White spots in MRI – What can this mean?
In MRI imaging, a distinction is made between two different procedures (T1/T2 weighting). As a result, structures that are displayed as white in one procedure appear as black in the other procedure. Therefore, color is not of major importance without considering the procedure (T1/T2).
In T1-weighted images, fatty tissue appears bright or white (including the brain marrow), whereas in T2-weighted images, liquids (including cerebrospinal fluid) appear bright. Clearly distinguishable spots in MRI imaging can be caused by different diseases. In some cases, it is also an old, healed inflammation in the brain and is not pathological.
Typically, round-oval white patches occur in the context of multiple sclerosis. These centres of inflammation are mainly found on the edge of the ventricles filled with cerebrospinal fluid. The patient can be given contrast medium to improve the visualization, differentiation and differentiation of the individual spots.
Tumors (benign/malignant) can also appear as white patches in the MRI image. Due to the strong blood supply of metabolically active tumors, a lot of contrast medium accumulates in the tumor tissue, which makes the tumor appear white in the imaging. In addition, white patches can appear on the MRI image in a T2-weighted image for free fluid, cerebrospinal fluid (z.B. with cysts) or scarring in the area of the brain. To further differentiate between the causes of the stains, tests are necessary, which are usually performed by a neurologist.
MRI of the head in various diseases
To confirm the diagnosis of multiple sclerosis (MS), an MRI of the head can be helpful. After the doctor has asked about the patient’s symptoms and there is a suspicion of MS, an MRI examination can provide information about the existing changes in the brain. In 85% of cases, multiple sclerosis can be detected at an early stage by an MRI of the head.
For this disease, there is a typical appearance on the MRI images. There are roundish to oval white spots (foci) at several locations in the brain. Preferably, these can be recognized at the edges of the cerebral ventricles.
In some cases, these patches already allow a clear diagnosis, but in other cases they cannot be distinguished from small areas with reduced blood flow. Young people sometimes show white patches in the area of the outer brain, but these are usually completely harmless. Migraine is a form of chronic headache.
It is typically unilateral and is often accompanied by nausea, vomiting and sensitivity to light and noise. Except for a few triggering factors, the exact cause and development is not known. For this reason migraine can easily be confused with other causes of chronic headaches.
MRI imaging is an additional form of diagnosis that serves to differentiate the cause from unclear chronic headache. Among other things, it helps to exclude life-threatening causes (e.g. subarachnoid haemorrhage or brain tumours). This may also be of interest to you: Therapy of migraineMagnetic resonance imaging (MRI) provides detailed cross-sectional images of the brain and cerebrospinal fluid spaces.
The cerebrospinal fluid is a chamber system in the brain that is filled with cerebrospinal fluid, the so-called liquor. Increased cerebral pressure is usually indicated by various indirect signs. The increased pressure leads to an expansion of the cerebrospinal fluid spaces, especially the internal ones, and in rare cases also the external ones.
As a result, the venous outflows of the brain can become narrowed and blocked. In addition, certain structures of the brain tissue, which normally appear roundish, may be flattened. Another sign is a prominent optic nerve papilla.
However, the signs should always be viewed as a whole under the existing symptoms and compared with previous images. Vasculitis is an inflammation of the vessels that can occur throughout the body. The individual diseases are subdivided according to the size of the affected vessels (including Wegener’s granulomatosis, Purpura Schönlein-Henoch, polyarteritis nodosa, giant cell arteritis).
In some cases, the vessels of the head are also affected. In rare cases, the central nervous system may also be involved. To improve the imaging of the vascular inflammations, contrast medium is administered during an MRI examination.
The inflammation foci surrounding the vessels appear as broad white lesions along the vessels. However, the MRI findings are often non-specific and indicate several clinical pictures – further examination is necessary. If a tumor in the area of the head is suspected, an MRI examination is performed to detect it.
This usually makes it possible to detect tumors and metastases very well and to assess their size and location. For this purpose, an MRI with contrast medium is performed, as this accumulates especially in tumors and metastases and these can thus be distinguished from the surrounding tissue. The performance of an MRI offers better possibilities in the field of tumor diagnostics than computer tomography.
In addition to the fact that the tumors in the head differ from the surrounding tissue in their coloration on the MRI images, it is also the case with larger tumors that they displace the surrounding tissue. The resulting pressure compresses the cerebral ventricles and displaces the entire brain mass. Despite these often clear characteristics, the first diagnosis of a brain tumor requires a biopsy to confirm the diagnosis of a tumor.
Epilepsy can either be genetic or acquired in the course of life. Both forms can be distinguished on the basis of MRI images. A genetically caused epilepsy usually shows no changes in the brain structure in MRI images.For this purpose, an electroencephalogram (EEG) is required, in which typical changes can be recognized.
In contrast, acquired epilepsies are based on structural changes of the brain, which can be seen on MRI images of the head. These structural changes are usually localized and can affect either one or both halves of the brain. Sometimes, however, the changes are so small that they are hardly noticeable, in which case post-processing of the images with the computer is necessary. Epilepsies can also be caused by structural changes, so scarring caused by a previous illness can cause epilepsy later on.
