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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What does my MRI scan report indicate?

Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6535 Questions

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Posted on Wed, 25 Apr 2018 in General Health
Question: Hi Dr XXXXXXX
I've got another question for you. I've asked you before about hemangioma and I understand that they're very common and to be ignored. I have some old imaging that showed a hemangioma (from about three years ago). I had other imaging 1.5 years after that that also showed the hemangioma again. It hadn't grown at all (it might even look smaller - is that possible?). But my question is regarding the MRI. I've read that hemangiomas are usually bright on T1 and T2 but mine is only bright on T2 and it's hypodense on T1. I assume that this is because it has more water than fat? The radiologist from this MRI didn't mention anything about it. I will attach the two pics I'm referring to. I'm also attaching the original thoracic images for reference. It is a bit more mildly hyperintense on the thoracic MRI than the cervical one. I'm curious as to what can cause this - if a hemangioma can get less "fatty" as time goes on.
doctor
Answered by Dr. Vivek Chail 5 hours later
Brief Answer:
The position of MRI coil and signal strength causes changes in brightness

Detailed Answer:
Hi,
Thanks for writing in to us.

The hemangioma appears more hyperintense on thoracic spine do to the technical reasons like position of the MRI coil, sequence parameters use and this slightly changes the brightness of the lesion.

Hemangioma is a clump of small blood vessels and has variable amounts of fat. Fat is bright on T1 and T2 and is dark on fat suppression sequences. Your hemangioma is less bright on T1 in the cervical spine images and on T1 thoracic spine it is not very clearly visualised.

The MRI cervical spine image which you have labelled T1 is a proton density image and there it is hypointense.

There is a relative change in fat and blood components in the marrow area where the hemangioma is located. The proportion of fat and blood vessels can change and there is no fixed pattern. Also we do have atypical hemangiomas.

Please do write back if you have any doubts.
Regards,
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Vivek Chail 24 minutes later
Thank you - so is it your opinion that this is just a hemangioma that can be ignored? It didn't grow at all in a year and a half and I'll assume longer (as I assume I've had it longer). I assume they don't get smaller?
doctor
Answered by Dr. Vivek Chail 2 hours later
Brief Answer:
The features fit in to a diagnosis of vertebral hemangioma

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

Yes, it is well defined, small in size (non progessive from previous images) and showing imaging characteristics of vertebral hemangioma on MRI scans.

Therefore the diagnosis of a vertebral hemangioma holds good and you can ignore it. If you have pain in the upper back over the years, let us say 10 to 20 years later, then a CT scan and MRI scan might be indicated to have a look is is has slowly grown in size.

The usually dont get smaller.

Regards,
Above answer was peer-reviewed by : Dr. Kampana
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