Should I get a second opinion?

Here is My Question:
Hello,
I have been having many symptoms of MS. Numbness, gait/balance disturbance, blurred vision, tremor, etc. I recently had an MRI of the Brain and Spine. It was done in the evening and the report reads 12:53 a.m. My issue is, the report is very generic. Only noting the very obvious. 

I'm no MD, however I am an RN and attending college for my APN. I have software that allows me to adjust the volume elements (grayscale) as on my MRI. In doing so, and before, I'm able to see hyperintensities. I see them as "isointense" on the original image(T2 axial). Once I saw them I was able to find the on other images as well and without any adjustments. I'd like to know why lesions are missed and what can be done about it?

In my case, I'm willing to seek 2nd/ 3rd opinions. I'm suffering, and for what, laziness? I had to study my MRI for many hours, and it seems like he only glanced at them. This is my life, and and tired of suffering. Please help.Thank you.


Answer:
An MRI provides a structural rendering of body tissues based primarily on water content and environment in tissues (including the presence of paramagnetic substances like iron or contrast agents) portrayed on a gray scale (a continuum from bright white to black). We often adjust the window settings in the images as you’ve described to more clearly see differences in tissue characteristics or identify artifacts from the imaging technique.

The interpretation of an MRI depends on an individuals’ age, symptoms and associated medical problems (e.g. headaches, hypertension, hyperlipidemia, diabetes, psychiatric illnesses etc) . These white spots on Brain MRIs are very common and Multiple Sclerosis is one of the LEAST common causes of these white spots.  It is precisely because these white spots on an MRI are so infrequently caused by MS, that they require careful deliberation based on your age, co-morbid medical conditions, symptoms, and findings on examination. This obviously requires expertise and often second or third opinions.

I hope this helps.

Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego