Help Reading MRI

[cynthia1962]

Hello ladies;

Got my mri back today and onc states the only thing he knows is normal mri of the brain. But, I am still confused and not satisfied becaused their is several findings that I am puzzled about. Here we gofindings: The ventricles and sulci are normal. No mass lesion is present. There are no enhancing lesions. But their is calcification in the flax. A few scattered unidentified bright objects are noted on flair and t2 weighted imaging. diffusion imaging shows no evidence of acute infarction. No hemorrhage is identified.

Impression. Scattered deep white matter nonehancing signal changes which may be due to early small vessel disease or chemotherapy. Otherwise, normal MRI of the brain.
The three things I am worried about is calcification in the falx, scattered unidentified bright objects notedon flair, and the impression.

[Jackie07]

Cynthia,

Sounded to me that the 'scattered unidentified bright objects' were explained by the radiologist as 'may be due to early small vessel disease or chemotherapy'. Usually if a 'growing' object is detected by the MRI, it will 'enhance' in the film after getting contrasting material (on the 'take' after you were injected with 'dye'.)

According to the report, your MRI is 'normal' except those scattered non-enhancing signal changes in the deep white matter of the brain. And the doctor who had read your MRI thought those signal changes could be [injuries] caused by chemotherapy or early 'disease' (such as 'hardening' or narrowing) of small blood vessels.


Disclaimer: I have no formal medical training except having a degree in medical librarianship. I took Anatomy & Physiology I & II in the local college in the mid-90's and studied my own MRI scans (about 10? different ones.)

[cynthia1962]

Jackie07;

Should I get a neuro opnion because if there is something scattered I need to know what it is correct.

[Jackie07]

http://upload.wikimedia.org/wikipedia/commons/thumb/d/de/Visible_Human_head_slice.jpg/200px-Visible_Human_head_slice.jpg (http://her2support.org/wiki/File:Visible_Human_head_slice.jpg)

http://en.wikipedia.org/wiki/Human_brain (http://en.wikipedia.org/wiki/Human_brain)

[Moved from postings on the thread "Need Advice"]

See the light colored region? That's the 'white matter' (bundles of nerve axons.) The darker parts are 'gray matter'(nerve cell bodies.)

According to the Anatomy & Physiology book I have on hand, Falx cerebri is located between the two central hemispheres in the longitudinal fissure [the center line straight down on this picture] while Falx cerebelli extend 'into' the major brain fissures.

...scattered deep white matter nonehancing signal changes which may be due to early small vessel disease or chemotherapy. what does that means.


Here's my interpretation:

When we have MRI, we usually get the first one 'without' contrast and then the second one (if there's something showing on the first MRI) taken 'with' contrast which is a dye of the chemical Gadolinium.

'Living' things such as growing tumors will 'enhance' on the MRI with contrast. Because the scattered signal changes (lit up) in the deep white matter were not 'enhanced' (getting bigger and brighter), they were believed to be either early small vessel disease (such as 'narrowing' of the arteries by cholesterol) or scars (dead cells) caused by chemotherapy.
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[Jackie07]

Cynthia,

The only way they can confirm the nature of the scattered 'non-enhancing' signal is to either go in there and take a sample (which you really don't want to do unless it is absolutely necessary - like when my huge brain tumor had started to cause problems) or wait for a while (3 months? 6 months? ) and take another MRI.

A couple of our members did have craniotomy to check on things that were showing on the MRI. I think those 'things' were all found to be 'necrosis' (dead tissue.) Since nothing 'extra' is good inside our brain, you do want to keep an eye on your 'migraine' headaches.