I'm sure someone can add more info. :)

GladysD
07-21-2008, 10:13 AM
Beats me what they are 'Supposed' to look like, lol....I just know what MINE look like ;)

{I posted on MySpace ;) :p}

lady_express_44
07-21-2008, 10:50 AM
Simply speaking, they are looking for the right size, shape and location.

A more technical description and comparison of demyelinating brain lesions (from the second link below), is:

"MS plaques are hyperintense on T2-weighted and FLAIR images and hypointense on T1-weighted scans. Specific signal intensities of MS lesions will vary depending on the magnetic field strength, the pulse sequence parameters, and partial volume effects. Occasionally, acute plaques may have a thin rim of relative T2 hypointensity or T1 hyperintensity. The T1 hyperintensity is attributed to free radicals, lipid-laden macrophages, and protein accumulations.

MS plaques are usually discrete foci with well-defined margins. Most are small and irregular, but larger lesions can coalesce to form a confluent pattern. Multiple focal periventricular lesions can give a "lumpy-bumpy" appearance to the ventricular margins. As a result of their perivenular distribution, many periventricular plaques have an ovoid configuration, with their long axis oriented transversely on an axial scan. The ovoid lesion is the imaging correlate of "Dawson's finger." In general, MS plaques have a homogeneous texture without evidence of cystic or necrotic components. Hemorrhage is not a feature of MS lesions. Edema and mass effect are also uncommon.

The periventricular white matter is a favorite site for MS plaques, particularly along the lateral aspects of the atria and occipital horns. The corpus callosum, corona radiata, internal capsule, visual pathways, and centrum semiovale are also commonly involved. When more than a few lesions are present, symmetric involvement of the cerebral hemispheres seems to be the rule. Any structures that contain myelin can harbor MS plaques, including the brain stem, spinal cord, subcortical U-fibers, and even within the gray matter of the cerebral cortex and basal ganglia. A distinctive site in the brain stem is the ventrolateral aspect of the pons at the fifth nerve root entry zone."

All three of these links provide more information . . . but it probably suffices to say "size, shape, location":

All about MS brain and spinal lesions:

http://www.radiologyassistant.nl/en/4556dea65db62

Demyelinating Diseases of the Brain:

http://spinwarp.ucsd.edu/NeuroWeb/Text/br-840.htm

What they are looking for to dx MS, and large list of differential diagnosis' for MS:

http://www.neurology.wisc.edu/publications/07_pubs/Neuro_2.pdf


There are many causes of lesions (which is just a medical term for "damage"), but if you have them, what are they saying yours are from?

Cherie

Cherie

Twinkletoes
07-21-2008, 11:01 AM
I only have one lesion that is located in my neck. It looks like a marble to me, but...

I believe it takes on many shapes, depending on which doc views it:


golf ball

Ferrari

Hawaii

RV

ATV

etc., etc., etc... :wink:

Jan4you
07-21-2008, 01:20 PM
WOW Cherie thanks so much for these very informative links. I do have a long history of autonomic problems, including sudden out of control BP/HR. It can get so bad at times, I look like I am losing consciousness, cannot make sense, then cannot talk or move my body. BUT I can hear.


But.. I have some, not all of the MRI features of MS lesions. I dont have the dawson fingers or ovoid shape tho, but in some of the areas typical of MS.

I have had multiple symptoms of MS but my exams are considered rather good. Go figure. Spasticity is the biggest, longest symptom as of far.

I do not have an MS dx. I had one, then he followed me for 4 years and now does not think it is. He's been trying, guessing but not sure. The "other" neuro in his office thinks I may have a form of Narcolepsy. All I know is that I definitely have autonomic problems and a new lesion on the PONS after years of stable MRIs.

I am not concerned now. But I may get a 2nd opinion when my new insurance (newjob) kicks in and I have time off.

Again, thank you all,
Warmly, Jan

new2net98
01-07-2012, 08:42 PM
I only have one lesion that is located in my neck. It looks like a marble to me, but...

I believe it takes on many shapes, depending on which doc views it:


golf ball

Ferrari

Hawaii

RV

ATV

etc., etc., etc... :wink:

OMG...that's precious

Aarcyn
01-07-2012, 11:31 PM
never occurred to me to look at the shape of my lesions.

But if I was to describe them, they look like maggots.

Seems like a fitting description...

freeinhou
01-08-2012, 08:00 AM
I am NOT going to pull out my last MRI films... They're sitting 5 feet away from me... This is hard...

I'm thinking most of my lesions look like star clusters in far away galaxies.

My last full MRI was in 2003. I had over 30 lesions then - fortunately all in the brain. Some were pretty large. Shape was variable.

I'm talking past tense here. There's a reason. I had regular MRI's 1988 - 2003. Some past lesions have disappeared. These things do come and go, although remyelination is not necessarily the reason why. I like to think so, but I'm hopelessly optimistic.

Tom

kicker
01-08-2012, 10:09 AM
I only have one lesion that is located in my neck. It looks like a marble to me, but...

I believe it takes on many shapes, depending on which doc views it:


golf ball

Ferrari

Hawaii

RV

ATV

etc., etc., etc... :wink:

Wow! Sounds like a Rorschach Ink Blot test!!!!

The thing about MS is it's different for everyone. Only read about Dawson's Finger, never saw it in me. Of course I'm PPMS, different from most.

MS theories constantly changng. Some believe it starts in gray matter before getting so evident in the white. MS theory is always changing, that never changes.

kicker
01-08-2012, 10:28 AM
Had tolook up Dawson'e Fingers.

Dawson's fingers
From Wikipedia, the free encyclopedia
Dawson's Fingers appearing on an MRI scan

"Dawson's Fingers" is the name for the multiple sclerosis lesions around the ventricle-based brain veins[1][2] of Multiple Sclerosis patients. The condition is supposed to be the result of inflammation or mechanical damage by blood pressure[3]around long axis of medular veins.

Dawson's fingers spread along, and from, large periventricular collecting veins, and are attributed to perivenular inflammation[4]. Lesions far away from these veins are known as Steiner's splashes[3].




No wonder I have no Dawson's Fingers! Being PPMS I don't enhance, don't get inflamation. Never numb or tingl-y but can't walk!!

SallyC
01-08-2012, 01:57 PM
I never wanted to look at any of my MRIs, so I don't know nor do I care what they look like. I picture them gone!!!:D

I am not suprised at how Tom pictures his...LOL!!

kicker
01-08-2012, 05:11 PM
Wouldn't a Rocket Man see stars!!!