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What Does "few Tiny Ovoid Regions Of Hyperintensity Noted" Mean In An MRI?

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Posted on Sat, 24 May 2014
Question: I'm 39 and a recent MRI showed a few tiny ovoid regions of hyperintensity noted within the supratentorial white mater. These foci remain isointense on T1 and no not enhance following gadolinium administration. Dfferential considerations again include minimal chronic microvaular ischemic change in the setting of a patient with hypertension or diabetes versus foci of chronic demyelination. There was a long explanation of sinus issues but to sum it up it states: Paranasal sinus inflammatory change (interval development of small volume fluid within left sphenoid sinus and ethmoidal air cell as well as the caudal aspects of the maxillary antra bilaterally. Minimal right mastoid air cell inflammatory change. What does all this mean? I currently see a Neurologist that specializes in MS and I feel I am seeing the wrong doctor.
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Answered by Dr. Indu Kumar (2 hours later)
Brief Answer:
You have consulted right doctor.

Detailed Answer:
Hello XXXX
Thanks for writing to HCM

I have thoroughly gone through your reports.You have consulted right doctor.Neurologist should treat you.
In MRI,FLAIR or T2 weighted nonspecific hyper intensities/prolongation less than five in number in white matter of brain can be ignored.
Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination,Lyme's disease should also be ruled out with follow up scans.Diabetes mellitus also aggravates the situation.
Hyper intensities more than five in number should be the cause of concern and it need investigations.

You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus.
You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen.
If there is any more physical problems then it should be treated also.

You need follow up MRI scan to see its progression of lesions.Demyelinating disorders are associated with many other neurological findings.You need clinical correlation.

Besides this you also have changes of chronic sinusitis in maxillary sinus,left sphenoid and ethmiod sinus.
You also have minimal changes in right mastiod bone due to mastoiditis.It is related to ear problem.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6729 Questions

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What Does "few Tiny Ovoid Regions Of Hyperintensity Noted" Mean In An MRI?

Brief Answer: You have consulted right doctor. Detailed Answer: Hello XXXX Thanks for writing to HCM I have thoroughly gone through your reports.You have consulted right doctor.Neurologist should treat you. In MRI,FLAIR or T2 weighted nonspecific hyper intensities/prolongation less than five in number in white matter of brain can be ignored. Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination,Lyme's disease should also be ruled out with follow up scans.Diabetes mellitus also aggravates the situation. Hyper intensities more than five in number should be the cause of concern and it need investigations. You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus. You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen. If there is any more physical problems then it should be treated also. You need follow up MRI scan to see its progression of lesions.Demyelinating disorders are associated with many other neurological findings.You need clinical correlation. Besides this you also have changes of chronic sinusitis in maxillary sinus,left sphenoid and ethmiod sinus. You also have minimal changes in right mastiod bone due to mastoiditis.It is related to ear problem. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX