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    What do these MRI findings indicate?

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Posted on Thu, 6 Jul 2017 in X-ray, Lab tests and Scans
Question: Hello - could you please give these MRI images a look? I just wanted a second opinion before I move forward. If the image file sizes are too small please let me know and I will adjust.

Do you happen to see a mass located left Maxillary Sinus, or any location? If so, given the certain risk factors should I proceed to ENT specialist and request FESS removal, or try another type of antibiotic first?

This would be an incidental finding if anything is to be discovered, original reason for the MRI was odd and persistent headache, radiating numbness and tingling, severe muscle spasms and cramping, cramping in the joints, minor gait issues, cognitive deficits and nerve pain that radiates on occasion from left tonsil area up into my brain and sometimes straight down from there. Neurologist cited possible Peripheral Neuropathy from chronic viral illness and weakened immune state.

RISK FACTORS:

-The day of this MRI is the same day I completed a full course of Ciprofloxacin antibiotic 500mg X2 daily for unrelated bladder infection
- I have no symptoms of runny nose, congestion or drainage - some blood on occasion when blowing nose but I thought maybe that was allergies
- Fever at 99.7-100.4 range for a very long time now
- High reoccurring rate for infections
- Frequent mouth sores
- HPV(16) infection about a decade ago
- High viral load of EBV for nearly a year now, with reactivation and recently tested positive for a new infection as well

I know that Nasopharengyl Cancers are very rare, even more so for my gender and age range. However, the strong ties of EBV to these forms of cancer is something I should pay attention to. Especially since this form of cancers is often not diagnosed until the late stages.

I hope I did not offend you citing information you already know. Thank you in advance for your time helping me make the best decision.
doctor
Answered by Dr. Vivek Chail 2 hours later
Brief Answer:
There is no large mass in the areas of concern to you

Detailed Answer:
Hi,
Thanks for writing in to us.
I have gone through the attached images

The left maxillary sinuses shows a suspicious mucosal thickening in few images in the medial wall but this is unlikely to be a mass. This is important only if you have any symptoms of left maxillary sinusitis. I would like to see your images on my work station to have a detailed look and give an opinion.

It will be nice if you can upload the complete contents of your CD or DVD containing MRI images to a file upload facility like dropbox or google drive from which I can download and view the images on my work station to give you a more accurate reply.

The images which you have sent do not show any concern for a mass in the nasopharynx area.

I understand your concern for a nasopharyngeal cancer and am not offended in any way. You are most welcome to send in your doubts.

Regards,
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Vivek Chail 7 hours later
Hello and thank you again for your time, I have gone through so much change in a year and had to learn so much regarding my own health its frightening.

I will get the CD uploaded later for your review.

Thank you very much!!

Dr. Chail,

I am having a little bit of trouble with the images, it will take a lot longer than I anticipated. Is there a series of images or a more specific set that you would like me to get versus the entire thing, or is the entire set best?


Thank you!
doctor
Answered by Dr. Vivek Chail 12 hours later
Brief Answer:
Best to send the entire set for a comprehensive view

Detailed Answer:
Hi,
Thanks for writing back with an update.

It is best to send the entire set for a comprehensive view of the area of concern.

I suppose you are uploading the DICOM format images (actual format used in the work station).

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail 7 minutes later
I am not sure what that means, but I learn quickly so I will figure it out and have the images ready by tomorrow evening.


Thank you kindly!!!
doctor
Answered by Dr. Vivek Chail 3 hours later
Brief Answer:
The DICOM is the format of the medical standard images

Detailed Answer:
Hi,
Thanks for your reply.

The DICOM is the format of the medical standard images which we view on a work station. They are included in the CD or DVD with a recommended viewer. I have my own viewer so can easily open the DICOM images from any source.

I will wait for your next update after you are done with uploading images.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail 18 hours later
Hello Doctor,

To share the images with you on Dropbox, do I need to email you the invitation link or is there another way?

Thank you!

Maybe this link will work?

https://www.dropbox.com/home/mri%20images%20for%20dr.%20chail
doctor
Answered by Dr. Vivek Chail 12 hours later
Brief Answer:
Your link does not work unless you share it with my email id.

Detailed Answer:
Hi,
Thanks for writing back with an update.

Your link does not work unless you share it with my email id.

My email id is YYYY@YYYY

Please share and send me a link in mail.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail 1 hour later
I sent the invitation. Thank you.

Also, I thought to look in my nose days ago and thought I saw something, today however I can really see something. My nose was not deviated ever before this is a really bad looking deviation as the left nostil (my right) looks like it is swollen on inside nostril, however it is not. It's my septum!

Also is some swelling coming from the other side, sort of looks like a polyp, it is a dark pink, my airway is almost fully restricted on that side.

Not sure if this helps at all, I am doing my best to understand the MRI images in relation to location so I almost wonder if the abnormal growth you see might be where the possible polyp (if it is a polyp) attaches to.
doctor
Answered by Dr. Vivek Chail 2 hours later
Brief Answer:
There is no mass or polyp

Detailed Answer:
Hi,
Thanks for writing back with an update.

I have viewed your MRI images in detail.

You have a mild devatiation of nasal septum with convexity to the right side. The left inferior turbinate is showing mild hypertrophy.

There is no polyp or mass in the nasal cavity.

I think you have got some dental treatment done in the left upper jaw.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail 39 minutes later
Thank you so much for your help!

I did have some work done years ago in that area. I will wait to see if symptoms of fever or worsening of inflammation happens in the days coming to decide on seeing a doctor for possible infection.

Actually - just one last question... I am incredibly interested in all things medical and how they work.

For my MRI's for instance, what causes that large black circle? You know the one where if you invert the coloring shows a slight rim of coloring along the inside of it?

I am in no way questioning your judgement - I am honestly interested in learning anything new when the opportunity presents itself. I am referring to the images of T2* that I originally sent to you.

Last time I bother your time, I promise
doctor
Answered by Dr. Vivek Chail 9 hours later
Brief Answer:
T2* is for bleeds and calcification

Detailed Answer:
Hi,
Thanks for writing back with an update.

I appreciate that you are interested in knowing the medical details.

Somehow I am a bit confused on your last question about the T2* images. MRI is a method by which we measure the radio frequency of hydrogen atoms in different structures. By altering the frequency we get different sets of images which then can be related to the conditions and molecules in the area.

I feel you are asking about the posterior fossa edge showing "slight rim of coloring on inverting". These are image artefacts. Gradient images like T2* have role in picking up bleeds and calcification in the brain. There is ongoing research and every day we are updating on new things which we learn on MRI.

Please correct me if you mean something else. You can send me a screen shot of the exact point in question to be clarified.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6710 Questions

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