Or: Can an average person make any sense of an MRI image?
I’m not looking for medical advice or trying to second-guess the radiologist here - I’m just curious about an MRI scan I had yesterday. After the scan was done, they sent me off with the images to deliver to my doctor next week, and to me, they’re little more than abstract art. Laid out on a grid, they look more like Andy Warhol’s soup cans in grayscale than a representation of my spine.
I can look at an x-ray and think “Aha, my arm is broken right there!” but with these images, it’s more like “Well, it looks like the spinal cord is getting squished there and there” but I don’t actually know this. On the other hand, there is a set of detailed cross-section images of only the squished-looking areas, so they apparently are areas of interest.
Are there any websites out there with examples of what’s normal vs abnormal, or at least road maps of the various structures and how to identify what particular vertebra you’re looking at?
Yes, but they won’t help. I do this for a living (review medical records), and I don’t even bother looking at MR images. Just read the interpreting physician’s report.
I’ve tried looking for this also. Unfortunately, most of the images and descriptions on the web are regarding extreme abnormal cases. I’ve had great difficulty trying to find comparisons to what “normal” looks like.
Really? I’ve had MRIs on my knee, one year apart, two different injuries. The doc pointed to the old one. “This,” as he pointed to a nice, bright, crisp portion of the image, “was your ACL.” This," as he pointed to a gray marbled blob on the recent MRI, “is your ACL now.”
Why would you need to look at them? I don’t know anything about reviewing medical records, but I assume the interpreting physician’s report would tell you everything you needed to know. The OP just wants to be able to point to something and find it by himself, and say, “That’s what’s screwed up on me!”
The problem is knowing what to point to, not identifying the differences. Unless you had your ACL replaced with a cadaver’s ligament or something, rather than repaired, you shouldn’t be able to tell the difference in the before and after by color alone. The same tissue would have been present in both instances, just damaged in one and not damaged in the other.
You don’t need to look at them, hence my advice to just read the report- but the OP was asking how to interpret them himself, or at least that’s how I read the question.
I mean, the interpreting physician could make a mistake, but a) that’s highly unlikely, b) the OP’s own physician will catch it, and c) you almost certainly won’t catch it no matter how much studying you do beforehand.
I trade in used books.
Current MRI reading textbooks are wickedly expensive, but ones 1 or 2 editions out would probably run you as little as a dollar or two plus shipping.
If this really fascinates you, it might be worth it.
Not really what you’re looking for, but a Google image search of “MRI healthy spine” gave me this blog on the first hit, which might give you a small idea of what normal is. This blog also shows a healthy MRI vs one of someone with a herniated disk.
Most of those image hits seem to be of a herniated disk, and I have no idea what your injury might be, so that might not be of any help.
Oh dear… mine looks worse than that. The large image in that link shows a herniation at L5-S1. On my scan, that area looks like someone stepped on a jelly donut, and the rest of my discs look dark, lumpy and odd-shaped, rather than the nice neat rectangles with light centers in the linked image. It’s as if my spine’s had a far more active life than I have - did it sneak out while I was sleeping to go play rugby and get into a few car crashes?
Guess that’s enough armchair radiology for now. I’m looking forward to seeing the actual radiologist’s report next week.
I don’t have an MRI from after the surgery. The original injury was only on my MCL. There was a definite difference in color and sharpness, though. When an ACL tears, doesn’t it end up not being where it was before? Kind of like if you were to break a rubber band by pulling it; there would be nothing in the middle?
If you had a complete tear, yes. IME, most connective tissue injuries involve partial tears rather than complete ones, but I don’t deal with sports injuries so maybe those are different.
I also don’t have formal medical training, so take my commentary here with a grain of salt. If think I’ve found a mistake in an X-ray report, I ask my dad, since he’s an orthopaedic surgeon, and doesn’t charge (me) consulting fees.
I feel perfectly qualified to answer the OP’s specific question because I know plenty about how much a layperson can expect to learn from looking at diagnostic imaging.
As a physician who has looked at thousands of radiology images, including MRIs, I think it’s unlikely looking at a normal MRI spine will help you interpret yours. There are several reasons why:
First, it’s unlikely to be normal everywhere except a single clinical anomaly. It’s possible, if you are young and perfectly healthy but it’s unlikely. The clinical situations that end up resulting in MRI spines are usually folks with enough degenerative disease such that the whole thing is loaded with subtle and less-subtle abnormalities. And of course, “normal” encompasses a wide range of variations, particularly so with the spine.
The second problem is that there is a surprisingly low correlation between radiologic and clinical findings for spinal exams. The areas of abnormality may not correlate accurately with where you are having symptoms. It’s quite a different situation from a typical broken bone.
Finally, they are just plain difficult to read. After someone says: “Right there” you may assume that’s all there is to it, but well…it’s a lot trickier than that. A host of charlatans have made a very good living over the years taking spine xrays and showing their patients all sorts of bony changes and misalignments and all manner of “abnormalities.” For the most part the study without the patient tells you very little except in acute trauma. Disc syndromes are notorious for poor correlation. An MRI is an order of complexity beyond plain films to interpret because it shows soft tissues along with bony structures.
I am delighted you have your studies in your hand, though. In medicine, it’s progress to give the patient their actual studies on the spot. Good on the people who did so.
