MRI Question

[jamilea]

Sunday morning, I'm doing a follow up MRI. Is there a way to get the radiologist to be detailed in his/her report?

Last time it just said few lesions. It gave no locations or how many. I found out there were 9 from the Neuro. I'd like to be able to see exactly what is going on in the radiology report.

[jreagan70]

Is there a way to get the radiologist to be detailed in his/her report?

It depends on what you mean by "detailed." As much as patients would like their medical records to be patient-friendly and written in a particular way, medical records are not intended for patients. They're intended for medical professionals and they're written that way. Unless you want to know more about that, you may want to stop reading here.

There are medical standards and customs that patients aren't intended to necessarily understand or agree with. The medical standard of care is what the average, prudent practitioner (not every practitioner) would do in the same or similar circumstances, not what the patient would want them to do.

For an MRI, it may not be medically necessary for a radiologist to measure lesions unless they're unusual in some way; a general description is generally acceptable unless there are particular standards for a specific type of lesion. MS-like lesions usually aren't measured unless they're atypically large. For MS-like lesions, a description of the location is customary, exact measurements of location (sort of like GPS coordinates) is not. In the case of numerous ("numerous" is an impression, not an exact number) MS-like lesions, it isn't medically necessary for a radiologist to count every last one. In the vast majority of cases, that wouldn't change the diagnosis or the treatment. There's no medical benefit to be gained by overanalysis. Plus, time is money.

Radiologists, like other medical professionals, write their findings in the style they were medically trained to do and in a manner that has been medically acceptable throughout their career. Training can be a little different from one residency program to another, there is some subjectivity to interpreting nonspecific areas of any imaging study -- about which any two radiologists may not agree -- and some doctors are just better at their jobs than others. Unless they're negligent, they perform within the standard of care.

Some radiologists may "take requests" from doctors who ordered the images by addressing something that the ordering doctor specified, but it would be highly unusual for them to "take requests" from patients. Remember, radiology reports aren't intended for patients, and it isn't their concern whether a patient likes the way their report is written. And a medical professional would be as welcoming of a patient telling them how to do their job as a patient would be of a radiologist telling them how to do their job.

So with your radiology report, you get what you get, depending on the radiologist. If you'd like different information than what's on your report, you have some options.

1. You can ask Dr. Langer to interpret your MRI and put that into her neurology record, and you could get a copy of her record. It would be best if you were in the office with her while she did that so you could be looking at your MRI at the same time. This situation would not be the time to skip an office visit because you don't want another appointment with a doctor whose medical opinion doesn't agree with you about what you want.
2. You can ask Dr. Langer to request a review/report by a different radiologist, asking for specific information. She may or may not be willing to do that, depending on how satisfied she is with the report. Remember that she has to respect professional boundaries.
3. You can yourself ask for a review/report by a different radiologist. You may or may not be able to specify what you'd like the report to say because, remember, the report isn't intended for the patient. Member Services may or may not be able to arrange that for you. I don't know what the process for that would be since I've never needed to ask for a different report.

[jamilea]

Thanks jreagan for taking the time to explain all of that. That makes sense to me.

Dr. Langer does telephone appointments and her Nurse has asked me to schedule one for me to get the rest of my questions answered and to discuss a few other things like the pictures of my feet I sent to them (one foot's toes were red and hot while the other was normal) and losing my bladder the other day.

I'll ask her if she can tell me where things are located. If she doesn't have the time (I know how busy she is with research), I guess I could go online and pay a Radiologist to give me that information. I hadn't thought of asking another Radiologist. Thanks for the suggestion.

It's not that I want people to do what I want them to do. I'm just trying to feel out all of my options. That's why I ask questions. Thanks again for sending a response to me. I respect your opinions.

[jamilea]

Oops. I just realized that list bit I said is not what you said at all. Sorry about that!

[marti]

I sign a release form and they send me the complete report of my MRI and the films on CD. This is in Springfield Mo. Is that where you are going this time?

[jamilea]

I sign a release form and they send me the complete report of my MRI and the films on CD. This is in Springfield Mo. Is that where you are going this time?

Going where?

[marti]

Going where?

Sorry, I think I have you mixed up with someone else in my area.

[jamilea]

Sorry, I think I have you mixed up with someone else in my area.

Lol! I thought maybe that was the case

[JerryD]

jamilea, I've read this entire thread and I can't figure out the reasons that you want the info about your MRI's . I think that you are correct to expect some explanation of the reports. I ask my neurologist to review them with me, in person. The language in the radiologist reports is too technical for me to understand. Good luck with your reports.

[jamilea]

jamilea, I've read this entire thread and I can't figure out the reasons that you want the info about your MRI's . I think that you are correct to expect some explanation of the reports. I ask my neurologist to review them with me, in person. The language in the radiologist reports is too technical for me to understand. Good luck with your reports.

Hi Jerry! Thanks for your response. I think I like to see information like what location, size, etc. so I can follow along with the doctors. I comprehend highly technical things because I read so much. I don't know as much as the doctors do, but I can search for definitions of things and get at least a basic understanding. My stepMom has a Masters degree in Speech & Language pathology so she knows a lot about the brain. I've learned a lot from her over the years.

For me, it helps me to know details. It makes me feel like I have some control over at least something by educating myself on what I have.

Thanks for the well wishes. It was disturbingly early this morning, but I made it through haha!

[Thinkimjob]

jamilea, I've read this entire thread and I can't figure out the reasons that you want the info about your MRI's .

I think that you are correct to expect some explanation of the reports. I ask my neurologist to review them with me, in person. The language in the radiologist reports is too technical for me to understand. Good luck with your reports.

Bit with you. The last thing I want to see is my shrinking/ lesion-ridden brain.

It would be different if there was something that could be done about it.

There isn't. Like the new Alzheimer's tests that let you know 20 years before you get the disease, when there is nothing they can do to prevent it, or do about it when you do get it.

I'd much prefer to live those years without thinking about it. When they can fix it, okay, bring it on.

I am cynical but I'm thinking it's getting people enrolled in clinical trials early on, so they can add an extra ten years of "efficacy" to their results.

That said - if you want more information about your MRIs you should be able to get it.

[MarkLavelle]

For me, it helps me to know details. It makes me feel like I have some control over at least something by educating myself on what I have.

You can't ask the radiologist for a more detailed report, but you can get a copy of their report and the MRI CD (usually for $25 or less).

Then start educating yourself...

[pennstater]

I have had three different radiologists report on my MRIs over the three years. The detail and style varies drastically.

As an example, first one noted numerous lesions C2-C6, then commenting only on size for largest lesion at C6. The next radiologist commented on smallest and largest lesion at C2, C3, C4, C5, C6. The 3rd was a hybrid approach of the two.

The one thing they all did in common was document location of both brain and c-spine lesions, as well as comparison to prior year imaging.

So really is in the hand of radiologist. I always review with neuro anyway. Unlike some people who can easily look at them, I have visual spatial issues and have trouble seeing relationships of images and what is on it. I too would prefer the detailed report, as I can research and get my questions together.

[Carolinemf]

http://www.msworld.org/forum/themecr...quote_icon.png Originally Posted by jamilea http://www.msworld.org/forum/themecr...post-right.png
For me, it helps me to know details. It makes me feel like I have some control over at least something by educating myself on what I have.

Ditto!my info ,my body, my decisions - after knowing all info.
It is hard to get sometimes from some docs and it shouldn't be.