MRI Result question

[Patty F]

Hi all. I haven't posted lately but I am always checking in with everyone. The recent losses have shook me.

I do have a question about my recent MRI results. I have been having headached with visual changed. So my clinical trial Dr. ordered a MRI. Everything looks good but I don't know what this means " Scattered small foci of T2/FLAIR signal hyperintensity seen in the left frontal lobe" of course I got the paperwork after I saw the Dr. and I tried to call after I got back to work and he was gone for the day.

Do any of you have any idea if this is something I need to keep an eye on?

[Chelee]

Hi Patty, I don't have an answer for you...but hopefully Becky will pop in here and see your post. I had a breast MRI I was worried about once & Becky had no problems explaining it to me. So as long as she sees this I am sure she will help you out. If nothing else this will keep your post bumped up to the top and maybe there are others here that can explain what that means to you.

I hope your headache and visual changes disappear soon.

Chelee

[Lani]

obviously your symptoms and medical history (breast cancer) are different than the person posting this question, I thought the neuroradiologists explanation might be helpful. Remember a "punctate focus" is different from "scattered small foci" and do not get freaked out about the discussion below of MS, vasculitis and Lyme's disease. I know someone whose brain MRIs have consistently shown small foci of enhanced flair over several years with no problems/changes--she was just told they were nothing to worry about and decided to brag about them..."I always knew I had flair!" was her retort! and she did! Now, one person's experience (without any information on her medical history, symptoms, etc nor on the location, number or size of her areas of flair/T2 hyperintensity) does not a randomized controlled clinical trial make, but I was trying to help give you some piece of mind on a long holiday weekend. I am in no way qualified to provide you with anything but the information below along how I found it (which may even point to the fact that it itself may not be accurate).

Here is what I found when I googled T2/flair brain MRI:

Need assistance on brain MRI interpretation
by StrictlyTopSecret, Jul 06, 2007 12:00AM

Last week, I had a brain MRI (w/ and w/o contrast) for the purpose of shedding some light on some neurological manifestations of lyme disease as well as 2 seizures I had in the past year.

I had a 24-hr EEG a few months ago which showed some unusual activity in the left temporal lobe, but the neurologist said he was going to "technically read it as normal". The purpose for the neuro visit was to see if we could determine why I had a 2nd seizure (had it 10 mins after the initial infusion of Rocephin for the treatment of Lyme disease). An MRI performed after my first seizure (about a year ago) was unremarkable.

In addition, last week I had an ultrasound which revealed a 2.5 x 1.3 x 1.1 cm thyroid nodule with microcalcifications. I am scheduled for an US-guided thyroid nodule biopsy this Monday. I'm not sure whether or not this could relate to the brain MRI findings, but thought it could be significant.

Below, I have appended the three phrases from the MRI report for which I am requesting assistance in interpretation.

Thank you in advance for your input,

1. "There is a punctate focus of abnormal FLAIR and T2 hypersensitivity adjacent to the anterior horn of the left lateral ventricle, which is nonspecific in appearance"

...


Doctor's Answer

by CCFNeuroMD JT, MD, Nov 11, 2007 08:05PM
To: StrictlyTopSecret
Dear StrictlyTopSecret-

Please allow me to elaborate on some of the answers provided to you by others. Understand that the following information should be used strictly for educational purposes and that I am unable to diagnose you without having had the ability to examine you and review your films.

To start off with, perhaps a brief explanation of FLAIR and T2 MRI sequences is warranted. Hyperintensity on a T2 sequence basically indicates that the characteristic of the brain tissue in that particular spot differs from the rest of the brain. A bright spot on T2 is rather non-specific and must be interpreted within clinical context. T2 hyperintensities may occur in demyelinating diseases such as multiple sclerosis, in vasculitis (inflammation of the arteries in the brain), in lyme disease- anything with a high water or protein content will tend to appear very bright. The FLAIR sequence is then used to suppress the hyperintense signal produced by water (or cerebrospinal fluid) in the brain. This is especially helpful when looking for lesions around the brain ventricles (which contain cerebrospinal fluid). An isolated T2/FLAIR hyperintensity is fairly nonspecific and of questionable diagnostic significance.

Hope this helps!
Don't have time to do my usual careful investigation of the literature. Am helping a PhD candidate edit her answers to the questions put forward by those reviewing her first publication (am only BARELY qualified to help with the grammar and spelling**, and hardly that!!)
**only because she has noone else to help her on such short notice, she is not a native speaker of the language and I volunteered to help!