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MRI shows small vessel ischemic disease. Meaning?

My mri says afew punctate areas of increased T2 signal are seen and a small vessel ischemic disease versus dilated perivascular spaces.sern on front lobe image 16 on right 15 on the left. Abnormal signal is seen in right frontal region on axial image18 series 6 This measures 7mm may be extraaxial. T1 T2 and fair images were obtained through the brain sing sagittal and axial imaging. Diffusion axial images were obtained. Please tell me what this means.I am 52 .
Asked On : Fri, 12 Apr 2013
Answers:  2 Views:  172
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Radiologist 's  Response

Multiple T2 white matter hyperintensities often cause a confusion while reporting an MRI. They may represent small vessel ischemia, Virchow Robbin (perivascular) space or just non-specific white matter changes. However, most often, it doesn't matter what these represent as there is no significant symptoms or specific treatment required for any of these. At most, a follow up MRI in 3-6 months maybe asked for.

The description in your scan fits that of Fazekas Grade 1-2 changes which are of no significance or worry, especially if you are above 40-50 years of age. However, if they worsen on follow up MRI, especially in young patients (less than 40 years), it maybe an indicator for predisposition to development of dementia early in life.

The reporting radiologist may have also considered the possibility of a demyelinating disease (like multiple sclerosis) and hence the exact number of lesions mentioned. However, demyelinating conditions usually have a strong clinical presentation and obvious symptomatology.

The small T2 hyperintense extra-axial lesion maybe a small arachnoid cyst which again need not be a cause of worry.

Overall, the scan report seems to be quite innocuous, and you probably do not have anything much to worry about, especially if your an older individual (more than 50 years of age). If you are young (less than 30 years) then you need to meet a neurologist early to evaluate various causes.

Answered: Thu, 25 Apr 2013
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Radiologist Dr. Ganesh Sanap's  Response
Hi, welcome to HCM.
It is grossly age related changes occuring in brain. Punctate areas on T2 sequence is either small changes occuring due changes in blood supply according to age. Virchowa robin space is dilated minute veins in brain. To comment on extraxial lesion we need to exam the scan. It is quite difficult to explain it without actual seeing the images.

Hope i have answered your query.

Answered: Wed, 24 Apr 2013
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