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What Does My MRI Scan Test Report Indicate?
Question: I had an MRI in March 2015 which said heterogeneous marrow signal in the left half of L4 vertebral body with hypo intensity on T1 and T2 weighted images which may represent focal sclerosis - however neoplasticism lesions can't be ruled out. The report goes on to say that the signal change noted in L4 vertebral body is likely to be benign.
In Nov 2015 I had a follow up MRI. The L4 vertebral body altered marrow signal focus seen on the previous imaging, this remains unchanged and has not increased in size.
My consultant now wants to discharge with me. However, I am suffering extreme exhaustion and terrible limb muscle pain ( like toothache but in my body ).
I have read that heterogeneous marrow signals should not be ignored. However, I have not any blood work or bone marrow tests. Surely I should not be discharged?
In Nov 2015 I had a follow up MRI. The L4 vertebral body altered marrow signal focus seen on the previous imaging, this remains unchanged and has not increased in size.
My consultant now wants to discharge with me. However, I am suffering extreme exhaustion and terrible limb muscle pain ( like toothache but in my body ).
I have read that heterogeneous marrow signals should not be ignored. However, I have not any blood work or bone marrow tests. Surely I should not be discharged?
Brief Answer:
It cxan be a benign lesion.
Detailed Answer:
Hello,
Thanks for posting your query.
The heterogenous vertebral body lesion that has not changed in size over 6 months is likely to be a benign lesion. This is less likely to be associated with ,malignancy. All such lesions are not harmful.
The exhaustion and limb muscle pain can be due to muscular spasms due to electrolyte imbalance. Do increase your intake of electrolyte rich fluids and get some oral muscle relaxants prescribed by your physician and see if it helps.
The decision to discharge depends on your physical condition. You can go for a repeat MRI scan after 3-4 months to be sure that the lesion is not increasing. Blood tests cannot help in ruling out the neoplasm.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
It cxan be a benign lesion.
Detailed Answer:
Hello,
Thanks for posting your query.
The heterogenous vertebral body lesion that has not changed in size over 6 months is likely to be a benign lesion. This is less likely to be associated with ,malignancy. All such lesions are not harmful.
The exhaustion and limb muscle pain can be due to muscular spasms due to electrolyte imbalance. Do increase your intake of electrolyte rich fluids and get some oral muscle relaxants prescribed by your physician and see if it helps.
The decision to discharge depends on your physical condition. You can go for a repeat MRI scan after 3-4 months to be sure that the lesion is not increasing. Blood tests cannot help in ruling out the neoplasm.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi
So I accept that this is my consultants view too, but now he is writing to me to say that I do not have a tumour ( when he has previously written to say I do have a tumour and he has shown me the Tumor on an MRI picture. I do appreciate that it is likely benign, but DR have you seen the research that says heterogenous marrow signal should not be ignored - if you will please google the term heterogeneous marrow signal - or altered marrow signal. The hospitals who have carried out an audit on patients who had this written on their MRI had varying degrees of eventual malignancy or myeloma.all such hospitals saw this term indicated that further oncology tests should be carried out I.e. The heterogeneous signal is an early red flag indicator. This is what I want blood tests or bone marrow tests.
I am on vitamin D tablets already and eat a healthy diet.
So I accept that this is my consultants view too, but now he is writing to me to say that I do not have a tumour ( when he has previously written to say I do have a tumour and he has shown me the Tumor on an MRI picture. I do appreciate that it is likely benign, but DR have you seen the research that says heterogenous marrow signal should not be ignored - if you will please google the term heterogeneous marrow signal - or altered marrow signal. The hospitals who have carried out an audit on patients who had this written on their MRI had varying degrees of eventual malignancy or myeloma.all such hospitals saw this term indicated that further oncology tests should be carried out I.e. The heterogeneous signal is an early red flag indicator. This is what I want blood tests or bone marrow tests.
I am on vitamin D tablets already and eat a healthy diet.
Brief Answer:
Chances of malignancy are 10-15%.
Detailed Answer:
Hello.
Thanks for writing again.
I have searched regarding heterogenous marrow signals and in 10-15% cases the chances of malignancy are there. But usually the malignancy symptoms appear 12-20 months after the heterogenous signals were detected. It is best to get yourself referred to an oncologist for other related investigation to remove the doubt of malignancy. An orthopedician or a neurologist may not investigate you properly in this regard.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Chances of malignancy are 10-15%.
Detailed Answer:
Hello.
Thanks for writing again.
I have searched regarding heterogenous marrow signals and in 10-15% cases the chances of malignancy are there. But usually the malignancy symptoms appear 12-20 months after the heterogenous signals were detected. It is best to get yourself referred to an oncologist for other related investigation to remove the doubt of malignancy. An orthopedician or a neurologist may not investigate you properly in this regard.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thankyou, this is what I thought. I will speak to my GP to ask for a referral
Do you have any idea what blood tests they should be running?
I first had my MRI in February 2015 so one year ago.
Should the heterogenous marrow signal in my L4 be reviewed annually - the Spinal Tumour association say you should be reviewed regularly to track change even in benign cases.
Do you have any idea what blood tests they should be running?
I first had my MRI in February 2015 so one year ago.
Should the heterogenous marrow signal in my L4 be reviewed annually - the Spinal Tumour association say you should be reviewed regularly to track change even in benign cases.
Brief Answer:
Details below.
Detailed Answer:
The investigations needed are CBC, quantitative immunoglobulins, free light chains, peripheral blood flow cytometry , bone marrow biopsy, skeletal survey, bone scan, etc.
It is best to get the MRI done annually to monitor the changes.
Regards.
Details below.
Detailed Answer:
The investigations needed are CBC, quantitative immunoglobulins, free light chains, peripheral blood flow cytometry , bone marrow biopsy, skeletal survey, bone scan, etc.
It is best to get the MRI done annually to monitor the changes.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thankyou for this reply, is an oncologist the best person to run all of these tests?
Brief Answer:
Oncologist is the best person for you.
Detailed Answer:
Yes. Oncologist will recommend you all these tests.
Regards.
Oncologist is the best person for you.
Detailed Answer:
Yes. Oncologist will recommend you all these tests.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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