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Old 02-11-2010, 10:30 AM   #1
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Interpretation of MRI

Interpretation of MRI by computer software?

My MRI of the spine was interpreted by a radiologist of a hospital on the East Coast, who dictated a detailed report. My MRI of the brain was done in the same hospital on the same day. The report of the brain MRI couldn't have be more vague.
The hospital contracted a MRI interpretation consulting service located in Texas; The interpreting physician is a radiologist affiliated with a hospital in Alabama; The report's dictating radiologist is located on the opposite side of the State where the MRI was done.
Was my brain looked at all over the country? How is that cost effective? Who did really interpret it?
I'm confused.
Neurologist told me that my MRIs were normal. EMG normal. Blood work normal.
Radiologist Alabama: demyelination of CNS, unspecified.
Radiologist East Coast: non-ischemic process or demyelination.

 
Old 02-11-2010, 12:42 PM   #2
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Re: Interpretation of MRI

Hi there. Sounds like you need to be asking your doctor to explain why this happened...the cross country route to a answer! In our local hospitals here, the radiologist reads the MRI and sends the report to the doctor immediately- in most of our larger hopsitals, the doc can pull up both the report and the films on his computer.

Tell me, did your doctor actually see your films? A good neurologist, wont usually read the radiologists report and simply interpret the films on his or her own, then possibly refer to the report to see if it concurs with his or her own opinion. If your doctor didnt actually see your scans, then you might want to rethink why he is telling you its normal.

However, demyelination is actually not unusual. Not knowing how old you are, I believe its safe to say as we get older, the changes occur (starting in our 30s) which can cause demyelination of the CNS. However, thats not a MS dx. Were there no lesions at all? If not, then it would be "normal'; however did he look to see if he saw any abnormalities??

Hope you are feeling better!!
Nikki
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Old 02-12-2010, 06:47 AM   #3
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Re: Interpretation of MRI

Most of all I wanted to put this topic out there, it is the future of medical reporting.

Allright, I don't know if he looked at it himself, I shall ask. I wouldn't have known this, had I not looked at the bill; Don't think a doctor needs to care about the how and where, he should just take what the report says into consideration, like you said. He should care about me, not the business side of diagnostics.
Yes, the scans are html on a network which can be accessed by doctors and apparrently anywhere in the world. Maybe therein lies the rub. Can doctors keep up with this rapid progress, are films still generated and mailed?

Our local hospital has two radiologists on staff. The spine report came from one of them.
My confusion is why did the brain report come from elsewhere and why doesn't he tell me what he really thinks. The "don't worry, everything normal" statement isn't working for me. I did see the MRIs and read the radiology myself. I had 5 lesions 7 years ago, now two of them are gone and a bunch of others are scattered all over.

I'm 52, I know some spots may be normal. ; 5 months and progressing symptoms aren't; Cannot be explained by TBI. (I'm the one who was hit by the Mack truck)
The EMG didn't pick up nerve problem, I can't just be happy with that and go on pretending nothing is wrong. Oh I wish I had a pinched nerve, 'normal' doesn't make me happy.

 
Old 03-18-2010, 11:01 AM   #4
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Re: Interpretation of MRI

Update: After 5 weeks of waiting to see my neurologist, I asked him if he looked at my MRI scan himself. He replied no, he hadn't. After my inquiry he then asked a colleague (neuro surgeon) to look at it, because the dictating one isn't specialized in neuro imaging. The surgeon's impression was that the lesions were not typical for MS.

Here is what I am understanding: this hospital's radiologist doesn't interpret brain MRIs, those are sent out to a contracted service, interpreted by software which aids a radiologist under contract of this service, but then somehow/maybe has to be dictated by someone else who is licensed in the State the scan was done - apparently I'm missing some information here - there seems to be a hole in my logic.
The MRI was not looked at by the ordering neurologist but later verified by a surgeon because the dictating radiologist is vaguely qualified. The process then would have involved a total of 5 doctors. What a round about way to save money.

My neurologist said he did not know how to help me further, and I am sad that he is frustrated enough to give up. It is not possible for me to ignore symptoms that are slowly getting worse and have to move on from here.

 
Old 03-18-2010, 11:54 AM   #5
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Re: Interpretation of MRI

Hi Biminia,

I'm so sorry for your frustration. You might reach out to your PCP to see if you should try another neurologist for a second opionion and then check with your health insurance to see if the second opinion will be covered.

Last time I had an MRI done it was in the abdominal area. The radiologist wrote that everything looked normal and included my gallbladder as one of the organs that was normal. Well... my gallbladder was removed over three years ago. Glad to know it looks normal!

I hope you get some answers soon.

Angie

 
Old 03-28-2010, 01:51 PM   #6
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Re: Interpretation of MRI

Hi Angie,

oye, :0 gallbladders grow back?!?! What a shocker. Mixing up two patient's files is a bad one too.
I want to still push my neurologist to think before turning it over to a second opinion. Proximity and ease to get referrals are another factor. His impressions (cancer) appeared to head into the wrong dead end. Most of his questions I answered with 'no' and eliminated other likeliest. My case is not typical, symptoms are obfuscated by tbi, I may even have two gallbladders LOL. Anyway, I'll first try to make him work harder.

 
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