Can someone please help me understand this Impression?

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Can someone please help me understand this Impression?

Postby blondie33 » Mon Sep 10, 2012 5:55 pm

So I had an MRI done and I have Multiple White Matter Lesions. And in the Impression it says that I have One Suspicious enhancing lesion along the Medullary Pyramid. What does that even mean? I had a Spinal Tap and that came back fine. And I have no symptoms of MS. God I'm so scared. Please anyone give me some insight, I would really appreciate it.
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Re: Can someone please help me understand this Impression?

Postby NHE » Tue Sep 11, 2012 12:37 am

The medullary pyramid is part of the brain stem.
http://medical-dictionary.thefreedictio ... ngatae.jpg

More info can be found here http://medical-dictionary.thefreedictio ... +oblongata
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Re: Can someone please help me understand this Impression?

Postby blondie33 » Tue Sep 11, 2012 7:30 pm

Thanks for your response. Do you by any chance know what enhancing lesion means? Also in regards to this same suspicious lesion it also stated that it was only seen on the Flair image. Do you by any chance know what that means?
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Re: Can someone please help me understand this Impression?

Postby Scott1 » Wed Sep 12, 2012 2:32 am

Hi,

FLAIR is the abbreviation of "Fluid attenuated inversion recovery ". It's just a term referencing the density of the tissue being scanned that tells the practioner something about how the image was created. It's not about you, it's about the image.

Don't worry too much about the term "enhancing". Again, it's basically a technical description. The operative word for you is lesion and as the earlier post shows in it's link yours is below the Pons (the bit at the base of the brain where all the nerves etc cross over so the left side of your brain controls the right side of your body and vice versa).

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Re: Can someone please help me understand this Impression?

Postby NHE » Wed Sep 12, 2012 2:35 am

blondie33 wrote:Thanks for your response. Do you by any chance know what enhancing lesion means?


An enhancing lesion is one that lights up with the gadolinium contrast that was used during the MRI. The gadolinium crosses the blood brain barrier at sites of active inflammation. It can cross because the white blood cells have been crossing there and have loosened up the tight junctions between the epithelial cells that line the brain's blood vessels forming the blood brain barrier. Essentially, it means that it's a site of active inflammation.

blondie33 wrote:Also in regards to this same suspicious lesion it also stated that it was only seen on the Flair image. Do you by any chance know what that means?


It's a type of MRI. FLAIR stands for Fluid-Attenuated Inversion-Recovery. FLAIR imaging helps to nullify the signal from the cerebrospinal fluid (CSF) to better image the brain tissue. It may reveal lesions that regular T1 and T2 imaging do not. T1 and T2 represent different times when the image data, or return EM energy, is collected. T1 is 20 mS after the EM pulse while T2 is 200 mS after the EM pulse. Water appears black in T1 and white in T2. Perhaps someone else can help with the significance of a lesion showing up only in the FLAIR image.

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