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What does my CT scan report indicate?

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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 1755 Questions

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Posted on Fri, 7 Apr 2017 in Brain and Spine
Question: Ct head scan came normal overall but they said in finding: cystic changes in left frontal calvarium felt to be venous lakes? What that means, is anything else that cystic changes in the left frontal calvarium could be? It could be dangerous? Venous lakes are dangerous?
Had MrI with and without contrast of the brain and the radiologist report said normal in both. They did not mention nothing about venous lakes in the left frontal calvarium or cystic changes there.
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Answered by Dr. Dariush Saghafi 1 hour later
Brief Answer:
I would believe the MRI read....it's more precise

Detailed Answer:
Thank you for your question. You raise a point which we see all the time in the routine use of CT and MRI scans in the same patient which is when a CT scan shows something considered to be a potentially important finding but a followup MRI fails to report anything near as impressive or even fails to report anything at all.

There is a lot of artifact or image residue that occurs in a CT scanner that does not happen in an MRI due to the ability of the MRI to resolve down to much smaller structural distances and to be able to distinguish tissue types and densities compared to the rather PRIMITIVE CT. In fact, on average MRI is said to be 10x more sensitive than CT scan in detecting REAL abnormalities. Therefore, in MOST cases, if a CT scan SEES something on a brain or other organ scan that an MRI fails to see I would tend to believe the MRI scan before getting too excited about venous lakes, cystic changes, or problems in the left frontal calvarium.

It seems to me that your brain and your skull (calvarium) are just fine from the MRI read and that you shall surely live plenty long enough and be in good enough health to see many more folk trying to sell worthless swamp land in Florida to unsuspecting "dumb northerners" like me, The XXXXXXX Indians BEAT The XXXXXXX Cubs this year cuz turnaround IS fair play and THIS IS OUR year, XXXXXXX Trump get re-elected to a 2nd term of office by even LESS of a popular vote total than he did this time, and of course, the #1 reason you MUST LIVE in good health, without pathology in your brain, calvarium, or skull's because you must see MANY, MANY, MORE April 15th's so that Uncle XXXXXXX can remind you just how LOVING he is on the one hand while SPANKING you hard enough with the other to make your change and other valuables fall from your pockets and ears right into his waiting big DEEP PANTS POCKETS!

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 22 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dariush Saghafi 49 minutes later
Thank you for the answer. I saw 2 neurologist, they both said my brain looks healthy and good from the MRI (with and without contrast) everything showed to be good in there. And told me that looks like a healthy brain, I do beleive MRI should be more accurate and the radiologist that made that report said that everything was normal.but the radiologist that made the CT head report said that about left frontal calvarium with some cystic changes, that feel to be venous lakes. Can they be something else? Cystic changes, does everyone has cystic in their skull? (I beleive skull in the bone/hard part of the head)
I will totally rate you and recommend you to my friends. I just need peace of mind.
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Answered by Dr. Dariush Saghafi 40 minutes later
Brief Answer:
Is anything 100% in this life? But this is about as close as it gets

Detailed Answer:
I've read through your clarification response and once again for all the reasons I stated above my belief (confirmed by 2 neurologists who actually SAW the pictures) is that whenever there is a CT scan and an MRI scan that say different things I always tell my patients that the MRI is the study of choice and the one we will guide therapy and intervention by...NOT the CT. The other thing is the fact that people who read CT's are sometimes not even neuroradiologists....therefore, they may overread things or think they see entities that are really not there and misinterpret artifact....I've seen that in a number of cases.

MRI's are almost always read by NEURORADIOLOGISTS who are highly trained and specialized in CT'S, MRI's and other radioimaging studies. I wouldn't even doubt if the reading neurorads doc took the CT and compared it to the MRI. Our institution does that all the time...when there is a CT and MRI the 2 are read simultaneously. Most of the time.....when it comes to contradictory findings....it's the MRI that wins out.

If the MRI doesn't show cystic changes then, the CT is either showing artifact that is being misinterpreted or the image is being OVERread by the radiologist or it's being INCORRECTLY read......putting it yet a different way....an MRI would not likely miss something as obvious as CYSTIC changes in what is normally a very thick and bony piece of the body.....MRI would have to pick it up. Maybe the radiologist read the scan of the guy who climbed in the scanner after you???? Believe it or not....I've seen that happen as well.....

I am doing my best to give you PEACE OF MIND.....and PEACE OF CALVARIUM......please take either my son and go in PEACE to love and serve the MRI read......NOT the CT! LOL!

Once again, your fine words of feedback are greatly appreciated for these insights if they've helped you in some way. My thanks for your questions.

This query has utilized a total of 37 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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