MRI Follow Up Results

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Denda
Regular Member


Date Joined Jun 2006
Total Posts : 329
   Posted 4/20/2007 3:51 PM (GMT -6)   
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....
I not only use all the brains that I have, but all that I can borrow.
  Author: Woodrow Wilson (1856-1924), 28th U.S. President


Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3538
   Posted 4/20/2007 4:15 PM (GMT -6)   

hey Denda,

I can't offer any advice or info.  I just thought I would offer my support.  You and I are the same.  I went and got my MRIs early when I could too.  So impatient.  Remember to judge your progress on how you feel and try not to worry about all the medical jargon.  The whole tonsil thing is a hoot.  Really strange.  Keep us posted.  Take good care and try not to worry too much.  Thanks for your words of support on my post.  I really appreciated it.  You all kept me going.

Love and prayers,

 


Gretchen
 
diagnosed: MS  July 2006
Treatment: copaxone, prayer, laughter, and positive thinking


Denda
Regular Member


Date Joined Jun 2006
Total Posts : 329
   Posted 4/20/2007 4:30 PM (GMT -6)   
Thanks Crotchen! ;o) It's nice to come here and be among friends. I did a little research on the tonsil thing and I guess our brains have things called tonsils too! Go figure!

Very interesting.. Still don't understand it, but looking up lots of words! :o) Where's a teacher when I need her??? Oh yeah... Here you are! :o) Hope you continue to shine!
I not only use all the brains that I have, but all that I can borrow.
  Author: Woodrow Wilson (1856-1924), 28th U.S. President


Kimber
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Date Joined Jun 2005
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   Posted 4/20/2007 5:21 PM (GMT -6)   
Hi Denda,
 
    I'm sorry i can't be of much help here.  I keep getting stuck on the comparison part where it says minimal change.  Maybe it's not as bad as what you are thinking?  I hope the doc calls you back soon so you won't worry about it too much :-)
 
Co-moderator for Multiple Sclerosis
 
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Denda
Regular Member


Date Joined Jun 2006
Total Posts : 329
   Posted 4/20/2007 5:53 PM (GMT -6)   
Yeah, I guess I'm not too worried about the change since it is minimal... I would have rather of had no change in 6 mos, but I'll take minimal.

What I'm wondering about is the 2 specific lesions he calls attention to. I just can't seem to find if that means a lesion is active or not. Because that basically is the nail in the coffin type thing isn't it? (I probably used the wrong analogy there..) I mean the doc can say, yeah, I think that's what you have, but it's not active right now and might not ever be active, but now with the slight change and the possible 2 being active, I think that's when medicine comes into play in this game? Again, I'm just trying to figure it out on my own. My first MRI just stated T2 lesions and nothing under FLAIR, this one states FLAIR and T2. I plan on calling the neuro on Monday and asking exactly what it means if no one here knows for sure. If someone here knows, then I plan on waiting on if my neuro EVER calls me back next week before I call her. Sorry, just bugs me that I wasn't important enough to take 5 minutes out of her day to let me know what was going on. She had the report in hand last Thursday. But then again, I wouldn't have know of the other MRI results if I wouldn't have called and asked what they were, don't know why this surprises me. She actually listens really well and spends a ton of time with me, but to get her to do anything out of her ordinary routine is like asking her to move a mountain. Thanks though!
I not only use all the brains that I have, but all that I can borrow.
  Author: Woodrow Wilson (1856-1924), 28th U.S. President


Denda
Regular Member


Date Joined Jun 2006
Total Posts : 329
   Posted 4/20/2007 6:01 PM (GMT -6)   
OK - Kimber while I was responding to you... DOH! I thought google FLAIR and gadolinium, contrast, w/o contrast.. Well that found my answer, yes it does mean that I have 2 active lesions. The FLAIR is the pics they take after the gadolinium injection and the T2's are before the injection. Don't know why I couldn't figure that out before! STUPID BRAIN! ;o)

Thanks everyone for your kind words, if I've got this disease, I wouldn't want to be anywhere else but this place! Well.. hang on.. maybe Aruba, with a really hot, half naked cabana boy (over 18 of course!) Ew.. but heat and MS don't like each other, crud! I guess I'll throw some clothes on him and take him up to Alaska with me! ;o0
I not only use all the brains that I have, but all that I can borrow.
  Author: Woodrow Wilson (1856-1924), 28th U.S. President


uppitycats
Veteran Member


Date Joined Jun 2005
Total Posts : 2135
   Posted 4/20/2007 6:58 PM (GMT -6)   
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:
 
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.

...I am not a doctor, nor health professional, and don't pretend to be one, here.....


Denda
Regular Member


Date Joined Jun 2006
Total Posts : 329
   Posted 4/20/2007 8:01 PM (GMT -6)   
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!


I not only use all the brains that I have, but all that I can borrow.
  Author: Woodrow Wilson (1856-1924), 28th U.S. President

Post Edited (Denda) : 4/20/2007 8:08:25 PM (GMT-6)


uppitycats
Veteran Member


Date Joined Jun 2005
Total Posts : 2135
   Posted 4/20/2007 8:47 PM (GMT -6)   
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!

A diagnosis of MS is dependent on getting some positive finding somewhere, either an MRI, or spinal tap, or significant clinical signs (not symptoms, but signs -- things that can be demonstrated, tested for, and are repeatable in front of a doctor. Sensory stuff are symptoms, not signs, for example).  The fact that your spinal tap came back "negative" for MS and apparently negative for "all CSF infection" is complicating the issue, because the MRI isn't definitive, either.
 
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.
...I am not a doctor, nor health professional, and don't pretend to be one, here.....


Gretchen1
Forum Moderator


Date Joined Jan 2007
Total Posts : 3538
   Posted 4/20/2007 10:32 PM (GMT -6)   

Hey Denda,

You made me throw my head back and laugh out loud.  You and your "crotchen....and Aruba and a cabana boy".  It has been a long hard week for me and I truly appreciate the laugh.  Thanks for that.  I like your whole tonsil thing too.  I am too new to give any good advice but I am always up for a laugh.  Jeez.  I am still wheezing.  Wooooooooooo..... good one.  Thanks again.  You rock.  Stay strong girl.

Love and prayers,

 


Gretchen
 
diagnosed: MS  July 2006
Treatment: copaxone, prayer, laughter, and positive thinking


Sunnycitrus
Regular Member


Date Joined Apr 2007
Total Posts : 334
   Posted 4/21/2007 10:45 AM (GMT -6)   

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


Denda
Regular Member


Date Joined Jun 2006
Total Posts : 329
   Posted 4/21/2007 1:32 PM (GMT -6)   
Thanks Sunny! I'm hanging on. 'Cause I've got no where else to go! tongue    Hope everyone is having the same beautiful weather we're seeing today!  I'm gonna go enjoy it
I not only use all the brains that I have, but all that I can borrow.
  Author: Woodrow Wilson (1856-1924), 28th U.S. President


Ann Ireland
Veteran Member


Date Joined Apr 2006
Total Posts : 511
   Posted 4/22/2007 1:36 PM (GMT -6)   
Hey, how do you get all these detailed tests reports? Here in Ireland you simply never get a report into your hand! They are sacrosant to the consultant who may pass em on to the GP but he would only pass on a brief resumee and not sent the full results.
If you are on 'friendly' terms maybe you'd see a resultj.
I saw ?CMT disease in my file when doc left the room and then did some internet investigation but if I had not illicitly seen this on the file I would never have been told.
Ann Ireland

Congenital Rubella Syndrome (CRS) Severely Deaf, Hypothyroidism, Pes Cavus, Crohns Disease, scoliolis, Hiatus hernia, diverticular disease, neuromuscular disorder (?parkinsons) movement disorder, ? another autoimmune disease.
Excema.

150mcg tyroxine, 20mg pantoprazole, 10mg Cipramil, 500mg 2 3times a day Mesalazine, 3mg Entocort, 62.5 Sinemet, 30mg Tamazipam, mystatin, sudocream


Denda
Regular Member


Date Joined Jun 2006
Total Posts : 329
   Posted 4/22/2007 7:17 PM (GMT -6)   
Hi Ann -

Here in the states, all we have to do is call the radiology dept and ask for copies. Sometimes you have to pay for them, sometimes you don't. That's really disappointing if where you are in Europe doesn't allow that. If you ask your doc for a copy of your medical records, would he/she give them to you? Just tell them you are wanting to keep track of everything since you have had so much going on, maybe that will do it.
I not only use all the brains that I have, but all that I can borrow.
  Author: Woodrow Wilson (1856-1924), 28th U.S. President


Denda
Regular Member


Date Joined Jun 2006
Total Posts : 329
   Posted 4/26/2007 2:24 PM (GMT -6)   
Hi All -
Just wanted to update everyone. Saw my neuro today... again for 45 minutes, I have to admit I love that. The 2 lesions are active and she wants me to have a full spinal MRI, the local hospital can't do it all at once and I would have to have it in sections, which we figued it up would run about $6500 (test & radioloists)! I have to pay a copay on this, so we are going to wait until I see the MS spec in 2 weeks and the hospital that he is affiliated with can do the full spinal MRI in one take and it runs about $2000 (test & radiologist). That's a little easier to swallow. Wow, I just can't believe these darn things are so expensive!

She did put my on neurontin for the tremors, aching, tingling and spasms. Hopefully this will work.
 
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.


I not only use all the brains that I have, but all that I can borrow.
  Author: Woodrow Wilson (1856-1924), 28th U.S. President

Post Edited (Denda) : 4/26/2007 2:36:29 PM (GMT-6)


KAS1
Regular Member


Date Joined Feb 2007
Total Posts : 161
   Posted 4/26/2007 4:07 PM (GMT -6)   
Hi Denda,

Wow...expensive aye! I'm obviously very lucky here in NZ, normally an MRI is free.....and if you want it in a hurry it's about $800. I really feel for you having the extra stress of money...on top of everything else....just doesn't seem fair!!!

Good luck with the MS specialist!

Kas
Not diagnosed
 
Neuro says he'd "bet on me having MS"
 
IF YOU CAN'T SEE THE LIGHT AT THE END OF THE TUNNEL...
GO DOWN AND LIGHT THE BLOODY THING!!!


rhondab
Veteran Member


Date Joined Mar 2006
Total Posts : 2146
   Posted 4/26/2007 5:30 PM (GMT -6)   
Hey Denda!

WOW...$6500 is huge!!! I'd opt for the lesser priced, late date version too!! I can certainly relate to the copays...and would love to have it FREE!!! WOW KAS!!! Good for u!!! I know the talk about meds is a bit alarming and surely it took u by surprise, but better to be prepared. I"m sorry...i really hope it's not ms, but i also know u'd love to have an answer. Hey, if u leave the land of limbo...can i have u'r cabana boy???? Take good care friend! ;)
rhonda
Co-Moderator, MS Forum
 
*~*Sometimes the Lord calms the storm. Sometimes He lets the storm rage and calms His child.*~*

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