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What Do My MRI Scan Test Results Indicate?
Question: Behcets vaculitis is likely diagnosed. Had MRI scan. These are the results: multiple, discrete and few confluencing abnormal signal intensity areas are seen in the centrum semiovale bilaterally, periventricular deep white matter and in the sub cortical white matter appearing hyperintense on T2WS and FLAIR. Intry cerebral and extra cerebral CSF spaces are mildly prominent. Mucosal thickening is seen in the frontal, ethmoid and sphenoid sinuses bilaterally. Conclusion: Microangiopathic ischemic changes. FAZEKA2. Age related cerebral atrophic changes. Please explain the result and suggest treatment please. Age 53 Female. Everything else in the MRI was normal . Please get back when you can thanks a lot.
Brief Answer:
These changes correspond to small vessel disease.
Detailed Answer:
Hi,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar, Neurologist,here to answer your query.
I have gone through the detailed MRI report you have uploaded over here.Of course, these changes are reflective of microangiopathic ischemic changes.
Micro means 'small' and 'angio' means 'blood vessel'- so microangiopathy is 'small vessel disease'. The most common cause of small vessel disease is hypertension in which chronically high blood pressure cause pathologic changes in wall of these small vessels of brain which results in their narrowing or blocking their lumen,thus resulting in a diminished supply to the brain,causing small ischemic changes.
Further, any vasculitis can cause similar changes in walls of these small vessels,resulting in a similar picture.Here,probable cause appears to be the Behcets vasculitis as you mentioned it as the probable diagnosis.
These small ischemic changes are appearing as hyperintense in T2 and FLAIR sequences.These are mostly found to be periventricular, subcortical and centrum semiovale, as here in your case.
Hope that it explains you the things to some extent.
If you have some further questions, I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
These changes correspond to small vessel disease.
Detailed Answer:
Hi,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar, Neurologist,here to answer your query.
I have gone through the detailed MRI report you have uploaded over here.Of course, these changes are reflective of microangiopathic ischemic changes.
Micro means 'small' and 'angio' means 'blood vessel'- so microangiopathy is 'small vessel disease'. The most common cause of small vessel disease is hypertension in which chronically high blood pressure cause pathologic changes in wall of these small vessels of brain which results in their narrowing or blocking their lumen,thus resulting in a diminished supply to the brain,causing small ischemic changes.
Further, any vasculitis can cause similar changes in walls of these small vessels,resulting in a similar picture.Here,probable cause appears to be the Behcets vasculitis as you mentioned it as the probable diagnosis.
These small ischemic changes are appearing as hyperintense in T2 and FLAIR sequences.These are mostly found to be periventricular, subcortical and centrum semiovale, as here in your case.
Hope that it explains you the things to some extent.
If you have some further questions, I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Ok so if behcets vasculitis is diagnosed and MRI is showing this what treatment will you suggest and how dangerous this is. I need to know about the treatment what options do I have. And what other tests should be done as I am having a lot of dizziness feeling weekends headaches. Left side of my body is feels week. Joint pains and coming up with skin rashes. But major concern is the MRI scan what treatments are there to prevent further damage
What you explained I already have read online. I would like to know the severity of this diseases and treatment suggested and what can be done. Please get back on that.
What you explained I already have read online. I would like to know the severity of this diseases and treatment suggested and what can be done. Please get back on that.
Brief Answer:
Steroids and Immunosuppressants.
Detailed Answer:
Hi,
Thanks for being in follow-up.
I deeply understand your concerns. Treatment of Behcet's disease depends on the organ system involved.
Nervous system involvement is considered as major manifestation of the disease and tilts the prognosis on the poorer side. Steroids and Immunosuppressants(like Azathioprine) treatment is vital to arrest the progression of the disease. However, in some cases, despite these drugs being given, patient may continue to worsen in terms of disease severity. On the other hand, in another group of patients ,these medicines may cease the progression and also prevent further recurrence.
But again, being on chronic steroids therapy side effects can be an issue and in that case comes the role of immunosuppressant medicines.
To summarize it for you, if you are diagnosed as Behcet's. You will likely be put on steroids/immunosuppressants therapy.If you are lucky enough, your disease progression may cease off. However, regular follow-up and strict schedule of medicines will be important. The goal will be to live your life as healthy as possible. The disease is not likely to be cured. At the best its progression may stop.
Hope that I have answered your query.If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Steroids and Immunosuppressants.
Detailed Answer:
Hi,
Thanks for being in follow-up.
I deeply understand your concerns. Treatment of Behcet's disease depends on the organ system involved.
Nervous system involvement is considered as major manifestation of the disease and tilts the prognosis on the poorer side. Steroids and Immunosuppressants(like Azathioprine) treatment is vital to arrest the progression of the disease. However, in some cases, despite these drugs being given, patient may continue to worsen in terms of disease severity. On the other hand, in another group of patients ,these medicines may cease the progression and also prevent further recurrence.
But again, being on chronic steroids therapy side effects can be an issue and in that case comes the role of immunosuppressant medicines.
To summarize it for you, if you are diagnosed as Behcet's. You will likely be put on steroids/immunosuppressants therapy.If you are lucky enough, your disease progression may cease off. However, regular follow-up and strict schedule of medicines will be important. The goal will be to live your life as healthy as possible. The disease is not likely to be cured. At the best its progression may stop.
Hope that I have answered your query.If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Sonia Raina
Looking at the MRI is it certain that it's behcets vasculitis or can be something else? My left whole side has gone very week and I have this itchy feeling on this side. When you say these steroids might not be able to cease the disease then what are the other option? How dangerous can this get? I had a test for HLA B51 gene and its negative I'm attaching the chest scan too. What is take on Rituximab and cyclophosphamide to use as treaments? Looking at MRI is the disease on a serious stage ?
Brief Answer:
On the basis of MRI one can't say that its Behcets vasculitis.
Detailed Answer:
Hi,
Thanks for being in follow-up.
MRI shows 'Microangiopathic ischemic changes'.
Most common cause of these MRI changes is-chronic high blood pressure. Elderly age,Diabetes and chronic smoking also predispose to these changes.
In some circumstances,vasculitis is the cause.Now,Behcets is just one cause of vasculitis and there can be many more causes like-SLE,sarcoidosis and many other autoimmune diseases.
So,on basis of this MRI only,we can't say it as Behcet's disease.We can't say MRI findings to be serious.Seriousness depends on the clinical picture and cause of these MRI features.
In presence of left side weakness and Behcet's disease as the likely cause-of course,it should be considered serious and treated well.
CT Chest is essentially normal,as mentioned also there.Some of the findings mentioned there may not be associated with your current symptoms.
I already mentioned that immunosuppressants are other options in addition to steroids.Rituximab and Cyclophosphamide come under the immunosuppressants group.Cyclophosphamide particularly,has troublesome side effects.Azothioprine, is one of the conventional ones and more frequently used.
Hope this helps.If you have any further questions,I shall be glad to answer.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
On the basis of MRI one can't say that its Behcets vasculitis.
Detailed Answer:
Hi,
Thanks for being in follow-up.
MRI shows 'Microangiopathic ischemic changes'.
Most common cause of these MRI changes is-chronic high blood pressure. Elderly age,Diabetes and chronic smoking also predispose to these changes.
In some circumstances,vasculitis is the cause.Now,Behcets is just one cause of vasculitis and there can be many more causes like-SLE,sarcoidosis and many other autoimmune diseases.
So,on basis of this MRI only,we can't say it as Behcet's disease.We can't say MRI findings to be serious.Seriousness depends on the clinical picture and cause of these MRI features.
In presence of left side weakness and Behcet's disease as the likely cause-of course,it should be considered serious and treated well.
CT Chest is essentially normal,as mentioned also there.Some of the findings mentioned there may not be associated with your current symptoms.
I already mentioned that immunosuppressants are other options in addition to steroids.Rituximab and Cyclophosphamide come under the immunosuppressants group.Cyclophosphamide particularly,has troublesome side effects.Azothioprine, is one of the conventional ones and more frequently used.
Hope this helps.If you have any further questions,I shall be glad to answer.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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