What exactly are "lesions" and will they say it on an MRI report?

[jillmb]

I'm new here, and trying to gather as much info as I can. I have a question, I keep reading about "lesions" what exactly are they and will the term "lesions" be on an MRI if they are present?

I had an MRI last week, and the word "lesions" is not on the report. Is there another term used to describe lesions that I just don't know about?

I'm going to my first neurologist appt. on Thursday and just want to get all my questions ready for him!

Thanks, Jill

[darius_kaspar]

Hi Jill....

From what I understand, lesions are what MS causes in your brain and spinal cord (the scars so to speak), they do show up on MRI reports, my doctor has shown me my MRI's and what they look like, basically white areas in the MRI.
Sometimes they can actually tell where you are having problems from the lesions on an MRI.
Also when you have past ones, of course they refer to them when doing a new MRI to see how bad an "attack" has been.
I recently had one on my neck for the first time following an attack and the doctor said that was why I had been having so much trouble and the kind I was having.
Hope that helps, good luck , and don't be afraid to ask your doc. questions.

[SNOOPY]

will the term "lesions" be on an MRI if they are present?

Yes, lesion(s) can be in the report and/or another word: Foci

[Redwings]

I keep reading about "lesions" what exactly are they and will the term "lesions" be on an MRI if they are present?

Hi Jill:
In general, a "lesion" is any localized abnormal structural change in an organ or body part. For example, a pimple or scar on the skin is a lesion.

In MS, "lesion" refers to a localized area of damage in the brain or spinal cord. A lesion can be caused by swelling from inflammation, loss of the myelin covering of the nerves and/or destruction of the nerve cells. These thickened or hardened areas are also sometimes called scars, plaques or sclerosis. "Multiple sclerosis" gets its name from from the characteristic appearance of many of these areas of sclerosis in the brain and/or spinal cord.

On MRI, lesions show up generally as white spots of various sizes. If present, the word "lesions" might or might not be used in the report. There are actually a few different ways in which areas of abnormality can be described and which might go beyond just a single word. The terminology used depends on the radiologist who wrote the report.

Ideally, your neurologist should look at your MRIs with you. Be sure to ask him to explain the terms in the radiologist's report, too.

[0485c10]

I wrote a description of how the MRI works in this thread
http://www.msworld.org/forum/showthread.php?t=103915

'My MRI last clear do I have MS?' In that thread I copied what I wrote about how the MRI works

The report will say as "foci" as snoopy says. Two key words to understand are "highlighting foci"which is an old lesion in the process of healing.
or a "highlighting foci of that enhances with the dye"... enhancement means a new and active lesion.


highlight on t2 scan= old healing lesions
enhancing with the dye on a t1 scan=new & active lesions.

Foci means a coming into focus, lesions especially in the spine can be diffuse also not concentrated or localized.
I never had one described as diffuse, I just read it can happen & its usually in PPMS (bad)

By convention lesions greater than 3 mm are measured. Less than that they can just be described a "small" or even smaller they are described a "puncuate"

[Redwings]

Foci means a coming into focus ... Less than that they can just be described a "small" or even smaller they are described a "puncuate"

Actually, foci does not mean "a coming into focus." Foci is the plural form of focus, just as cacti is the plural form of cactus. A focus or focal point is the center of some kind of entity or activity. In medicine, a or the focus is the point where a disease process is localized or most active. In MS, that's the same as a lesion. Foci means two or more of such areas, as in "highlighting foci."

Small spots are not called "puncuate." The correct term is "punctate." Punctate is derived from a term meaning "having tiny spots or points." The grammatical terms puctuate (puncuate is a misspelling) and punctuation have the same origin. A term that might appear on a radiology report is "punctate foci," meaning two or more small, localized spots.

It appears as if the radiologist who wrote the report from which the preceding explanation was taken was not a native speaker of English or was illiterate...

[0485c10]

It appears as if the radiologist who wrote the report from which the preceding explanation was taken was not a native speaker of English or was illiterate...

Not a radiologist just someone who spent much time reading my MRI report and trying to understand it - by looking up terms. Unfortunately PUNCUATE was not in my MRI report just EXTENSIVE DAMAGE FROM MS WAS. I looked that term up for someone else.

Thank you very much for the english lesson. English is my native language. I'm someone who diverted from a degree in BIOLOGY because I didn't want to spend time learning spelling so I switched to chemistry/chem eng. wer a missssppelling meant a different substance. It apppears u found yr tru caling in spelling. Its so nice wen u seeee som1 find what they wer ment to do in life.

Thank for the correction in my spelling. I read in another post, you have Devics. I'm sorry about that.

[Redwings]

Thanks for the clarification. As you can see, it isn't just in chemistry that a misspelling means a different "substance." Sometimes a misspelling becomes an error of fact. In a technical discussion in a forum atmosphere, errors of fact are misleading and harmful to anyone who is following a thread to learn something instead of just chat.

My post isn't so much about spelling as it is about refuting -- with evidence -- an erroneous description about "how the MRI works." It's the next logical step in the flow of the discussion. To not rebut the errors would be a disservice to the person who originally asked the questions.

[JoanFrances]

misspelling

Thanks for the clarification. As you can see, it isn't just in chemistry that a misspelling means a different "substance." Sometimes a misspelling becomes an error of fact. In a technical discussion in a forum atmosphere, errors of fact are misleading and harmful to anyone who is following a thread to learn something instead of just chat.

My post isn't so much about spelling as it is about refuting -- with evidence -- an erroneous description about "how the MRI works." It's the next logical step in the flow of the discussion. To not rebut the errors would be a disservice to the person who originally asked the questions.

I have always had a very hard time with spelling because I have a hearing problem, which robs me of the ability to hear tones correctly, so I can not sound a word out. Prior to spell check I lived with a dictionary on my lap.

While in nursing school, (which I was in the top 10 of my class) exams had 2 grades, content and spelling. So if you earned 100% for a grade for content but couldn't spell properly you could end up flunking the exam.

ex: a portion of the bowel and a bone in the hip has the same name, except one has an I in the word the other has an e. Spelling the word incorrectly could cause the patient to have hip surgery instead of bowel surgery. (I forget the name of the body part, at this time in my life but I never forgot the blasting I got from the nurse who was teaching that class)

[QuickType]

Ilium and ileum.

Then there's nitrates (heArt) and nitrItes (urIne), perineal and peroneal, abduction and adduction, dysphagia and dysphasia, and many others. (Let's not even get started on lab tests - did the patient have a BMP or a BNP?)

Medicine is definitely an area where spelling counts for a lot - not just to be "picky," but because a misspelling can either change the meaning or make it much more difficult to get correct information.

[Susanette]

ironic, isn't it?

And yet, we office girls who have to schedule the BMP's and UA's and excisions get to attempt to read chicken scratch! I kid you not, at the medical clinic I worked at last, it took me over a month decipher one particular doc's writing! I finally caught on to shortcuts like that an upward stroke on the last word meant labs next week, while an even scrawl meant labs next month. There's no such test as an ACT in the medical world, but AST and ALT usually go together, lol.

Ilium and ileum.

Then there's nitrates (heArt) and nitrItes (urIne), perineal and peroneal, abduction and adduction, dysphagia and dysphasia, and many others. (Let's not even get started on lab tests - did the patient have a BMP or a BNP?)

Medicine is definitely an area where spelling counts for a lot - not just to be "picky," but because a misspelling can either change the meaning or make it much more difficult to get correct information.