Reading an MRI

A friend's neuro-radiologist read last year's MRI for me as a favor.  AMAZING, huh?  They're friends and apparently he's awesome like that.  Alfred apparently got a bad rap, and probably nothing more than an annoying polyp.  But, he says my MRI is anything but normal with "suspicious" areas, "abnormal dynamic uptake" (meaning the contrast dye wasn't absorbed in a "normal" fashion), and some micro-adenomas that he even used arrows on the photos to indicate so someone like me can know what he's talking about.  He suggests I repeat the MRI (which again can't be done locally) and to have a neurosurgeon read it.

They are tiny small, but Cushing's Disease is often caused by tiny little tumors no larger than a pencil-tip. Some 50% of proven Cushing's tumors aren't seen on MRI, so the fact that we now have a "target" is great!  A repeat MRI and more biochemical "proof" they are problematic (ie, lots and lots of lab tests) and I can get an official diagnosis and move forward to surgery.

Here are the five pictures he sent back with his comments about them:

 

 

The arrows indicate the hypo enhancing spots on the dynamics (first two pictures).  The [third] picture is a spot that he said is “very concerning.”  Then there is a post-enhanced hypo-enhancing spot where it doesn’t belong (ie, there is an area that didn't absorb the dye like it should, which is common with these type of tumors).  The side view shows what could be tumor, but it could also be a juncture spot. 

I made the pictures with arrows larger since they turned out pretty small on here, so it is hard to see.  To start, look right under the center of the brain for the white blob (from the side) or arch(from the back) that is the pituitary, surrounded by black arteries, etc.  That little blob/arch is where you'll find the arrows.