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What Do My MRI Scan Test Reports Indicate?

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Posted on Wed, 30 Sep 2015
Question: I need numbers about hyper-intense T2 foci on an MRI. My wife is a GP, and I'm a scientist, so we understand the report we have. The urgent need to get care locally is hard numbers from someone with experience reading these MRI's, Getting the right physician's care will be a mighty challenge. Adjectives won't even get us a hearing, the resource constraints are so large. Only hard numbers will open the first door.

Two MRI's were taken four months apart in April and August, to get some data background to some interaction between an abscess behind the year, an ongoing inflammatory process after antibiotics (CRP ranging 3 to 5, Sed 10 to 12), sudden rashes and blisters, and known problems in C4-5-6-7 with a non-union C7 fracture just found on X-rays.

The MRI's show, - maybe related, maybe not - "hyperintense T2 foci". For several reasons, my care team - my GP wife and me - need someone with experience to provide some numbers to this specific finding.

The viewing application - and we really need an expert read at this point, not just the stills - only runs on Windows (sorry). The full zipped archive with viewing app from the radiology clinic can be downloaded from the link nder medical history.

Examples of numbers would be how many are there, even as a range, in that MRI, such as "between 10 and 15", or "between 10% and 20% more in the second", or whatever numbers best quantify the change. Quantifiable metrics are the key need.

With the greatest thanks and appreciation.
doctor
Answered by Dr. Vivek Chail (29 hours later)
Brief Answer:
The change might be subjectively put at 5 to 10 percent and not significant

Detailed Answer:
Hi XXXX,
Thanks for writing in to us

I have read through your query in detail.
Please find my observations below.

1. The change in white matter hyperintensities in the two MRIs is within the 10 percent range.

2. It is possible that due to change in the plane of acquisition of images, there might be an apparent increase in the white matter T2 hyperintensities in the scan done on august 28, 2015

3. Drawing an exact change in the white matter hyerintensities is difficult however it has not progressed more than 5 to 10 percent and this might be accepted as insignificant. This is a subjective analysis

Hope your query is answered
Please do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Vivek Chail (5 hours later)
Thanks so much. I guess my wife and I are assessing pursuing a specialist since this was within 4 months. If the plane of acquisition did not increase the If a 5% change it would be 15% a year, if 10% then 30% a year. One way or another, I am feeling other symptoms, like indreasing squeeling in my head, so we need numbers wherever available to open the first door and get the rest examined.

Could you please also let me know number of such foci.

Sorry, that sent before I was ready. I meant to add, my understanding is there are more than five, but know nothing more than that. We are not going to over-react to any data. However, any metrics you can provide on number visible in the second MRI, breakdown by side, relative size compared to others you have seen, would be very very useful. There is nothing more tangible and factual than a number.
Thanks so much
doctor
Answered by Dr. Vivek Chail (51 minutes later)
Brief Answer:
Size is small and numbers are discussed below

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. The size of these small hyper intensities in the brain is around 2 to 3 mm. The size is not significant.

2. The numbers are about 20 on the right side and 10 on left side. The numbers are not a worry in you keeping in mind the size of these lesions.

3. I agree that numbers are an important guide to the progress of disease. I hope a complete clinical examination will help now t look for any change in symptoms.

Hope your query is answered
Please do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Vivek Chail (9 hours later)
Very exact numbers, thanks. Now we can be detectives! Any advice greatly appreciated:

That is, I had a terrible abscess behind my ear only discovered after two months of terrible head and neck pain, in early April, internal infection, 2 cm, purulent exudate coming out when finally found. Antibiotics cured it completely. However, about three weeks after end of antibiotics, another smaller opening occurred a couple cm from the abscess, and some flakes of blood came out. Everything has been slowly downhill from there. Since I have a non-union C7 fracture, a channel to my internals is available, only cm from where all this infection activity occurred.

Now, my right jaw often feel numb, and my right eye often feels cold inside. Rather disconcerting. I am breaking out in blisters daily, mainly upper body, back, however as far as my calves. And there is a raised ridge, like a welt from a blow, except no discolouration, about 5 cm by 3 cm on my head, growing over the last couple weeks. I will upload the pic so you can see what I mean. And the ringing in my ears, pressure in my head, and inability to work without lots of ibuprofen, is concerning my wife and I.

Through her connections, I had an LP and are waiting cultures, however it will likely be 10 more days before results are back. And I am definitely feeling worse by the day.

With this context, any further advice? We are not sure what to do except wait for the cultures. However I am bedridden now for half the day. If there is a process making these hyper intensities worse, while showing up on my skin as well, it would match my internal feeling of flu-like illness. Anything we can do to arrest the effects of any ongoing progress, at least until the cultures are complete, would be very useful. However, we are both out of our depth, and not sure what the next best steps are.

Thanks much.
doctor
Answered by Dr. Vivek Chail (7 hours later)
Brief Answer:
Having nutritious food and avoiding stress might protect your brain

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. It is likely that you might have a viral infection which is causing your symptoms like blisters and staying bedridden for half a day. The LP culture should be discussed for this.

2. The abscess is less likely to be a cause of discomfort. The fracture is not going to cause any internal spread of infection

3. Please continue taking symptomatic treatment and avoid anxiety and stress. Having healthy food containing balanced nutrients and minerals might help in controlling features which might be secondary to deficiency of essential vitamins especially B complex.

Hope your query is answered
Please do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (1 hour later)
Thanks for the input. Makes sense. We will think more about this viral infection.
doctor
Answered by Dr. Vivek Chail (9 hours later)
Brief Answer:
Welcome

Detailed Answer:
Hi XXXX,
Welcome and thanks for sending in your query,

Let us hope for the best and a complete recovery.

Hope your query is answered
Please do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6873 Questions

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What Do My MRI Scan Test Reports Indicate?

Brief Answer: The change might be subjectively put at 5 to 10 percent and not significant Detailed Answer: Hi XXXX, Thanks for writing in to us I have read through your query in detail. Please find my observations below. 1. The change in white matter hyperintensities in the two MRIs is within the 10 percent range. 2. It is possible that due to change in the plane of acquisition of images, there might be an apparent increase in the white matter T2 hyperintensities in the scan done on august 28, 2015 3. Drawing an exact change in the white matter hyerintensities is difficult however it has not progressed more than 5 to 10 percent and this might be accepted as insignificant. This is a subjective analysis Hope your query is answered Please do write back if you have any doubts. Regards, Dr.Vivek