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MRI question for MedScanMan (non-cancer related)

NewDay's picture
NewDay
Posts: 172
Joined: May 2012

I apologize for posting this here because it is not related to kidney cancer, but until I talk to my doctor, I don't know what forum to go to. I promise I won't keep posting here on this topic. I'm hoping the scan man can help with one comment on an MRI. When I mentioned some "weird" events to my Oncologist, he ordered a brain MRI to rule out the met possibility. I had been concerned about the TIA possibility, but he said TIA's won't show on an MRI or CT scan. I have an appointment with him Thursday. The good news is there is no sign of a tumor, but there are a couple of comments that concern me.

"Deep white matter shows some scattered subcentimeter foci of increased T2 and FLAIR signal intensity within the coronary and centrum semiovale."

"Impression: Small size number foci of the deep white matter hyperintensity suggesting some microvascular ischemic disease."

Question: I succeeded in googling "centrum semiovale". I'm not sure whether I'm reading the "coronary" part correctly. A non-medical person could read that statement one of two ways. Either it is saying "within the coronary(as a noun) and also the centrum semiovale" or it is saying "within the coronary(adjective) semiovale and centrum semiovale". I understand "coronary" in the context of coronary artery disease, but not as a stand-alone term, but I also don't find references to "coronary semiovale".

I'm not asking you for a diagnosis, just help interpreting the terminology correctly. It is probably intuitively obvious to everyone else, but not to me so excuse my ignorance. I really, really appreciate any help.

Thanks,
Kathy

MedScanMan's picture
MedScanMan
Posts: 108
Joined: Jul 2012

To say that a TIA won't show on a CT or MRI of the brain is not true. A simple CT brain with no contrast will show an early TIA. To distinguish whether it's new or not is difficult. Any infarct...even lacunar infarcts (the smallest of strokes) will show on a CT with no contrast.

"Deep white matter shows some scattered subcentimeter foci of increased T2 and FLAIR signal intensity within the coronary and centrum semiovale."

When T2 and Flair is mentioned here it's simply MRI talk for two of the maybe four sequences of images taken. Each sequence looks different and shows different things. Some fluid, some soft tissue, some a combination of both. Usually you'll have a total of six or seven sequences from three different directions. Axial, Sagittal and Coronal. The increased foci here on the T2 and flair signal can mean some earlier or new TIA's. Hard to tell without seeing images. You might read in the body of the report something like "periventricular white matter disease". Just be close to 60 and you'll probably have that. The brain of a teenager compared to ours looks nothing alike other than shape.

"Impression: Small size number foci of the deep white matter hyperintensity suggesting some microvascular ischemic disease."

This is just a repeat of the above in different MRI Speak.

Also if a doctor suspects a TIA, an Infarct or even new early blood from a true stroke the technologist will add to the sequences one called a Diffusion Weighted Image. This takes about three minutes and gives the Radiologist a definite call for Stroke.

I really don't see anything in this report that would worry me, unless I was having symptoms. This is one of those posts where I have to give the old disclaimer. Remember, I'm not a Radiologist. I'm trying to help you understand the report. You have to know that what I say is not set in stone............but with this one......I'm right.

P.S. The coronary and centrum semiovale is just an area of the brain. Just an anatomical point. It's like saying frontal lobe, or parietal lobe, just the location being referenced.

Hope this helped you
Jeff

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

Funny - Jeff took the words out of my mouth - exactly what I was going to say :-)

Kathy, I'm so glad that Jeff is able to say you're fine and I bet you're glad you asked him about it! Keep well (both you and Jeff who has lifted the value of this site to new levels).

NewDay's picture
NewDay
Posts: 172
Joined: May 2012

Jeff & Tex:

Thanks for the help. Anything abnormal in the brain is scary. You continue to educate me and you have saved me a few days of worry.

Kathy

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