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With most healthcare facilities in the U.S., your radiology report will be automatically available in the patient portal. So you may actually see your report before the referring doctor sees it. And it's important to note that these reports are generated for the referring doctor, so there may be words in the report that you don't understand, but it's important to know that you have the right to ask questions, to see your report and to understand about your brain health. So please don't be afraid to ask any questions to your referring doctor. There are certain things that radiologists will tend to put in an MRI brain report. And so, I just want to talk to you about a few of those things so that you recognize the wording.

There might be a mention of microvascular ischemic disease, and that's just changes in a certain area of your brain called “the white matter,” and they look like signal changes, and often your radiologist will list it as mild, moderate, or severe. And just know that everyone has some component of microvascular ischemic disease for the most part after the age of 60 or so. And so if it's mild, you might see wording like “but commensurate with age” or “appropriate for patient age.” And if it's more moderate or severe, that may be an indication that there might be some underlying vascular disease related to high blood pressure or high cholesterol that your doctor may talk to you about.

Usually, an MRI brain report will talk about your brain volume. If there is a loss of brain volume then we use the term “atrophy.” And just because you see the word atrophy, don't think that it's necessarily something wrong. Everyone actually loses brain volume after the age of 40. And so everyone will have some component typically of atrophy after that age. Also there may be a mention of whether you have mucosal thickening or mucous retention cysts in your paranasal sinuses, those are the air cavities in the bones of your face, because that can cause headache if you have a lot of that. But just know that most everyone has some mucosal thickening in their paranasal sinuses.

Don't be alarmed if you see that. And then, also, maybe whether you have fluid or opacification of your mastoid air cells and those are the air pockets behind your ears in the bone there. That can cause headache if you have some of that.

See here that there are different contrasts here of the brain. And we look for different kinds of pathology based on the type of sequence here that's involved. So for example, this sequence we use to look for acute strokes in the brain, and this is one that we use to look for bleeds in the brain. And they're also not just different sort of contrasts, but they're also different angles of the brain. So, these are what we call axial images. This is what we call a coronal, and this is a sagittal. So, we're sort of slicing through the brain in different angles so that we get the best view. And this is what just sort of scrolling through the brain. This is the cerebellum here. These are the lobes of the brain, these are the eyes, these dark spaces here are fluid filled spaces -- ventricles.

And this is the type of thing that your radiologist is going to see when they're interpreting the exam. There's a little mucous retention as this we just saw on the left maxillary sinus. Here's the brain tissue and the ventricles here.

And then as we dictate our reports, the first thing we'll do is list the history. So this is what your clinical symptoms are here. Then the technique and this will tell us what kind of scanner was used and the different sequences that the technologist obtained and then whether there was a comparison study. Then we list our findings. So, these are all the things that we see on the exam.

We start out with the pertinent negatives often. So no evidence of mass bleed or infarct, and we might talk about whether there's microvascular ischemic disease and again, very normal to have some microvascular ischemic disease for anyone typically over the age of 60, this case was just minimal and within normal limits for age. We might talk about their cerebral volumes and mentioned whether they were normal for age, and the mastoid air cells as well, and then whether there's degenerative disease in the temporomandibular and here was a small mucous retention cyst in the left maxillary sinus. And then we finish off with the impression. These are the important points that we want to convey to your referrer.

So here are the pertinent negatives that we didn't see a mass bleed or infarct. Basically, what we're saying is there's nothing really to worry about on this exam. And these, the microvascular ischemic disease and volume loss were normal for age, a little bit of degenerative change in one of the temporomandibular and again, that small mucous retention cyst.

There are a lot of incidental findings that are listed in your MRI brain report and there’s really no need to be alarmed by those unless your doctor is telling you that this is something that we need to worry about or focus on.

If you have any questions, please go to RadiologyInfo.org. There's a lot of very important information contained there. Thank you.