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Dr. Joshua, can you please interpret this report?

My doctor say that there was nothing worry about and I was tested for MS. I have a huge history of migraines as well.

Can you please please please interpret this into something that I can understand? Thank you so much for your time.

EXAM: BRAIN MRI WITH CONTRAST
HISTORY: MR of the brain with and without gadolinium

Clinical information: Multiple sclerosis

Technique: sagittal and axial T1-weighted images, axial FLAIR images, axial coronal T2-weighted images, axial diffusion images, axial gradient echo images, and sagittal axial and coronal postgadolinium T1 weighted images of the brain were obtained.

Findings: No prior similar studies are available for review.

The brain is significant for a small number of punctate foci of abnormal signal hyperintensity on the long TR images. The most prominent leasions are demonstrated on the axial FLAIR images in the right and left frontal vertex subcortical white matter. These lesions are inconspicuous on the T1 weighted, diffusion weighted and grandient echo images. There is no associated pathologic enhancement or mass effect. No other abnormal signal intensities recognizing the brain. No infarct is seen. No intracranial hemorrahage as found. Following gadolinium administration the developmental venous anomaly of the supraorbital portion of the right frontal love is also evident.

The ventricles, sulci and basal cisterns appear unremarkable.

The vertebral and internal carotid arteries demonstrate expected flow-voids indicating patency.

The orbits are unremarkable. The paranasal sinuses are clear. The nasal cavity demonstrate shallow deviation of the nasal septum from the left to the right. The nasopharynx is symmetric. The skullbase and calvariumm are intact.

IMPRESSION:
1. Punctate subcortical white matter lesions are nonspecific. The differential diagnosis remains broad.
this should include vasculitis, vasculopathy, such as SLE, sarcoid, Lyme disease, and an atypical imaging presentation of MS. Recommend followup evaluation. Evaluation of the cervical and thoracic cord or optic nerves may be appropriate if MS is a clinical consideration
2. Right frontal development venous anomaly

Answers:


THanks for your question. I am not a radiologist. I cannot interpret this report to the extent that I could give you any advice regarding your diagnosis or treatment. Your neurologist can interpret this in the light of your medical history and physical examination.

I am only providing this to try to help you understand some of the terms that the radiologist has used. Please ask your neurologist for more information.

Quote:
Technique: sagittal and axial T1-weighted images, axial FLAIR images, axial coronal T2-weighted images, axial diffusion images, axial gradient echo images, and sagittal axial and coronal postgadolinium T1 weighted images of the brain were obtained.

This is just technical jargon related to how the images were obtained.
Quote: The brain is significant for a small number of punctate foci of abnormal signal hyperintensity on the long TR images.

This is the main (abnormal) finding: there are a small number of bright dots in the brain in certain type of images.

Quote: The most prominent leasions are demonstrated on the axial FLAIR images in the right and left frontal vertex subcortical white matter.

They are in the white matter in the frontal lobes.

Quote: These lesions are inconspicuous on the T1 weighted, diffusion weighted and grandient echo images. There is no associated pathologic enhancement or mass effect.

They are not clearly seen in all image types. They don't collect contrast medium (which is in most cases a good thing), and they don't cause any pressure to the surrounding structures.

Quote:
No other abnormal signal intensities recognizing the brain. No infarct is seen. No intracranial hemorrahage as found. Following gadolinium administration the developmental venous anomaly of the supraorbital portion of the right frontal love is also evident.


Otherwise the brain seems normal. No bleeding, no signs of stroke. An unusual vein is seen, which is a fairly common birth anomaly, and most likely harmless.

Quote: The ventricles, sulci and basal cisterns appear unremarkable.
The vertebral and internal carotid arteries demonstrate expected flow-voids indicating patency. The orbits are unremarkable. The paranasal sinuses are clear. The nasal cavity demonstrate shallow deviation of the nasal septum from the left to the right. The nasopharynx is symmetric. The skullbase and calvariumm are intact.

Various other structures seem normal.

Quote: IMPRESSION:
1. Punctate subcortical white matter lesions are nonspecific. The differential diagnosis remains broad.
this should include vasculitis, vasculopathy, such as SLE, sarcoid, Lyme disease, and an atypical imaging presentation of MS. Recommend followup evaluation. Evaluation of the cervical and thoracic cord or optic nerves may be appropriate if MS is a clinical consideration
2. Right frontal development venous anomaly

There are various possible causes for these bright spots. According to the radiologist, they are not the type that is typical in MS, but can represent various other diseases, such as autoimmune diseases. The radiologist feels that the diagnosis cannot be made from the MRI alone. He/she feels that if MS is suspected, further studies should be done such as spinal MRI.Thank you so much in taking the time in interpreting this report. I do feel much better knowing what this means.

I did have some tests for MS and other test, and they are all normal.

Is it possible that these white spots are from my history of migrains???

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