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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pancreatic Adenocarcinoma. On Chemotherapy. Nodular Foci Of T2, Flair Hyperintensity, Mild Vessel Disease On MRI. Whats This?

I had a MRI done in Jan of this year and then was diagnosed with pancreatic adenocarcinoma-stage 2B in Feb. I've since undergone a whipple procedure and currently going through chemotherapy. Obviously, my PC trumps my numbness and tingling, but I'm curious as to what the following results from my MRI mean. I have not followed up with my Neurologist. My question is, what does this mean, and under the circumstances, should I even bother following up with my Neuro? Thank you...

This patient has multiple small nodular foci of T2 and FLAIR
hyperintensity evenly scattered in the lateral and superior frontal
subcortical white matter involving the superior medial frontal
juxtacortical white matter. The white matter hyperintensities do not
fill McDonald's revised criteria for demyelinating process disseminated
in space as they spare the periventricular white matter, corpus
callosum, brainstem, and posterior fossa and I think they are a
manifestation of mild small vessel disease.
Mon, 29 Apr 2013
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Oncologist 's  Response
Dear Malyson,
You are undergoing chemotherapy post operatively for pancreatic carcinoma. The MRI findings do not suggest that you have cancer secondaries in the brain. There are some neurological menifestations incidently found in your MRI which are related to blood vessels. You can see the neuro physician for for the symptomatic problems, but you may have to continue chemotherapy as advised by your Oncologist. In my opinion ideal would have been immage guided radiation therapy post operatively but your Oncologist may have the reason to have put you on chemotherapy.
Truly,
Dr. J. Ticku
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General Surgeon Dr. Dr. Ivan Romich's  Response
Hi and welcome to HCM.
This is something that will be found on MRI in the most people older than 50 years. This is sign of degenerative and ischemic brain processes and this is part of ageing. if you dont have any symptoms you shouldnt be worried. Usually sometimes multiple sclerosis can be suspected but this isnt indicating it. If you are afraid of pancreatic metastasis you should not be because this is very rare and different mRI findings would be seen. I sugegst to check again braun mRI in a year and see is there progression. WIsh you good health.
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Pancreatic Adenocarcinoma. On Chemotherapy. Nodular Foci Of T2, Flair Hyperintensity, Mild Vessel Disease On MRI. Whats This?

Dear Malyson, You are undergoing chemotherapy post operatively for pancreatic carcinoma. The MRI findings do not suggest that you have cancer secondaries in the brain. There are some neurological menifestations incidently found in your MRI which are related to blood vessels. You can see the neuro physician for for the symptomatic problems, but you may have to continue chemotherapy as advised by your Oncologist. In my opinion ideal would have been immage guided radiation therapy post operatively but your Oncologist may have the reason to have put you on chemotherapy. Truly, Dr. J. Ticku