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paul_milander
Joined: 16 Mar 2008
Posts: 520
Location: Shippensburg, PA
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 Posted: Thu May 01, 2008 11:27 am Post subject: Anyone know how to read a MRi?CT Scan report? |
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LMK if someone can help
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.45chel
Joined: 26 Oct 2007
Posts: 2490
Location: Chambersburg
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| Posted: Thu May 01, 2008 6:38 pm Post subject: |
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Wish I could, I used BIO profs and medical reference and text to get a feel for my stuff...
GL
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paul_milander
Joined: 16 Mar 2008
Posts: 520
Location: Shippensburg, PA
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| Posted: Thu May 01, 2008 6:41 pm Post subject: |
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| .45chel wrote: | Wish I could, I used BIO profs and medical reference and text to get a feel for my stuff...
GL |
Darn It
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.45chel
Joined: 26 Oct 2007
Posts: 2490
Location: Chambersburg
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| Posted: Thu May 01, 2008 7:07 pm Post subject: |
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Have you considered walking in to the ER and asking the Dr on duty?
Quite a few hospitals contract out the interpretations now-a-days. I know Chambersburg uses some company in Australia.
It bugs me 1) having to wait 2) not having easier access to second opinions, especially when it comes to scans and MRIs because your results are subject to a strangers thinking and emotions at that moment.
I'm probably not helping, but I wanted you to know that I've been there...also, there is no reason you shouldn't have some opinion within a few hours--- a day at the most, other than chain of custody, slow message B.S. etc.
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If, lately, it seems as though I've been unreasonable, it is only because I have lost all reason. |
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paul_milander
Joined: 16 Mar 2008
Posts: 520
Location: Shippensburg, PA
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| Posted: Thu May 01, 2008 9:00 pm Post subject: |
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| .45chel wrote: | Have you considered walking in to the ER and asking the Dr on duty?
Quite a few hospitals contract out the interpretations now-a-days. I know Chambersburg uses some company in Australia.
It bugs me 1) having to wait 2) not having easier access to second opinions, especially when it comes to scans and MRIs because your results are subject to a strangers thinking and emotions at that moment.
I'm probably not helping, but I wanted you to know that I've been there...also, there is no reason you shouldn't have some opinion within a few hours--- a day at the most, other than chain of custody, slow message B.S. etc. |
Let me explain so I dont sound odd..I have had headaches, dizziness, hearing loss for a few years. And finally last October they did a MRI which showed "something" then they did a CT scan which showed a tumor but when I went to the Neurosurgeon he said "let's wait and see" so I have waited 6 months and I go in on Friday for a new CT Scan. But when the hospital called me to verify information they said that the scan was being done to check the size of my brain tumor. Now I freaked out, yes I know any mass is a tumor and not all masses are cancer. But I got a copy of my MRI and CT scans reports and the wording sounds scary as hell, like I have a deadly cancer so I was looking for someone who could explain it to me more than mu surgeon did. Here is what it said
here is a MRI report from 10/12/08 " a 1.7 x 1.4 x 1.2-cm heterogenious mass-like area arising from the anterior and superior aspect of the clivus protruding into the left sphenoid sinus. The legion probably demonstrates fatty components with questionable heterogenous enhancement. differential diagnosis includes pituitary adenoma versus complex mucous rentention cyst versus chordoma. Recommend clinical coorrelation. If clinically indicated, CT of the cella would be helpful
CT two days later "The paranasal sinsuses are free of disease. In the clivius there is a well defined luncent lesion with sclerotic bordering measuring 1.6 x 1.2 cm in axial dimenssion. This is located in the midline extending toward the left midline.
the orbits are unremarkable, no intra-axial fluid collections are seen. No midline *** is noted. No major vascular territory infacrt is seen. No significant enhancement is seen in this lesion after contrast administration. Differntail diagnosis inclused chordoma o metastic disease. If patient has a history of primary carcinoma, chordoma is favored in this age agroup
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.45chel
Joined: 26 Oct 2007
Posts: 2490
Location: Chambersburg
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| Posted: Fri May 02, 2008 1:41 am Post subject: |
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Okay first of all: I AM NOT A DOCTOR!!!
NOT EVEN CLOSE. I read books and look up definitions and Google example imagery and try to put it all together.
 Just wanted to get that out there.
There is growth (slow) of the mass. They know this by the appearance of some bone thickening. (sclerotic border is present due to slow enlarging. Sclerotic = A thickening or hardening of a body part, as of an artery, especially from excessive formation of fibrous interstitial tissue.)
questionable heterogenous refers to a non-uniform mix of two unknown components (think oil and water- they don't mix uniformly so the result is heterogeneous.
The doctors have narrowed it down to:
Pituitary adenoma
| Quote: | Pituitary adenomas are almost always benign with no malignant potential. In general, pituitary lesions can be subdivided into nonsecretory and secretory tumors of the pituitary gland, other intrasellar tumors, and parasellar tumors.
Pituitary adenomas are slow growing, encapsulated tumors of epithelial origin that penetrate adjacent structures. The tumors can contain necrotic, cystic, or hemorrhagic regions. In rare cases, the tumors become calcified. The incidence of malignant degeneration among pituitary adenoma is exceedingly small.
The mortality rate related to pituitary tumors is low. Advances in both medical and surgical therapies and the availability of hormone replacement have contributed to successful management.
http://www.emedicine.com/radio/topic557.htm
Pituitary adenomas are the fourth most common intracranial tumor after gliomas, meningiomas and schwannomas. Even malignant pituitary tumors rarely spread to other parts of the body. Adenomas are by far the most common disease affecting the pituitary. They more commonly affect people in their 30s or 40s, although they are diagnosed in children as well. Most of these tumors can be successfully treated. Tumors that produce hormones are called functioning tumors, while those that do not produce hormones are called nonfunctioning tumors.
TRANSLATION: These are very common and usually undiagnosed because they don't typically cause a lot of problems. It is more a group of growths rather than one large one. Most are benign --- they can spread, but are slow growers. They can be made up of broken blood vessels, cysts, dead material and other gross stuff, but are easily treated. |
Complex mucous rentention cyst
| Quote: | | (think: severe sinus infection only not as fun) A lump of possibly infected snot and stuff that isn't draining like it should >gag< This is beyond antibiotics and well into necessary drainage territory |
Chordoma
| Quote: | As you've already read, this is something the doctors are most likely to will focus on if you have a history of malignant cancer in that region. (I think you would have mentioned that)
A rare tumor that usually occurs in the spine and base of the skull. Chordomas are tumors originating from embryonic remnants of the primitive notochord. Because they lie in bone, they are usually located in the outermost of the three layers of the meninges surrounding the brain and spinal cord and cause bone destruction.
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or
Metastatic disease
| Quote: | (Metastasis, is the spread of a disease from one organ or part to another non-adjacent organ or part. Only malignant tumor cells and infections have the capacity to metastasize.
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Now, lets get a better idea of the location.
Clivus
The clivus is an important landmark for checking for anatomical atlanto-occipital alignment; the clivus, when viewed on a lateral C-spine X-ray, forms a line which, if extended, is known as the known as Wackenheim's clivus line.
BELOW
Figure 1a: Saggital T-1 weighted MRI imaging depicting compression of the brainstem by a hetergenous mass arising from the clival plate
Sphenoid sinus
The sphenoid sinus has been described as the forgotten sinus or neglected sinus because of its anatomical location and the difficulty in diagnosing disease there. Diseases of the sphenoid often were determined only when complications arose. With the advent of modern imaging techniques and a higher index of suspicion, diseases of the sphenoid are much more easily found and treated. Modern imaging, antibiotic, and surgical options have changed the presentation and, often, the treatment of acute sphenoid sinusitis.
The image below gives a pretty good idea of location only its a pencil where the arrow is
So, that's basically the gist of it. If you want a list of symptoms or want me to try to look into anything else, let me know.
I know how awful it is to wait for interpretation. I look up a lot of my own stuff these days...I got tired having doctors talk over my head.
Take care of yourself and try not to let the worry eat you up---especially considering all you have to be thankful for (like a family that loves you and an awesome forum to post in and a month before you get to eat PA food!!) 
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paul_milander
Joined: 16 Mar 2008
Posts: 520
Location: Shippensburg, PA
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| Posted: Fri May 02, 2008 8:25 am Post subject: |
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OK you just gave me more detail in that then my Neurosurgeon did in October. When I was sent to the Neurosurgeon by my neurologist ( within 24 hours of my CT) I thought I was all but dead. I mean they do a MRI on Moday, call me Tuesday to say they want to "clarify' a image so on Wednesday I have a CT scan. By Friday morning I am at a Neurosurgeons office so I was really amped up. Well as with most surgeons he had no bedside personality or felt he had to explain anything. He walked and basically said " Well if I was going to place a foreign object in your head this would be a perfect spot so it would not affect your brain, Let's wait 6 months, do another scan and if it has grown we will do a biopsy, thanks for coming in" shook my hand and left.
So today is my six months but my follow up is not until 05/22/08 and I will have the CT report by Tuesday and I dont know if I can wait that long. I have been sick for awhile now and have been to Johns Hopkins who felt that I have Menergianes Diease (sp?) but they kept checking my Thyroid because of my symptoms. ( always hot, dizziness, sweating, bulging eyes, weight gain, etc) so I find out that the Pitituary Gland is the Master Gland that runs everything and the Thyroid the most. Thyroid conditions run in my family. So a tumor on the Pitituary would not be that surprsing, however Cancer would be. The only Cancer that runs in my family is Skin Cancer and that is why I am Pale year round and carry a 30SPF Sunblock. A Chordoma from what i read is always fatal within 10 years so you can see why I am freaked out
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.45chel
Joined: 26 Oct 2007
Posts: 2490
Location: Chambersburg
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| Posted: Fri May 02, 2008 7:07 pm Post subject: |
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Like I said before, I'm no doctor, but I would be leaning towards the pituitary adenoma. Not only because I would be hoping for the best, but because it is just more likely (even before I knew your family history.)
I've had a good deal of time on the patient side, which is why I started looking stuff up. I got tired of not understanding what the heck was being said to me. I took a few Biology courses a couple years ago and they helped even more.
With me, I had always been relatively healthy, joined the military, became injured and it all went downhill from there. Surgical sites got infected, chronic pain, six months after surgery I went hyperthyroid and lost thirty pounds in two weeks, had to be fed through IV, then the veins started to go. Two months later, my thyroid showed no signs of irregularity, my T levels were normal.
That was a few years ago. I haven't had any thyroid problems since (unless you count the fact that I wish it would go hyper for a little while so I could drop some excess poundage!!) except for barely abnormal levels every once in awhile.
I still have issues, but they are greatly varied. I'm convinced it has something to do with the initial infections of the surgical sites, but *oops* all record of infection was lost! 
Now, I average 4 blood draws, 2 MRIs, 3 X-rays and 1 CT a year. Oh and one bone density scan (at 25 years old I started losing bone mass.)
Soooo, I've adapted. I research. I take notes and draw diagrams (none of the above was mine) and use the stupid pain scale. I over think...a lot. And worry.
But now it has all been worth it because I got to help you!! (Srsly, I mean it.) If it can help someone feel a little bit better then the time is justified. IMO
I'm completely normal, I SWEAR. >twitch<
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paul_milander
Joined: 16 Mar 2008
Posts: 520
Location: Shippensburg, PA
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| Posted: Sat May 03, 2008 6:36 am Post subject: |
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| .45chel wrote: | Like I said before, I'm no doctor, but I would be leaning towards the pituitary adenoma. Not only because I would be hoping for the best, but because it is just more likely (even before I knew your family history.)
I've had a good deal of time on the patient side, which is why I started looking stuff up. I got tired of not understanding what the heck was being said to me. I took a few Biology courses a couple years ago and they helped even more.
With me, I had always been relatively healthy, joined the military, became injured and it all went downhill from there. Surgical sites got infected, chronic pain, six months after surgery I went hyperthyroid and lost thirty pounds in two weeks, had to be fed through IV, then the veins started to go. Two months later, my thyroid showed no signs of irregularity, my T levels were normal.
That was a few years ago. I haven't had any thyroid problems since (unless you count the fact that I wish it would go hyper for a little while so I could drop some excess poundage!!) except for barely abnormal levels every once in awhile.
I still have issues, but they are greatly varied. I'm convinced it has something to do with the initial infections of the surgical sites, but *oops* all record of infection was lost!
Now, I average 4 blood draws, 2 MRIs, 3 X-rays and 1 CT a year. Oh and one bone density scan (at 25 years old I started losing bone mass.)
Soooo, I've adapted. I research. I take notes and draw diagrams (none of the above was mine) and use the stupid pain scale. I over think...a lot. And worry.
But now it has all been worth it because I got to help you!! (Srsly, I mean it.) If it can help someone feel a little bit better then the time is justified. IMO
I'm completely normal, I SWEAR. >twitch< |
So you know what TSH levels are??? LOL Me Too!!! anyhow I had my scan done and after coming home and flushing my system with Cranberry juice and taking a Ativan to sleep ( The dye gives me majour headaches) I feel much better. Now I will get a copy of the report on Tuesday but no follow up until 05/20.. I will post what it says.
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Mister Me
Joined: 23 Mar 2008
Posts: 193
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| Posted: Sat May 03, 2008 5:19 pm Post subject: |
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Don't get me started. Pictures of skulls make me all emotional and stuff.
My ex-wife had a skull *runs away crying*
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Like Armando's stiletto, Me Delivers. (Offer Void In Sectors R and F After Curfew.) |
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.45chel
Joined: 26 Oct 2007
Posts: 2490
Location: Chambersburg
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| Posted: Sat May 03, 2008 5:59 pm Post subject: |
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Isn't that the one that sits on the shelf above your TV? 
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Mister Me
Joined: 23 Mar 2008
Posts: 193
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| Posted: Sun May 04, 2008 4:01 am Post subject: |
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Who sent you??? WHO sENT YOOUU??? *jumps thru the moving subway and disappears*
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paul_milander
Joined: 16 Mar 2008
Posts: 520
Location: Shippensburg, PA
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| Posted: Mon May 05, 2008 10:12 am Post subject: |
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OK got my preliminary report today..
MRI Of The Brain
Clinical: Brain Tumor
The examination is compared to the prior study of October 9, 2007. The previous examination demonstrated a 1.7 x 1.4 x 1.2 heterogenous mass arising in the anterior and superior aspect of the clivus to the left of the sphenoid sinus. This was thought to possibly represent a pituitary adenoma versus chordoma versus retention cyst.
Again demonstrated is an approximately 1.5 cm diameter heterogenous mass in the anterior and superior aspect of the clivus protruding into the left sphenoid sinus. The appearance is unchanged. There is some gadolinim enhancement.
The brain stem and cerebellum are unremarkable. The seventh and eighth cranial nerves are within normal limits. The diffusion weighted images are unremarkable, no new abnormalities are identified.
Impression:
Stable appearance to a 1.7 x 1.4 x 1.2 cm mass arising from the clivus on the left.
No diagnosis is listed yet
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.45chel
Joined: 26 Oct 2007
Posts: 2490
Location: Chambersburg
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| Posted: Tue May 06, 2008 10:05 am Post subject: |
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I am so sorry that it took me this long to see your post. (I lost internet yesterday, just got it back) I know how antsy and uncomfortable it can be to wait.
I bet you already had a gist of what was in the report, though. Nothing has changed according to what you posted.
Which is good. (No diagnosis, but still good.)
They know it is growing slower than the time between scans.
As for the gadolinium:
| Quote: | Gadolinium accumulates in the abnormal tissue that may be affecting the body or head. Gadolinium causes these abnormal areas to become very bright (enhanced) on the MRI. This makes it very easy to see. Gadolinium is then rapidly cleared from the body by the kidneys.
Gadolinium allows the MRI to define abnormal tissue with greater clarity than ever before. Tumors enhance after Gadolinium is given. The exact size of the tumor and location are very important in treatment planning and follow up. Gadolinium is also helpful in finding small tumors by making them bright and easy to see.
Side effects of the contrast agent injection include mild headache, nausea and local pain. Rarely (less than 1% of the time) low blood pressure and lightheadedness occurs. This can be treated immediately with intravenous fluids. Very rarely (less than one in one thousand), patients are allergic to the contrast agent. These effects are most commonly hives and itchy eyes, but more severe reactions have been seen which result in shortness of breath. |
You just have to keep on keeping on, big guy.
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paul_milander
Joined: 16 Mar 2008
Posts: 520
Location: Shippensburg, PA
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| Posted: Tue May 06, 2008 12:27 pm Post subject: |
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| .45chel wrote: | I am so sorry that it took me this long to see your post. (I lost internet yesterday, just got it back) I know how antsy and uncomfortable it can be to wait.
I bet you already had a gist of what was in the report, though. Nothing has changed according to what you posted.
Which is good. (No diagnosis, but still good.)
They know it is growing slower than the time between scans.
As for the gadolinium:
| Quote: | Gadolinium accumulates in the abnormal tissue that may be affecting the body or head. Gadolinium causes these abnormal areas to become very bright (enhanced) on the MRI. This makes it very easy to see. Gadolinium is then rapidly cleared from the body by the kidneys.
Gadolinium allows the MRI to define abnormal tissue with greater clarity than ever before. Tumors enhance after Gadolinium is given. The exact size of the tumor and location are very important in treatment planning and follow up. Gadolinium is also helpful in finding small tumors by making them bright and easy to see.
Side effects of the contrast agent injection include mild headache, nausea and local pain. Rarely (less than 1% of the time) low blood pressure and lightheadedness occurs. This can be treated immediately with intravenous fluids. Very rarely (less than one in one thousand), patients are allergic to the contrast agent. These effects are most commonly hives and itchy eyes, but more severe reactions have been seen which result in shortness of breath. |
You just have to keep on keeping on, big guy. |
Well I am going to go get another MRI report on Thursday, I was told that I picked it up too early and it was not completed. I figure it cant say really anything since the tumor has not grown. I guess they will just leave it alone for now
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