Here is My Question:
What does this mean? "There is a nonspecific T2/FLAIR hyperintese focus within the subcortical white matter of inferior right temporal lobe (7/20)"
What is a "non-specific T2/FLAIR hyperintense focus" on an MRI scan? Other descriptions which mean the same thing include, "non-specific white matter lesion" or "non-specific T2 hyperintensity". Some radiologists will push the appropriate limits on this description and use the term, "microvascular ischemic changes", although this is not an appropriate description since it implies a diagnosis that is often not based on the facts. Remember, a white spot on a T2/FLAIR imaging sequence does not mean demyelination. White spots essentially represent areas of altered interaction of water with the underlying tissue or replacement of tissue with essentially water. There are many causes, including primary or inflammatory demyelination.
When we say non-specific T2/FLAIR hyperintense focus, we are referring to signal alterations within the tissue (basically white spots on the typical image viewed by your doctor) that carry no diagnostic specificity. The possible causes of white spots - including normal things like aging - are numerous and often depend on your age and other medical conditions, as well as their location, size, and appearance on other imaging sequences.
When the "white spots" have the location, shape, size, and characteristics on other imaging sequences that are more specific for MS, it is appropriate for the radiologist to raise this possibility, but the radiologist cannot diagnose MS.
Unfortunately, all too often the report says something like the following: nonspecific white matter lesions consistent with microvascular ischemic changes, migraine or demyelinating disease (MS). This is unfortunate since non-specific white matter changes require expert neurological evaluation to determine if any of these possibilities are correct.
Revere P (Rip) Kinkel, MDProfessor of Neurosciences
Director of the Multiple Sclerosis Program
University of California San Diego
#MS #multiplesclerosis #MRI
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