Brain MRI w/Contrast

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Postby LoveActually » Thu Jun 11, 2009 1:27 pm

I just called the Neuro. The imaging center say's they sent the Radiologist Report on Tuesday & the Neuro say's they won't get it for a week. Who to believe?
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Postby patientx » Thu Jun 11, 2009 1:33 pm

You are entitled to a copy of the MRI report, like any other medical record. I'm not sure how thinks work with the military doctors (where you had the MRI done). But when I had my first one done, I went to the MRI facility and asked for a copy - I didn't need to go through the doctor.

Actually, it might be a good idea to get your own copy ahead of time. That way, you can go in with some questions. But keep in mind the radiologist report is not the final word - that's what you have a neurologist for. Sometimes the radiologists get things wrong, or the films are just too non-specific.

You know, going back to your last post, when I was given the news, I asked the neurologist about recommendations for an MS specialist. He wasn't offended at all (as he shouldn't be). This might be tougher for you, being in the military system.
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Postby Sharon » Thu Jun 11, 2009 2:45 pm

Might I suggest that you jump over to the CCSVI forum and take a look (it is listed at the bottom of the Forums). The theory of chronic cererospinal venous insufficieny and MS is not well known, but there is a hard working bunch of MS'rs on that forum that are researching, and becoming guinea pigs for research - I think you might find it quite interesting.

Sharon
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Postby LoveActually » Thu Jun 11, 2009 5:00 pm

I got the radiologist report. I contacted the imaging center in the neighboring city (same company) and they gave it to me with zero problems. I'm going to have to get my dictionary out to understand this thing but it's better then not having it at all.

I'm seeing civilian doctor's but I'm unable to choose my doctor. The military GP pretty much refers you to whoever accepts Tricare Insurance and is closest to your location. Which in my case, is not the best choice in care.

Thank you for the info Sharon.
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When I got the diagnosis...

Postby lyndacarol » Thu Jun 11, 2009 5:47 pm

LoveActually--
You asked what followed when I was told, "You have MS."I was home alone and promptly melted into tears. I called my husband at work with the news. He immediately called the neurologist and said we wanted to see him. My husband came home, we went to the doctor's office, but I did not get great comfort there. By the way, I see a different neurologist now -- on an "as needed" basis.
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Postby patientx » Thu Jun 11, 2009 7:10 pm

LoveActually wrote:I got the radiologist report. I contacted the imaging center in the neighboring city (same company) and they gave it to me with zero problems. I'm going to have to get my dictionary out to understand this thing but it's better then not having it at all.

I'm seeing civilian doctor's but I'm unable to choose my doctor. The military GP pretty much refers you to whoever accepts Tricare Insurance and is closest to your location. Which in my case, is not the best choice in care.

Thank you for the info Sharon.


Well, if you don't mind giving up some privacy, you can always post some of the things you don't understand here in the forum. There's lots of smart people here; they might be able to explain the harder to understand things.
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Postby LoveActually » Thu Jun 11, 2009 8:02 pm

Don't mind at all. Ok, here it goes.

EXAMINATION: MRI Brain with and without Contrast

IMPRESSION:

1. Punctate areas of round white matter signal change adjacent to the Anterior Lateral aspect of the left Lateral Ventricle and slightly higher in the Centrum Semiovale non specific. These do not conform necessarily to Demyelinating Disease. Differential diagnosis includes Vasculitis, Migraine Variant, Lyme Disease. These do not conform to those seen in small vessel ischemic change. Close Follow-Up Suggested.

2. Preservation of the normal flow with no intracranial mass.----Subdural fluid collection.

FINDINGS:

The calvarium and subcalvarial regions are normal. There is no intracranial hemorrhage or restricted diffusion with preservation of the vertebrobasilar carotid artery flow voids. The sinuses, pituitary gland and orbits are normal. The ventricles are midline. There is a round 7 x 9mm focus of increase signal on the FLAIR and T2 images adjacent to the anterior aspect of the left lateral ventricle as seen on series 12 image #15 which demonstrates no areas of enhancement on the post contrast study. The rest of the FLAIR images only show a few punctate subcentimeter changes on series 2 image #18 non confluent. The rest of the white and gray matter pre and post contrast show no abnormal signal. No intracranial mass is noted.


I googled a lot of the terms just to get a grasp on the meaning but I'm still a little lost. From what I gather, I have tiny areas of round matter which are lesions? I also googled Vasculitis and that doesn't sound very good however after reviewing all types, I have zero syptoms pointing towards that.

I know that the doc will ultimately make her ruling but what do you think? Any of this stuff look familiar.
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Postby Wendigo » Fri Jun 12, 2009 5:42 am

LoveActually wrote:Thank you patientx.

"Well, then, do you know any GOOD neurologists?"


I agree 100% If I didn't have to jump through hoops to get another referral through this military insurance then I would be seeing someone else already. And if I had the patience.

I must of read the reason for contrast wrong somewhere but thanks for clearing that up. And thank you for the other great advice.

Do you (or anyone else) think my neuro's office will give me a copy of the radiologist report before I sit down and speak with the neuro? She offers no compassion or sensitivity so there's no real benefit from hearing it from her, good or bad.

\

One would like to believe that if anything critical had been found on your MRI scans you would be notified right away, i.e. no news is good news. It's just my opinion but I think the MRI scan is just one piece in a puzzle the neurologist must ultimately try to make fit into a diagnosis together with clinical findings, labs, and history. The report itself would not make any sense to you and probably cause unnecessary anxiety. Even normal findings put in medical terminology can sound pretty scary.

In the summary part of my MRI report, even though I am being treated for MS, gave several possible causes for the findings.
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Postby Wendigo » Fri Jun 12, 2009 5:54 am

LoveActually wrote:
FINDINGS:
There is no intracranial hemorrhage .


Years ago in medical transcription, before computers, we used word processors and any error was multipled by however many carbon sheets came with the particular form. Errors were sent back to us for correction.

I got someone else's error back to correct by mistake once, dictated by a doctor with a HEAVY Asian accent...another transcriber had thought he said "intracranial hemorrhoids" instead of "hemorrhage."
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Postby patientx » Fri Jun 12, 2009 7:04 am

I guess when I said there were lots of smart people here, I should have mentioned, I'm not one of them.

To read up a little bit on the MRI you can check here:

http://www.medhelp.org/health_pages/Multiple%20Sclerosis/How-MRIs-Show-Lesions-in-MS/show/23?cid=36

There may be better info out there in Google university.

Or, you may just want to wait to see what the neuro says. But, the white matter mentioned in the report refers to the white matter of the brain. The way the MRI works, "abnormalities" will show up as bright spots, or hyperintensities, on the images. However, these hyperintensities can be due to many things, not just de-myelination. This is part of the problem in diagnosing MS. Exerience shows that MS lesions will show in typical areas of the brain. So, the neuro will use this, along with symptoms, to make a diagnosis (as well as a slew of other tests to rule out other conditions).

So, to me, it sounds like the radiologist noted some small areas of hyperintensity that weren't that remarkable; but there was one spot that is 7x9 mm. It might be tough to say if this is loss of myelin or not. I think this is where the value of the neuro looking at the films comes into play.

Sorry, this doesn't give much info. Maybe someone else can chime in.
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Postby LoveActually » Fri Jun 12, 2009 3:06 pm

I guess when I said there were lots of smart people here, I should have mentioned, I'm not one of them.


LMAO! That's ok. I'm not too concerned with finding out right this second. Just was wondering if anything looked familiar. We'll see what the Neuro says.

To read up a little bit on the MRI you can check here:

http://www.medhelp.org/health_pages/Mul ... /23?cid=36


That's a great article. Thanks for sharing.
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Postby msmything » Fri Jun 12, 2009 5:08 pm

It seems kind of strange to say 'welcome to the site', but it is a genuinely good site for info, I'm glad you found it.

Each time I've had an MRI the neurologist sits down with me in front of the computer and we look at the scan together. Each time I have asked for a copy of the disc...which takes about 5 minutes for the technologist to 'burn'
Then, I've followed up with medical records and gotten my own copy of the radiology report.

Unfortunately the world of chronic disease, which we've been dragged kicking and screaming into requires ALOT of self advocacy.

Keep a file and hope it doesn't get too fat.
I also take questions with me to the neuro, write the answers and file that as well.
Either way, you will have a long positive life with your lovely daughter...
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Postby Sharon » Fri Jun 12, 2009 6:33 pm

DITTO to msanything!
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Postby Needled » Sat Jun 13, 2009 5:29 am

msmything and Sharon are so right. I treat each appointment as a meeting. I don’t have time to waste, and neither do they. I list the date and doctor, include my list of current medications, any changes since the last appointment, then my questions. I bring two copies, one for me, one for the doctor. Some doctors use it, some don't. You always get sidetracked during the appointment, but you have your list to get you back on track. When I get home, I type up the notes, and it goes in my file. Sure, it takes extra time, and time is precious, but so is having a written record of all my doctors’ appointments and tests, including note and comments. Dr. X doesn’t know what Dr. Y prescribed or told you 2 years ago, but you do, with the help of your notes! It’s been said so many times and so many ways, but you are your own best advocate.
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Postby msmything » Sat Jun 13, 2009 12:48 pm

needled, you bring up a good point...I actually have asked my neuro to be a captain of this very confusing ship I'm in. His answer was 'well I'll captain the MS part' There is no MS part. It's all me. Every thing that I do has an affect on my chronic disease.
They don't do the team thing well. So again, we are our own best advocates.
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