Help with reading MRI report
 

My sister who has had a dx of probable MS, (who has now been told probably not) read out some of her MRI reports to me.
Can anyone help interpret it please? I just jotted down words... so it's not all in context.

"5 lesions posterior.. right & left cerebral.. Parietal.. occipital region.
...elongated dimension"..
represent an old change of demyelination".
"5 burnt out plaques"...

2nd MRI 6 months later - no new lesions. Report said:
" non specific but may represent multi-focal demyelination"...

is this not typical of MS, so is that why the neuro said 'probably not'....??

Thanks.

5 burnt out plaques... I guess that's just a good way of saying it as any other (ie - non-active),

There's several things that can cause demyelination. That's why a dx boils down to clinical observation. Lesions caused by ischemic related stuff don't look any different than lesions caused by ms stuff, nutritional deficiencies, direct viral invasion, hereditary stuff, or even stuff like carbon monoxide toxicity.

I'd be inclined to say I don't have MS, but those lesions keep increasing in number and there's no other explanation. I've been told I'm textbook MS, and I really was initially. But after 22 years and I'm still walking and running, it's hard to believe. Last MRI was in 2003 - over 30 lesions.

I digress. The locations are, well, just locations. Burnt out, I assume, means inactive (lighter shade of gray as opposed to white, which is active). I have no idea what an old change in demyelination is, unless it's in reference to a non-active lesion. Non specific means - see above discussion. Most radiologists will say this because they don't know you. Multi-focal - yeap, it could be caused by different things. "No new lesions" is good.

Tom

The "burnt out" plaques one is new to me. It could just be the way the radiologist writes up the report, but my experience has the term plaque associated with the spine. Was it only a brain scan?

I've got a ton of inactive leisons, and one that says chronicity on my reports. Basically, according to my neuro it's permenant damage for me.

Like Tom said, there are other things that could cause demyelination. Has she been tested for some of the other suspects? I had a couple of rounds of feeding the vampires during my DX process.

Glad to hear she didn't have any new ones on her last scan. Hope they can figure out what's going on soon. :hug::hug:

How many symptoms did she have? Could it be the neuro is waiting for her to have a new batch of symptoms before diagnosing her. It's been my experience that some doctors will tell you "no, you dont have MS" until you have a new batch of symptoms or another MRI that shows more evidence.

Finlady - yes, it was a brain scan, and she has had the range of bloods and a VER done etc.

Erin - she's actually had sx for 10 yrs! She mainly gets pins and needles, dizziness, numbness, and 'drop attacks'.

The 2nd neuro she saw got his own radiologist to look at her scans, and he said she just has 'age spots', she doesn't have MS, and to see a psychiatrist!

Great he doesn't think it's MS though.

It gives me a bit more hope then for my own 'mysterious condition/sx'....
I know stress can do weird things, although my 1st neuro said she doesn't think it's stress, which presents differently. Anyway.... we'll see how it goes. Maybe we're both loopy!!:D

Especially, if you have MS..:D:D

Could "burnt out plaques" mean black holes?

That's what I was thinking..:confused:

What are black holes??
(I'm having visions of Star Wars!!.....)

"PATHOLOGY OF MS

The pathology is characterized by multifocal lesions, the MS plaques. The usual evolution of the MS plaque is s follows: in the acute phase, activated mononuclear cells, including lymphocytes, microglia, and macrophages destroy myelin and to a variable degree, oligodendroctes. Myelin debris are picked up by macrophages and degraded. At an early stage, macrophages contain myelin fragments; later, myelin proteins, and, at the end, lipids from chemical degradation of myelin lipids. This evolution takes a few weeks. With time, gliosis develops, and plaques reach a burned-out stage consisting of demyelinated axons traversing glial scar tissue. Remaining oligodendrocytes attempt to make new myelin. If the inflammatory process is arrested at an early phase, plaques are partially remyelinated. In more advanced lesions, remyelination is ineffective because gliosis creates a barrier between the myelin producing cells and their axonal targets. The pathological process may be arrested at any time, sometimes after partial demyelination."

http://www.neuropathologyweb.org/cha...apter6aMS.html

I'm not sure what other diseases could cause lesions in the brain that might appear "burned-out" ... strokes?, aging? etc.?, but it sounds like they originally predicted MS based on symptoms and/or the results of her first MRI (which showed these suspicious lesions).

The next course of action is usually to wait 3 - 6 months, to try to determine "dissemination in time and space" ... which basically means another MS-like attack, or evidence of neurological change in the next MRI.

The reason he is probably backing away from a MS dx at this time, is there has not been change. That doesn't mean to say there might not be in the future, in which case MS could be put back on the table as a consideration (probably dx at that point, with the right evidence) .... but for now, it is being shelved.

Cherie