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Multiple Sclerosis Message Board

Multiple Sclerosis Board Index


Your doctor can measure the lesions/spots and better tell you "what is what". Migraines and infections can cause lesions (spots) and the sizes can vary.

MS lesions are usually discrete foci with well-defined margins. Most are small and irregular, but larger lesions can coalesce to form a confluent pattern. Multiple focal periventricular lesions can give a "lumpy-bumpy" appearance to the ventricular margins. As a result of their perivenular distribution, many periventricular plaques have an ovoid configuration, with their long axis oriented transversely on an axial scan. The ovoid lesion is the imaging correlate of "Dawson's finger." In general, MS lesions have a homogeneous texture without evidence of cystic or necrotic components. Hemorrhage is not a feature of MS lesions. Edema and mass effect are also uncommon.

The aforementioned is "medicalese". Suffice to say is that there are known, typical lesions and there are non-typical lesions. This shows that the MRI cannot be used as a specific test to confirm or deny MS. If every single MS caused lesion had the "Dawson's finger", things would be much easier. Another factor or variable to look at is when multiple lesions occur on the same nerve area or region. This can cause several lesions to appear as a single, large lesion. This optical illusion could also present during to infections or migraines too.

I would say that spots are lesions. New, active lesions are identified when the MRI uses contrasting solution. The active lesions will "light up" and when compared or laid over the non contrasted image, the difference is apparent.

Lastly, I think spots versus lesions might also depend on the doctor whom you are seeing and who has interpreted the MRI image. I call all of my spots or lesions as simply lesions.


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