Radiology/Lesion on MRI follow-up
QUESTION: Hello. I've been trying to send you images regarding my lesion so you can take a look at it. Here are a couple more. Thank you.
Well we finally got the lesion in view.
It is a non specific focus. I reviewed first question and it seems that it is stable since 2012. and who really knows how long it has been there.
2 year stability is a very good sign, so pehaps we are not dealing with demyelination.
Did you ever have MRI with contrast? I dont' suspect that it would take up contrast but I am curious. If you never had contrast then I would suggest that at the next follow up MRI, they should use contrast.
Is there a sequence that is labeled GRE or gradient or SWI. If you can find it in the folder send me some earlier images from it, I'd say start with image 4 or 5.
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QUESTION: Hello Dr. K. Thank you. I attached two more. What causes these "non specific" lesions, and what does that even mean? Is it something serious that I need to go see a doctor about? It wasn't even mentioned on the report two years ago and neurosurgeons that looked at my scans because of my cervical stenosis did not mention it. I did have brain MRI with contrast, in fact, it was this scan. The one two years ago did not have contrast. Here are the titles of the headings on the CD: MRA 2SLAB; SGT1; AXT2; AX-FLAIR; AXDW1; AXSW1 (FSBB) 3DFE; AXSWI; JET FLAIR COR; FE3D_ssftp T2 Thin; AXT1Thin; AXT1 thin CT; COT1FSct; 3DT1Axc. I'm happy to pay you a fee and send you all the images to an email account. Thank you very much.
You can't really send allof the images to an email account - the file size would be huge and any normal email would reject it. I am more than happy to look at the MRI if you'd like to upload it to a dropbox or yousendit.com or a similar site. You'll probably have to zip the disk and upload it as a single file. Once uploaded to the site, the site will give you an option to send an email or will give you a link to the upload that you can cut/paste into here.
Looking at these images we'll have to jump to image 20 and see where we end up. These are too low and they used SWI which is made from very thin slices. So you can do that unless you are going to upload the whole thing to me.
We say non specific lesion because we don't know the etiology behind them. Sometimes we just don't know and some times the possibilities are just too numerous. There is miriad of things that can cause a lesion like this (although, I only have two images through it). some are congenital, some are developmental and may have to do with some unknown event that may have happened while baking inside a mom; some are caused by chronic disease like diabetes or other cardio risk factors like small strokes; some can be tumors, demyelination etc...