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What Do My MRI Scan Test Reports Indicate?

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Posted on Wed, 16 Sep 2015
Question: I'm rather confused and hope you can help me. My problems started about 9 years ago with an accident. The end result was a fusion of C5-C6 and injury to T6-T7. An MRI of the Thoracic in 2011 showed "posterior disk osteophyte complex at T6-T7 causing moderate central canal stenosis. Herniated disk at T6-T7". I am symptomatic with pain. There were other findings but this is the one I'm confused over. Subsequent yearly MRIs have repeated this finding. That is, until the one in 2014. If I may add, all MRIs were done at the same center so they could be compared.
The one done in 11/2014 impression stated "no evidence of significant spinal stenosis in the Thoracic spine". How can this be? Can central canal stenosis suddenly disappear? Did the treatment I receive reverse this condition?
Three previous MRIs showed moderate central canal stenosis as well as moderate neural foraminal stenosis and a herniated disk at T6-T7. The one in 2014 says "disk bulge and small end plate osteophytes at T6-T7. No evidence of a focal disk herniation. No evidence of a significant central canal or neural foraminal stenosis."
So were the three previous MRIs wrong or is this one? This is quite a drastic change. Any ideas about this? Can stenosis just disappear or is it more plausible that my MRI was misread or even the wrong one read?
I've recently moved to a new State and have to find new physicians. It was obtaining my records from my previous doctor how I saw this discrepancy. My old doctor never even mentioned this. I am completely confused. Can stenosis disappear?
doctor
Answered by Dr. Ajay Panwar (1 hour later)
Brief Answer:
Disc may shrink somewhat.Upload MRI's.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

Though, herniated disc may shrink a little with time,while the patient is on medicines and physical therapy,which may apparently show some reduced canal stenosis.However,significant change is usually not the norm.

There is no point for what spinal canal stenosis will disappear suddenly.

I would like to have a look at the latest MRI and previous MRI's,to comment upon the degree of canal stenosis.Only then,I would be in a position to tell,whether there is any significant difference or not.

Please upload the MRI CD's as zipped files on google drive and paste their google drive links here in the follow up query.I shall analyse them with my default .dicom viewer.

Waiting for your follow-up query.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajay Panwar (28 hours later)
Thank you for your prompt answer. As I stated, I do not have the cds. I only have the physician's records with the findings of the MRIs. I only have a report of the last MRI done. Again, the only reason I know about this is because I have the records due to moving to another State.

I understand disks can shrink. That is what I had hoped for with the injections. What I don't understand is how can moderate central canal stenosis basically disappear. According to my physician's notes, the first three MRIs I had showed "moderate central canal stenosis". In reading the latest MRI report, from what I understand, it states that basically my Thoracic is normal. It was explained to me that stenosis will only get worse and should be monitored. Thus the reason for the yearly MRIs.
Was this correct?

The only other information I have is an EMG that was done of my cervical. I also have problems in this area with a fusion and other issues. The two MRIs done of my cervical at this center at the same time as the first 2 of the Thoracic were accurate. The EMG done showed problems in my cervical area and he tested down to the T6 paraspinal muscles. I was told these findings were abnormal. Per his notes: "The left and right T6 paraspinal muscles showed denervation with 1+ polyphasia as well as increase in duration and amplitude." I was told this showed problems in the T6-T7 area. Now I'm not sure if this is correct.

I'm just quite confused how three different MRIs stated stenosis, moderate at that, then this one show basically a normal Thoracic. If you are saying that stenosis can not just disappear, as this report says, then I believe I should request a new MRI be done especially since I am still symptomatic with perithoracic radiculopathy.
Is the degree of stenosis subjective to the radiologist? Is there such a difference between mild and moderate that it could have been misread? So stenosis doesn't just 'go away'?
doctor
Answered by Dr. Ajay Panwar (36 minutes later)
Brief Answer:
Moderate stenosis should not disappear.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.

Even I mentioned in the previous discussion that 'However,significant change is usually not the norm.There is no point for what spinal canal stenosis will disappear suddenly.'So,I am not at all saying that moderate stenosis can disappear.It does not happen so in the usual clinical practice.
Even radiologists should not be having so much variability in analysing.So,please tell me how can I say without having a look at the MRI,whether radiologist misread it or has it actually disappeared?

EMG findings you have described were corresponding to the spinal level affected in MRI.That can well explain the findings in EMG resulting because of the nerve radicles compression at the same level.

So,without having a look at the MRI's,I just can't blame the radiologist blindly nor I can say that it has actually disappeared.I am in a fix.

If you have any further question,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajay Panwar (11 hours later)
Thank you again for your prompt answer. You have answered my question of can central canal stenosis completely reverse. You said in most settings it does not.

What ever happened, my course of treatment was not altered. Clearly my physician, according to his notes, didn't find the impression of the MRI relevant. Things happen. I know this.
At least now I know that if this does alter my care, I should be my own advocate and request new testing.

If I may ask one last question. You mentioned the CDs. Is it possible to still obtain a copy of these CDs even though it's been 4 or more years? Does the MRI that did them have to keep them on record and available to me? Since you asked for them, it seems prudent to have them on hand so my new physician can compare my progression.

Thank you for taking the time to answer my question. Things are much clearer. It's wonderful that physicians like you will take the time to answer questions we can not find answers for elsewhere. Your time and knowledge is appreciated.
Take care.
doctor
Answered by Dr. Ajay Panwar (12 minutes later)
Brief Answer:
Depends on the MRI centre.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and appreciating.

You may still find the CD's with the MRI centre where you got it done.Different MRI centres may preserve the data of different time frame.Like at my place,they erase it after 3 months.Though,4 years is a long time,still you may check it up if they preserve the data that long.

If you have any further question,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Please get back to me in case of any future query.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Ajay Panwar

Neurologist

Practicing since :2007

Answered : 1827 Questions

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What Do My MRI Scan Test Reports Indicate?

Brief Answer: Disc may shrink somewhat.Upload MRI's. Detailed Answer: Hi XXXX, Thanks for being on healthcaremagic.com. I am Dr.Ajay Panwar,a neurologist,here to answer your query. Though, herniated disc may shrink a little with time,while the patient is on medicines and physical therapy,which may apparently show some reduced canal stenosis.However,significant change is usually not the norm. There is no point for what spinal canal stenosis will disappear suddenly. I would like to have a look at the latest MRI and previous MRI's,to comment upon the degree of canal stenosis.Only then,I would be in a position to tell,whether there is any significant difference or not. Please upload the MRI CD's as zipped files on google drive and paste their google drive links here in the follow up query.I shall analyse them with my default .dicom viewer. Waiting for your follow-up query. Regards Dr.Ajay Panwar, MD,DM(Neurology)