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Old 03-08-2007, 08:21 AM
Lazarus Lazarus is offline
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Default So, what are T2 hyperintense and T1 hypointense lesions?

What I am quoting below is from my recent brain MRI. The thoracic and cervical MRIs have the same words. Lots of lesions...all NON ENHANCING...
My questions= What if none of the lesions are enhancing? Does that mean ...well, what does it mean? The contrast stuff injected did not seem highlight lesions (I assume that is what non enhancing means). There are many lesions in both spinal MRIs also. What do hypointense and hyperintense words mean as applied to lesions?

I know my neuro will see me soon but I am driving myself nuts.

Thanks for anyone who helps explain these words
Linda

"There are multiple foci of T2 hyperintense signal within the subcortical, deep cerebral and periventriculr white matter, left thalamus, right paramedian pons, right medulla, and left cerebral peduncle.....some lesions have slightly increased while others have slightly decreased in conspicuity. None of the lesions enhance....several demonstrate T1 hypointense signal...."
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Old 03-08-2007, 10:14 AM
WhataBreeze WhataBreeze is offline
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Hello Linda

I am posting here, as I can truly understand your anxiety in regard to your MRI. I'm not a doctor but I know there is much info on that report. I will tell you in most cases your doctors office will recieve the report normally within 48 hours, as they usually tell you a week or two. My current lady friend was married to a radiologist. I have been told that if an MRI poses any immediate issues, your physicians office would surely contact you. Just by opinion only, I would guess your report is much to do with demyelination and other issues. Both Franky and I will be hoping for a posite report if in fact this is not your first one. You have a great Forum group arround you and I'm sure maybe more info will trickle in for you. One other suggestion I would make is if by chance you are seeing someone for other issues like anxiety, depression, etc., you might contact them in regard to how you are feeling because of this and possibly they might try to assist in getting your questions answered in a more timely manner. One question I do have is normally you don't get posession of a Brain MRI unless you go through all the paperwork to get it. Atlest you can see if you have so does your doctor. G-d Bless...

Franky and Breeze
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Old 03-08-2007, 10:48 AM
Braindead Braindead is offline
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Default short version

Here is the short version.

Braindead


Brain MRI scans are abnormal in more than 90 percent of MS victims. Typically, areas of abnormal brightness, suggesting increased water content, appear on "T2-weighted" scans; dark areas on "T1-weighted" scans suggest focal areas of tissue destruction; and abnormal brightness after a dye is injected into the patient's bloodstream ("enhancement"), suggests that inflammation has damaged the blood-brain barrier (blood vessel tissue that shields the brain from undesirable molecules in the blood).

Unlike CT, MRI can show pictures along many planes--the axial plane, the saggital plane (side to side) and the coronal plane (front to back)--enabling physicians to see images that were previously impossible to visualize except during autopsy. Of clinical significance, using different pulse signals results in different image types. The three most commonly used types are termed T1, T2 and proton density.

T1 is a short, fast pulse that makes fat tissue appear bright and cerebral spinal fluid (CSF) dark. T1 images look like CT images and are more focused than the other MRI image types. T1 allows for the overall visualization of structures in the body--a view that can be enhanced by using a contrast medium. In the same way that iodine can be used in CT scans to stain blood vessels, gadolinium diethyylenetrinine pentaacetic acid (gadolinium DTPA) renders blood vessels in a T1 MRI image white. (Gadolinium does not routinely cross the blood-brain barrier unless the barrier has broken down due to, say, tumors or infections.)

T2 pulses last four times as long as the T1 variety, which makes hydrogen nuclei, surrounded by water, a more suitable contrast. In T2 images, CSF appears white and areas that have an abnormally high water content (those affected by tumor, infection or stroke) look bright as well. In proton density images, CSF and the brain look the same, making it easier to see tissue changes next to ventricle structures.
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Old 03-08-2007, 11:28 AM
Lazarus Lazarus is offline
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Hello Braindead and Breeze--
Thanks for responses. We did this latest round of MRIs in preparation for a sitch from my current meds to methotrexate and steroids and keeping the copaxone.

We did brain, thoracic and cervical spine.
My first brain MRI was at diagnosis in 1990.

My neuro just got the results yesterday as did I. He will call soon but I was trying to understand them.

For others who come this way: I went to google and typed in hypointense lesion and immediately got many articles about SPMS an MRI results.
I've been reading for hours.

I really liked the clear information presented here.
Thanks
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Old 03-08-2007, 11:31 AM
lady_express_44 lady_express_44 is offline
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If I recall correctly . . .

In simple terms, if they are not enhancing (and assuming you had dye), this means they are not "inflammed/active". Those non-enhancing lesions are plaque/scar tissue.

It used to be that they thought that enhancing lesions implied that we were in an attack, but it seems it may just indicate disease "activity" and not necessarily an attack.

As Braindead indicated, T1 and T2 lesions indicate the MRI method used (slices) when looking at our lesions in certain parts of our brain . . . however, I think that T1 lesions may be able to identify more extensive damage (black holes).

At the end of the day though, most agree that the extent of lesions isn't nearly as tell-tale as the location of them. I had only one lesion located in my spine (once upon at time) and was paralyzed from the get-go. I was fortunate in that I recovered well, but apparently 2/3 of us would not with the same lesion location.

Hopefully someone will jump on if I have inadvertantly misled you.

Cherie
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Old 03-09-2007, 10:48 AM
xo++ xo++ is offline
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Hi Linda,

Just putting things in different words than other people have already used, T2 hyperintensities are the white blobs we typically see on our MRIs. These lesions are not closely correlated to disability, and routinely come and go.

T1 hypointense lesions ("black holes") are generally thought to represent areas of axonal loss and have been correlated with disability scores. (However, even T1 lesions sometimes disappear on subsequent MRIs.)

Enhancing lesions, i.e. lesions that glow more brightly when gadolinium or other contrast medium is given, are thought to represent areas of active disease and breaches of the blood-brain barrier.

Mark
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Old 03-09-2007, 12:40 PM
Lazarus Lazarus is offline
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Default Thanks Mark--clear and concise

As always, I appreciate the effort.
Linda
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