Please Help me Understand

[scotts]

I just received my 1st 6th month MRI results.

Originally I was diagnosed in April of this year with an 11mm x 6mm right-sided intracanalicular enhancing lesion almost certainly a schwannoma of the 8th cranial nerve (acoustic neuroma). 

Now I just got my results - waiting to be interpreted by Dr. next week - but it says an enhancing mass in the right CP angle extending into the right-sided auditory canal.  The mass measures .8cm in AP x 1.2cm in transverse by approximately .5cm cc.  There is a small cisternal component which measures approximately 5 to 6 mm in diameter.  Postcontrast images demonstrate peripheral enhancement of the cisternal portion possibly representing tumor necrosis. 

What is this possible small necrosis of the clsternal segment???

Also - I understand that since this is a different MRI unit at a different facility it could have a difference of 1-2mm is readings.  Is that correct?  If so, it would appear that if I was 11mm by 6mm - now am I 12mm by 8mm or 5mm?

Any help with interpretation before I see my doc would be terrific. 

Thanks in advance.  I know there is a lot of well educated people on this board regarding this info.

Thanks again.

[CHD63]

Scotts .....

Others will chime in here soon, I know, on your specific questions.  In the meantime, welcome to this Forum of caring, supportive people.

Most of us are non-medically trained people but we have done extensive research on acoustic neuromas and will be glad to share what we have gleaned.

Question:  have you had radiation treatment already for your AN?  If so, that would explain the necrosis (dying) of the tumor ..... which is a good thing.

As you already know, MRIs are subject to wide interpretation ..... even the same MRI being read by different physicians/radiologists.  What we want to know is comparison from one MRI to the next.  It is always an advantage to have MRIs done at the same facility, but not mandatory.  Most CDs of your MRIs can be put into your computer and you can look at them yourself to see if you can tell any differences.

Is your AN doctor an ENT, radiation oncologist, neurosurgeon???  Whoever is in charge of your AN care would be the one to explain your new MRI results.  It sounds to me like you are within the margin of differences (1-2mm) so if you are pre-treatment and in Watch and Wait mode, there is essentially no change ..... which is a good thing.  (Remember, I am not medically trained.)

Let us know what the doctor says next week.

Clarice

[Jim Scott]

Hi, Scotts ~

A "cisternal" tumor has extended outside the IAC.  "Postcontrast images demonstrate peripheral enhancement of the cisternal portion possibly representing tumor necrosis" would seem to indicate some necrosis of that section of the tumor. 

Regarding acoustic neuromas, we may be well-educated people posting here but As Clarice correctly noted, we're not doctors and cannot offer credible explanations of MRI results, although we can try to, as I have, help you interpret some of the medical nomenclature.  Anything beyond that is speculation and may turn out to be completely wrong, so we tend to avoid making concrete statements that we cannot justify without the requisite medical training to do so.

I trust the doctor's reading of the MRI report will be what you want to hear.

Jim   

[scotts]

Thanks Jim and Clarice for the information.  No worries, Jim - I know that everyone on here is just folks trying to use the knowledge they have accumulated to help those like me who are not as far along in the journey as the rest of you are - and I very much appreciate any insights which can be gained from your experience.  I am really trying to arm myself with more information for my meeting with the doctor next Tuesday and was completely thrown for a loop by the whole tumor necrosis piece. 

In answer to Clarice's questions - 1) I have not had any radiation treatment for my AN.  About 3 1/2 months ago I embarked on a reasonably dramatic lifestyle shift in an effort to arrest the growth of the tumor. Maybe this has accounted for the necrosis?? 2) Unfortunately  I did not have the MRI at the same place as that place had closed and even the remaining centers left owned by that company did not have a high field or high definition MRI which my doctor wanted so this MRI was done on a different machine and read by a different doc.  Also the first place did not give me a disk - but film.  My primary AN doc is a neurosurgeon.  I am also working with my original ENT as well. 
I meet with the neurosurgeon next week and the ENT at the end of the month.

Again thanks so much.  I really need to research more information regarding the necrosis (I did not even know what it was 3 hours ago) but you have given me some good information to get started.  As I read through other posts keyed to that search word I most often found necrosis attached to post radiation MRI's where it meant that the tumor was dying.  I take it that in these cases it is a good thing.  More research to come.  That is my biggest question at this point - regarding the necrosis and apparently how quickly it has developed.

Thanks again for your time and wisdom.

Scott

[ppearl214]

In answer to Clarice's questions - 1) I have not had any radiation treatment for my AN.  About 3 1/2 months ago I embarked on a reasonably dramatic lifestyle shift in an effort to arrest the growth of the tumor. Maybe this has accounted for the necrosis??

Hi Scott and welcome... good to have you here. Sounds like everyone is chiming in with help (only to be expected of everyone here... besides terrific support).

Ok, you got me interested. for your #1 notation above, can you please elaborate in detail on this? I bet there are quite a few curious one's around here ... including myself

Again, welcome!
Phyl

[scotts]

Hi Phyl,

The short answer to what I have done (and am continuing to do) is to focus on alkalinity (the ph value of the food in your system - the higher the ph the better - more alkaline - the lower the ph the more acidic).  I started with a 23 day Master Cleanse (you can look it up on line for info) - that was just drinking alkalized water with fresh squeezed lemon juice, organic grade B maple syrup and cayenne pepper.  That effectively detoxed my system!  Then I did about 5-7 days just juicing vegetables.  After I slowly added back solid food, very focused on the alkalinity of the food.  As such, I eliminated all meat, dairy, caffeine, sugar, alcohol etc. and basically anything from a box.  Each day I begin with about 30 oz of freshly squeezed vegetable juice (kale, cucumbers, parsley, chard, carrots, etc) and eat about 70-80% raw.  Following an alkaline lifestyle is the way that I choose to go.  Also, I am focused on cleansing the blood --- so in addition to the foods I choose to eat I take about 12 capsules of 500mg high quality wheat grass a day.

Add to this about 60 minutes of aerobic exercise daily.  A nice side benefit is I feel terrific, lost a bunch of weight, and am not tired at all during the day anymore (previously I was a 2-3 cup of coffee drinker daily). 

That is the short version but the main focus was on the alkalinity of the food which translates to the alkalinity of the tissue / blood. 

If you want additional detail just let me know.

Thanks for the support!

Scott

[nancyann]

Scott:  I was at a spa in Canada last year called Graile Springs & they had us drink the lemon juice with Maple Syrup, a sprinkle of cayenne & water a couple of times a day.
They were very much into the Alkaline diet.

[leapyrtwins]

Also - I understand that since this is a different MRI unit at a different facility it could have a difference of 1-2mm is readings.  Is that correct? 

I've heard that this is correct.

Jan

[mk]

First of all, certainly there can be a difference of 1-2 mm when different machines are used, or even when different slices are viewed on the same machine.
Second, it seems that your recent report mentions all three dimensions (1.2x0.8x0.5) compared to the previous report (1.1x0.6). Obviously one of the dimensions is missing from the previous report (hard to tell which one, I am assuming the coronal - ie. vertical which is often not mentioned). In any case, these differences are so minute, that they are usually not considered significant. Sometimes looking at a change of shape itself is more meaningful.

Regarding the necrosis, it is usually reflected by a change in contrast - darkened centre, but the opposite is not necessary (i.e. some dark spots may be seen, but they do not necessarily mean necrosis). Radiologists sometimes use their own jargon, because they are not specialists in the specific pathology - they most reliable person to interpret these results is your specialist.

Marianna

[route66]

I think it is also possible that the radiologist used the term 'necrosis' when they are actually referring to a cystic component of the tumor.  The neurotologist or neurosurgeon would be the best person to review and discuss the specifics of the MRI with you.

Route66