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Thread: MRI images

  1. #1
    Guest

    MRI images

    I received all of my MRI images in digital format. I was wondering if anybody(Wise especially) can tell me if there's anything unusual in the radiology report I received today:
    CLINICAL INDICATION:
    History of fracture/dislocation at the C5-6 level with C6 spinal cord injury.

    TECHNIQUE:
    T1, T2 and STIR images were obtained in the sagittal plane. Gradient echo images were obtained in the axial plane. After administration of gadolinium, T1-weighted images were obtained in the axial and coronal planes. Comparison is made to CT of the head dated 04/13/2001.

    FINDINGS:
    The examination is degraded by motion artifact. The patient appears to have had previous anterior cervical fusion with plate fixation at the C4, C5 and C6 levels. The plates and screws are associated with some magnetic susceptibility artifact. The patient also appears to have had posterior fusion with placement of bilateral plates and pedicle screws from C4 through C6. These are also associated with some magnetic susceptibility artifact. On T1, T2 and STIR images, there is some decreased signal at the ventral aspect of the spinal canal at the C5 and C6 levels, believed to represent prominent flow artifact. The axial images are too degraded by motion artifact to further evaluate these findings. At the C6-7 level, there is suggestion of mild disc protrusion extending across the ventral aspect of the thecal sac without evidence of spinal stenosis or neural foraminal stenosis.

    There appears to be severe cord atrophy associated with abnormal bright signal on T2 and STIR images within the cord at the C4, C5 and C6 levels, suggesting severe myelomalacia. On postcontrast sagittal images, there may be some very faint associated enhancement.

    IMPRESSION:
    1. The patient has had cervical spine trauma. There do appear to be both anterior and posterior cervical fusions with plate fixation from C4 to C6, which appear satisfactory. There is some artifact associated with the plates and screws.
    2. At the C6-7 level, there is suggestion of mild disc protrusion without evidence of spinal stenosis or neural foraminal stenosis.
    3. There is decreased signal at the ventral aspect of the spinal canal at the level of C5 and C6. Because of motion artifact, these are not well evaluated on the axial images but are thought to represent prominent flow voids related to CSF pulsation and movement.
    4. There is severe myelomalacia involving the cervical spinal cord at the C4, C5 and C6 levels. I do not see evidence of syringohydromyelia in the cord superior to the C4 level or in the cord inferior to the C6 level down to the top of T3, which is the lowest level included on the scan.
    5. The examination is quite degraded by motion artifact.
    If anybody is interested, all 141 images can be viewed on my webpage by clicking the links in the upper left hand corner under "Series" - the links categorize the different views. The images view a lot better with the Dicom software the radiology department sent. Here's one image that shows my cord:
    Attached Images Attached Images  

  2. #2
    cjo, unfortunately, the study was not optimal because motion artifacts (movements during the scanning). Some of the scan results are obvious. You had spinal cord injury involving C5 and the spinal column was plated anteriorly from C4-C6. There is tissue damage at C5 and C6. There may be some disc protrusion at C6-7 but it is not compressing the cord. There is cord atrophy (not unusual) down to T2. The presence of "bright" signal there means that there is reduced cellular and increased water content (since MRI signal is generated by hydrogen and water contains a lot of hydrogen). You do not have syringomyelia from C1-T3 (T3 is the lower limit of the image). I don't know whether this rewording helps. Wise.

  3. #3
    Guest
    Thanks Wise, the rewording does help. Is severe myelomalacia unusual? Did you get a chance to look at all of my images?

    This report was from a neuroradiologist I believe. The initial one I received was from my SCI doctor and he stated that my lesion was 2.5 cms - disqualifying me from Dr. Lima's trial. If there is atrophy down to T2, does that make my lesion considerably longer? Hopefully there's enough axons present that not too much regeneration is needed.

    I really appreciate your thoughts on this. I'm trying to learn as much about my injury as possible. My neck hurt quite bad that day and the MRI was quite uncomfortable for me, hence the motion artifact. Do you think I should have another one?

    Thanks.

  4. #4
    cjo,

    About half of the spinal tracts go up (mostly dorsal) and half go down (mostly ventral). Spinal cord injury interrupts these tracts and the part of the tracts isolated from their cells of origin will die. For example, the part of the downward going spinal tract below the injury site will degenerate (because they have been isolated from the cells from which they came). Myelomalacia means "bad-looking" white matter. The ventral white matter below the injury should look bad because they have degenerated. Likewise, the dorsal white matter above the injury also should look wasted because they have degenerated. The finding of myelomalacia simply confirms that you have had spinal cord injury and degeneration. The good news is that your spinal cord does not seem to be compressed, you have no syrinx, and there appears to be plenty of tissue at the injury site through which axons can regenerate. I think that it doesn't look bad. Does that help?

    Wise.

  5. #5
    Hey cjo how did you get the digital report? can i ask for that when i go for my mri study on tuesday? I am having mri of brain and c-spine and l-spine...I want to get the pics like you have..what do I ask for?

    thanks

    Mary

    ...and she lived happily ever after...

  6. #6
    Guest
    Thanks again Wise. It does help, more than you know. Especially when you say "there appears to be plenty of tissue at the injury site through which axons can regenerate." Now we just need to get those axons regenerated.

    Mary, I just called the radiology department and asked for my MRI in digital format. They mailed me a CD with the 141 .jpg images and some medical software(Dicom) that I was told doctors use to view it, but the .jpg files will open in any image editor. BE STILL, otherwise you'll have motion artifact like me that distorts the view. Did you look at all of the different views? What did you think? I'm kind of amazed by the whole thing. Best of luck, and I hope the reason for your MRI isn't a bad one.

  7. #7
    The MRI is just because I am screwed up....

    hee hee...shaken but not not stirred is a good diagnosis at the moment.....its just that lately no one is impressed with the intermittent ability to not feel my hands and feet while I am walking around dropping things and burning here and there.....i think its really minor.

    thanks

    mary

    ...and she lived happily ever after...

  8. #8
    Guest
    Wise,

    I printed off your last response to me and showed it to my mother. She was quite concerned with the "severe myelomalacia involving the cervical spinal cord at the C4, C5 and C6 levels."

    She knows your place in the SCI community. When I showed her what you had written me, her first question was, "How much did he charge you to look at that?" She couldn't believe that you provide us with all this knowledge, just because you're a good guy.

    I just thought I'd share this with you because it is a testament to how wonderful you and this website are.

    Thank you.

  9. #9
    cjo,

    I had my mri yesterday and was told they are not equipped with the technology to provide a disk for me. I am lucky to get to see them!

    Welcome to Managed Care

    Mary

    ...and she lived happily ever after...

  10. #10
    Senior Member Max's Avatar
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    Jul 2001
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    Montreal,Province of Quebec, CANADA
    Posts
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    CJO & others

    How to scan or put existing MRI images in digital format?

    I also scheduled to make new MRI in two month,-Could technitian in hospital put them on computer disc??

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