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Unread 02-21-2014, 10:42 PM   #1
strberigrl
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Confused please help me understand this crap

Ok here goes been battling with something for the last 3 years said to be probable multiple sclerosis had many mri that showed a few lesions but not other markers neg lp
the only thing on my previous MRI that i remember sticking out was abnormal non fatty bone marrow with over reactive something or nother and borderline spinal stenosis c5-c6 i believe the lp did show on a 3 week study my red blood cells where low and my 2 of my immunoglobins were low as well neg ana lupus lyme aids just not getting whats going on

on this MRI done 2/15/2014

Mri of the brain
Finding:
Midline structures of the brain include corpus Collosum and pituitary gland demonstrate normal morphology and signal intensity
Reduced marrow signal with in the clivus visualized upper cervical spine within skull unchanged
There is normal signal intensity within superior sagittal sinus
Visualized cervical cord within normal limits
A Few tiny High T2 Flair signal cerebral white matter lesions again identified unchaged
NOrmal flow voids at base of brain
No susceptibility artifact on gradient sequence to suggest hemorage
No areas of restricted diffusion
Mild benign appearing mucosal disease of sphenoid sinus and ethmoids
Impression
No acute intercranial process a few tiny white cerebral white matter lesions are again identified non specific but stable
Presume Hemopoietic marrow changes unchanged

MRI cevical and Thoracic spine
Presumed hempoietic bone marrow signal intensity with in the cervical and upper thoracic spine
visualized cervical and upper thoracic spinal cord unremarkable craniocervical junction appears within normal limits paravertebral soft tissues appear within normal limits
c2-c3-c4-c5 no significant disc pathogy NO CANal or foraminal stenosis
C5-C6 mild broad based disc potrusion mildy compresses ventral cord narrowing ap diam canal to 9mm no stenosis foramen patent
C6-C7 minimal broad based disc potrusion canal and foramen patent
C7-T1 and below canal and foramen patent at all levels

Impression
minimal disc buldge at c5c6c7 no cord lesion so stenosis

I know this was long but if you can tell me what it means i would be very grateful i have all the symptoms of ms actually my very 1st mri showed 3 lesions 2nd showed 5 no specific amount on this one also all my mri was done without contrast
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Unread 02-22-2014, 11:27 AM   #2
Mariel
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Just replying to let you know I read this, but I never was good at interpreting such reports.
I hope the more medically educated members can help. Sometimes a condition is never diagnosed 100%, that is, sometimes doctors will always disagree as to what tests mean.
In my case over about thirty years, 50% of doctors said I had MS and 50% said I had something else or "nothing". When I got another dx which might explain symptoms and signs, one doctor claimed the new dx was not correct and I still had MS. I treat both diseases, with diet (Swank diet for MS) and trigger-avoidance for Porphyria. I now have a third dx which all doctors have to recognize because of what blood tests say. The people on the forum for the third disease moan and groan because of "slow diagnosis"--they ought to try having MS or Porphyria!

Some people will never fit a typical pattern.
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Unread 02-23-2014, 02:33 PM   #3
NurseNancy
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welcome to NT,

i'm not a dr and i can't really interpret the results but it doesn't appear to be MS. sometimes it can take a few yrs for the mri's to pick up brain/cns changes. usually you will have a f/u appt with the dr to discuss the results and his plan of action.

if you don't i would call to make an appt.
get a copy of the report and the mri in case you ever see another dr. they usually want to see the mri for themselves.
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Unread 02-24-2014, 05:35 PM   #4
TXBatman
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Quote:
Originally Posted by strberigrl View Post
...
A Few tiny High T2 Flair signal cerebral white matter lesions again identified unchaged

...

Impression
No acute intercranial process a few tiny white cerebral white matter lesions are again identified non specific but stable

...

C5-C6 mild broad based disc potrusion mildy compresses ventral cord narrowing ap diam canal to 9mm no stenosis foramen patent

Impression
minimal disc buldge at c5c6c7 no cord lesion so stenosis
First, I am not a doctor or radiologist. My comments below are worth exactly what you paid for them. For the real answer, take the report to your neurologist along with a CD of your MRI and ask them to show you on the scans what the radiologist is talking about in the report. If they won't do that, get a new doctor.

With that said, I highlighted the parts that stood out to me above. The part about white matter lesions is what is important for possible MS. that language is exactly what a radiologist says on nearly every MRI report I have ever seen posted when people ask about MS. What it means is that there are white spots in the white matter that they don't expect to see there, but that they are not in a size or shape or location that gives the radiologist any clues about what they might be. Thus they are referred to as non-specific. Without an MRI with contrast during an active flare, you won't usually get much more than that from any radiologist's report. They will sometimes say something like "may be demylenating process" or "possible MS in this age group", and sometimes will recommend clinical correlation of symptoms to achieve diagnosis.

One thing to realize is that the radiologist rarely has access or takes the time to look at the clinical file when reading an MRI. So they are just looking purely at the scan to see if anything appears to be abnormal. Because MS is a disease that does not have a "classic" presentation that can be seen in a single test or scan result, it will always be a diagnosis using clinical evidence and symptoms as well as tests and scans. So the radiologist is just saying they see something unusual (the lesions), but they don't know what they are and they appear "stable" which probably means the size and quantity are similar from previous scans. It is up to your neurologist to look at your other test results and symptoms and compare them to the number of lesions you have and determine if you meet the McDonald Criteria for diagnosing MS. if you haven't looked at that before, go google it, and it will help you understand what your doctor needs to see to give an MS diagnosis.

As for the spinal MRI, the radiologist says two kind of contradictory things, noting compression of the spinal cord and narrowing of the canal to 9mm (normal is anywhere from 15 to 27mm), but said there was no stenosis, and that the open space around the nerve was still present (foramen patent). What he probably means is that the canal has narrowed and the disc is pressing on the cord, but because there is still open space, the spinal cord is not being pinched (no stenosis). The key is the statement of no cord lesions, so anything that might have to do with MS appears to be only in your brain according to the MRI results. Unless you are having motor difficulties in areas served by the nerves around C5-C6, I would not think the spinal findings are very significant. Again, ask your neurologist to explain this...I am not a doctor and you are paying the neurologist way more than you pay me.

Finally, understand that most neurological disorders (MS included) are diagnosed by a process of elimination. It can take a long time to get a diagnosis for anything, MS or otherwise. What is important is that your doctor is not dismissing your symptoms or test results as "nothing". If they are, get another doctor. If they won't sit and patiently explain what they see on the scans to you, get another doctor. If you don't have a neurologist yet and these reports are going to a primary care doc who is not qualified to read the scans themself, ask for an appointment with a neurologist. Most of all, if you are comfortable that you have the right doctors, then be patient with them and help them find the right diagnosis for what is ailing you.

And lastly, good luck and keep coming around! We don't bite...much.
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Unread 02-24-2014, 05:48 PM   #5
TXBatman
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I just read your post on another thread and I think it makes a little more sense now. If you had one MRI and 5 lesions and only one clinical episode of MS type symptoms, your neurologist may be looking for changes over time to confirm that things are progressing. If they are strictly looking at the MRI evidence and saying they need 7 lesions, it sounds like they are using the McDonald Criteria and looking for new lesions separated from the original 5 by more than 6 months. I would have thought that with a history of clinical symptoms over time and the 5 lesions on MRI, the doc would give a diagnosis, but it sounds like they want to see it on the MRI before they give it. Also, be aware that radiologists saying the lesions are "stable" doesn't mean there aren't more. I had a report of "no change to high signal intensity areas in white matter" when my lesion count went from 2 to 7, and resulted in me getting an MS diagnosis. It is best to let your neurologist look at the scan and go from there. Again, Good Luck!
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Unread 02-26-2014, 11:20 AM   #6
goldie
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I'm not a doctor of any kind, but I have had a lot of MRIs.

To me, this doesn't look like an MS MRI.
Just my opinion.
BUT, that doesn't mean you don't (or do) have MS.

The really tiny lesions, sometimes referred to as pinpoint lesions, aren't classic MS lesions.
Maybe they will change over time?

FYI, other things besides MS cause MRI lesions, even migraines can.

The only thing I see on that report that is helpful/meaningful (at least to me) is that it appears you have some discs bulging and touching your spinal cord.
That is something that could cause some symptoms that are similar to some MS symptoms.
I don't know what your symptoms are, but some of the thing this could cause are headaches and problems with legs and arms, including movement issues, pain, tingling, numbness, weakness.
I only know this because somebody I am close to has this condition, it could be different in different people, I do not know.

MS is complicated to diagnose in many cases.
It is a diagnosis of exclusion, which means they have to rule out everything else.
Lots of other conditions can cause the same symptoms as MS.

If I were you, I would be investigating those bulging discs. (but don't rush into surgery) Learn everything you can about it, and how it relates to your symptoms.
Then see the best specialist you can find and get their opinion and a second opinion.

Please know that I am not minimizing what you are going through.
I know it's very, very hard to be sick and not know why.
I have been there.

I wish you the best.
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