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Old 05-05-2008, 02:51 PM #1
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Default Is this "good" news? (recent MRI)

Well, I got my second MRI done last Thursday evening. For those of you who have seen posts from me, I was dx in January "out of the blue" - and had several (multiple) lesions - they wouldn't give me a number. Some of the lesions were large - over 1cm or more. Didn't have a C-spine MRI at that time b/c they were not looking for MS! (Thought I had a pinched nerve, I swear.)

Anyhow...results of my second MRI - I think they are "mixed" -

Still have multiple lesions of high T2 and FLAIR signal intensity in a perpendicular orientation at the callososeptal interface as well as involving the subcortical white matter, bilateral cerebellar hemispheres, right middle cerebellar peduncle, and left pons.

However - this part is the good news:

Two of the larger lesions have decreased in size.

1 went from 2cm to 6mm. Another from 9mm to 5mm.

There are also 2 new lesions in the bifrontal subcortical white matter.

I think this is mostly good news - that two big ones shrunk? I wish I had this done before my first Tysabri infusion (which was on April 1). Oh well.

I am trying to get into program at Johns Hopkins - where they require "active inflammation" - which I think is what is meant by high T2 and FLAIR intensity. Is that correct?

Oh - and NO lesions on the C-spine!! woo hoo.



~Keri
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Old 05-05-2008, 05:53 PM #2
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hi keri,

this does sound like your disease has subsided some. i'm not a good one to evaluate that tho.

and, no c-spine lesions. that is good news.

i hope your tx con't to go well.
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Old 05-05-2008, 08:20 PM #3
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I am trying to get into program at Johns Hopkins - where they require "active inflammation" - which I think is what is meant by high T2 and FLAIR intensity. Is that correct?

No...active lesions are those that show enhancement on post-gadolinium (contrast) sequences. Did you get a contrast injection?



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Old 05-05-2008, 09:06 PM #4
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Did they do a scan of the entire spine or did they just do your cervical spine?

I think that any time the lesions would shrink in size is probably a good thing.

I'm a little curious to know if I have any more in my spine or brain or optic nerve, I just dont want to get inside another MRI machine again.

Hope your lesions keep getting littler and littler.
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Old 05-06-2008, 01:03 AM #5
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Default Hmm...

Thank you, NN.

Yes, good news that two big lesions shrunk - however, as I think we all know, lesions aren't necessarily an indicator of what is happening or what is to come... ie: my symptoms continue....and my disability is increasing with QOL decreasing. But - still, I like knowing there are smaller holes in my head! LOL

Kingrex - yes, they did Gd contrast. It didn't mention much specifically about that in the report though... Hmmm, I will have to pull out the report and look again in a few minutes.

Erin - they only did my C-spine - and b/c I requested it from my doc as I wanted a baseline, if nothing else. I am THRILLED that my spine doesn't have lesions - but it does say this: I have “minor disk desiccation at C2-3 and C3-4 and I have “mild straightening of lordotic curvature”.

The desiccation is not good - I've only read a little on it - but I have learned this thus far: This means "atrophy" or "drying out" of the intervertebral disc, resulting in loss of height. Spinal discs are normally rubbery round pads that are filled with a jelly-like substance called the nucleus. Normal disks are well hydrated, the nucleus containing 80 to 85% water and the anulus about 80%. Together with the cartilaginous end plates of the adjacent vertebral bodies, the intervertebral disk forms a disk complex that gives structural integrity to the interspace and cushions the mechanical forces applied to the spine. Dessication is often considered the first stage of spinal degenerative changes, and no longer provides the cushioning necessary between vertebrae.

That doesn't sound so good! LOL

~Keri

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Old 05-06-2008, 08:46 AM #6
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No...active lesions are those that show enhancement on post-gadolinium (contrast) sequences. Did you get a contrast injection?

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Hi Rex So nice to see you again. I've missed you and how are you keeping?

What does "high T2 and FLAIR signal intensity" mean?

I had understood T2 to be the slice of the ultrasound, and T2 to be the 'not "black holes" (more inflamation type of lesion) . . . but doesn't the flair signal intensity mean enhancing?

Cherie
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Old 05-06-2008, 12:13 PM #7
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My understanding is that T2 and FLAIR are both different imaging sequences and they are pre-contrast sequences. I think they do a T1 before and after the gadolinium and that is where enhancement would show up. T1 is also where black holes show up, I think.
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Old 05-06-2008, 12:55 PM #8
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Quote:
Originally Posted by RedPenguins View Post
Thank you, NN.

Yes, good news that two big lesions shrunk - however, as I think we all know, lesions aren't necessarily an indicator of what is happening or what is to come... ie: my symptoms continue....and my disability is increasing with QOL decreasing. But - still, I like knowing there are smaller holes in my head! LOL

Kingrex - yes, they did Gd contrast. It didn't mention much specifically about that in the report though... Hmmm, I will have to pull out the report and look again in a few minutes.

Erin - they only did my C-spine - and b/c I requested it from my doc as I wanted a baseline, if nothing else. I am THRILLED that my spine doesn't have lesions - but it does say this: I have “minor disk desiccation at C2-3 and C3-4 and I have “mild straightening of lordotic curvature”.

The desiccation is not good - I've only read a little on it - but I have learned this thus far: This means "atrophy" or "drying out" of the intervertebral disc, resulting in loss of height. Spinal discs are normally rubbery round pads that are filled with a jelly-like substance called the nucleus. Normal disks are well hydrated, the nucleus containing 80 to 85% water and the anulus about 80%. Together with the cartilaginous end plates of the adjacent vertebral bodies, the intervertebral disk forms a disk complex that gives structural integrity to the interspace and cushions the mechanical forces applied to the spine. Dessication is often considered the first stage of spinal degenerative changes, and no longer provides the cushioning necessary between vertebrae.

That doesn't sound so good! LOL

~Keri
You should really have them do the rest of the spine. There's more to the spine than just the cervical area.
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Old 05-07-2008, 08:05 PM #9
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Hi Rex So nice to see you again. I've missed you and how are you keeping?

What does "high T2 and FLAIR signal intensity" mean?

I had understood T2 to be the slice of the ultrasound, and T2 to be the 'not "black holes" (more inflamation type of lesion) . . . but doesn't the flair signal intensity mean enhancing?

Cherie

Hi Cherie,

Hope you're doing well...I'm doing ok...2 epidurals since January 1 and I'm marginally better.

"High T2 and FLAIR signal intensity" means something was bright on those sequences, the FLAIR confirming that the bright signal seen on the T2-weighted sequence was pathologic and not just CSF (cerebrospinal fluid).

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Old 05-07-2008, 09:09 PM #10
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Shrinking lesions that's good news and no spinal lesions is very good news. I wish I didn't have my two C-spine lesions.
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