Radiology/Signal

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QUESTION: Hello,

I had a brain T3 MRI and if you can explain to me what does those statements mean or and indicate

1- "There is asymmetric increased signal that caps the occipital horn of the right lateral ventricle"

2- "There is linear signal within the right centrum
semiovale"

3- "There is mild artifact related upper cervical cord signal"

Thank you

ANSWER: Mark,
without looking at the images I can tell you that these descriptions (1 and 2) represent non specific gliosis that we see on numerous patients.  IF you are older tnan 50 then these may be some chronic changes related to atherosclerotic vascular changes.  If you are less than 50 than possibilities include just non specific gliosis (sorry not that helpful to you) which really can be from any insignificant cause.  sometimes people with migraines have similar findings.  The one is centrum semiovale may be something separate, and I don't know how significant the possibilities are without further information. Centrum semiovale just refers to a specific white matter area.  I would need more information to advise further. Why did you get the scan in teh first place. Also, if you would like to ask a follow up question, tell me your age and symptoms that led to an MRI.
Regarding #3 - I can't tell for sure without the images but there is something from the way the images were obtained that is seen overlying the cord.  Artifact means it is something that is seen on an image but really not there.


Hope this helps.

MK



---------- FOLLOW-UP ----------

QUESTION: Sure, i am 38 male, i had an mra and mri using 3T MRI machine, the mra was normal, ct scan was normal but the MRI showed some lesions and i do not know the cause
can you tell me if those lesions were caused by mini strokes or something else and does those signals mean that i have a high possibility of strokes, my mra and circle of willis was very normal

my symptoms are stroke like symptoms and continuous head pressure but not migraine and fatigue , weakness, numbness...

we do not have MS in the family, i can move all my hands and feet  and balance is ok and eye sight too, except some pain in the eye, eye doctor saw nothing, and i have recently left thigh cold sensation that comes and goes but the thigh itself is always warm and no numbness or pain in it

would it show if i had a small stroke on the mri or something  like vessel problem or small bleeding

Here is the report

CLINICAL INFORMATION: Head pressure pain and numbness.
IMAGING SEQUENCES: Multiplanar 3-T MR Imaging of the brain is performed prior to
and after the administration of 8 cc of Gadavist.
FINDINGS: There is a small lesion adjacent to the right lateral ventricular body and
there is an ovoid lesion within the left centrum semiovale. There is a small nonspecific
left ependymal/subependymal nodular focus that bulges into the superior aspect of
the left ventricular body. There is asymmetric increased signal that caps the occipital
horn of the right lateral ventricle and there is linear signal within the right centrum
semiovale. The corpus callosum is unremarkable. There are no suspicious infratentorial
parenchymal findings. There are right basal ganglia postcontrast findings of a DVA.
There are no extraaxial masses or collections. The diffusion, T2* and postcontrast data
sets are normal. The craniocervical junction is normal. There is mild artifact related
upper cervical cord signal. There are no suprasellar or pineal region lesions. There are
no suspicious intracranial vascular flow void asymmetries or abnormal postcontrast
dural venous sinus findings.
There is ethmoid air cell and left frontal sinus mucoepithelial thickening. The mastoid
air cells are clear. There are no petrous apex abnormalities.
IMPRESSION:
1. SUPRATENTORIAL LESIONS THAT CAN BE A MANIFESTATION OF
DEMYELINATING DISEASE OR FROM NONSPECIFIC FOCI OF GLIOSIS
2. SMALL LEFT EPENDYMAL/SUBEPENDYMAL NODULE OF POSSIBLE GREY
MATTER HETEROTOPIA.
3. RIGHT BASAL GANGLIA POSTCONTRAST FINDINGS OF A DVA.
4. ETHMOID AIR CELL AND LEFT FRONTAL SINUS MUCOEPITHELIAL THICKENING.

CLINICAL INFORMATION: Head pressure pain and numbness.
IMAGING SEQUENCES: Multiplanar 3-T MR Imaging of the brain is performed prior to
and after the administration of 8 cc of Gadavist.
FINDINGS: There is a small lesion adjacent to the right lateral ventricular body and
there is an ovoid lesion within the left centrum semiovale. There is a small nonspecific
left ependymal/subependymal nodular focus that bulges into the superior aspect of
the left ventricular body. There is asymmetric increased signal that caps the occipital
horn of the right lateral ventricle and there is linear signal within the right centrum
semiovale. The corpus callosum is unremarkable. There are no suspicious infratentorial
parenchymal findings. There are right basal ganglia postcontrast findings of a DVA.
There are no extraaxial masses or collections. The diffusion, T2* and postcontrast data
sets are normal. The craniocervical junction is normal. There is mild artifact related
upper cervical cord signal. There are no suprasellar or pineal region lesions. There are
no suspicious intracranial vascular flow void asymmetries or abnormal postcontrast
dural venous sinus findings.
There is ethmoid air cell and left frontal sinus mucoepithelial thickening. The mastoid
air cells are clear. There are no petrous apex abnormalities.
IMPRESSION:
1. SUPRATENTORIAL LESIONS THAT CAN BE A MANIFESTATION OF
DEMYELINATING DISEASE OR FROM NONSPECIFIC FOCI OF GLIOSIS
2. SMALL LEFT EPENDYMAL/SUBEPENDYMAL NODULE OF POSSIBLE GREY
MATTER HETEROTOPIA.
3. RIGHT BASAL GANGLIA POSTCONTRAST FINDINGS OF A DVA.
4. ETHMOID AIR CELL AND LEFT FRONTAL SINUS MUCOEPITHELIAL THICKENING.

ANSWER: Mark,

You hit on major points in your follow up question.

The way the report is written, I agree with the Impression part of it.  This is either nothing to worry about and may reflect some non specific incident that happened before birth or in the past 38 years... The reason we can't say 100% is that because at this time we only have information from one point.  It is true that similar findings are seen in many many patients without any symptoms and never cause any problems.  It would be unusual for a male of your age to be newly diagnosed with MS. Is it impossible...well know...nothing really is.  I think further check into that by a neurologist could be prudent But wouldn't lose sleep over it.  It is more to complete the work up so everyone can move on.  Can these be a sequalae of some minor "stroke" like episodes.  yes but again at your age, two spots in the brain are not concerning.  it's like having arthritis...the longer you live the more things you have.
No hard answers here but again nothing overly worrisome on the scan. Just need to finish the work up and move on!
Hope this helped a bit.

MK

---------- FOLLOW-UP ----------

QUESTION: SOrry i really suspect in minor strokes, because the episodes i have are more like it, so what do you mean exactly by " Can these be a sequalae of some minor "stroke" like episodes "

you mean i had   a couple of mini strokes that are causing me those continuous symptoms  and how can i avoid those things in the future , what can i do

I thought a ct scan and mri 3T would show if i had any mini strokes or strokes or bleeding,

And wouldn't show if i had any stroke or vessel issue like arteries on the MRA and ct angiography that came back normal

AGain i have no migrain , it is severe head pressure continuous with stroke like symtpoms when it goes to the extreme

I doubt that i have MS, mine is more like a severe stroke thing

the lesion on the left centrum simovale is at least 1 cm in size, i think this is the cause of my symtpoms,  is this a vessel or artery area , like could it be i had a mini stroke and no one saw it or ischemia

Answer
Mark,
sorry for the delay, I've been out of town.

At this point it is hard to prove one way or the other if the lesions are a cause of a prior mini strokes.  
There are many vessels in the area which supply your brain with blood.
I agree that MS is a remote possibility and these lesions may not have anything to do with any of your symptoms.
However, a good work up should be done to exclude MS, other inflammatory abnormalities like vasculitis.
This may not provide much answers but at this point the findings on MRI are really non specific and may not be clinically relevant at all.

MK

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Michael K.

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Almost any kind of questions regarding any types of radiology exams, procedures, meaning of radiology reports etc...

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12 year experience in the field of radiology

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American Society of Neuroradiology, Senior Member Society of Pediatric Radiology, Active Member

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Radiology Seminars in pediatric neurology American Journal of Roentgenology American Journal of Neuroradiology

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