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Dr. Mark
Dr. Mark, Doctor (MD)
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Experience:  U.S. Physician/Surgeon in Neurosurgery
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On my Brain MRI I have a white spot on my left frontal lobe,

Resolved Question:

On my Brain MRI I have a white spot on my left frontal lobe, the spot is not a bright white, (a cloudy white spot) but it is enough that it has caught my attention, the MRI is with gadolinium, what could this be?
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Mark replied 6 years ago.
This is a key question:

Did you see that spot on a T2 weighted image?

Or was it on the T1 with gadolinium image?

Or was it on the T1 without gadolinium image?

Unfortuantely, the answer is complicated, and depends on which "sequence", or type of picture that was taken, to determine what it could be. It could be something as simple as an old area of brain that has had a small "mini-stroke" in the past, or could be some edema (swelling), or could be an area of a tiny bleed in the brain, or could be a tumor (if it enhances).

But again, the most important piece of information is what type of MRI sequence you see this image. If you aren't able to tell, the radiologist's report will interpret this area for you.
Customer: replied 6 years ago.
T1 se tra, I am not sure if it is with gadolinium, I don't think it is it seems to say on the file and this file does not seem to have it marked.
Expert:  Dr. Mark replied 6 years ago.
If this is on a CD, is it listed near the start or the beginning of the list (before the gadolinium would have been given), or is it near the end of the list (after the gadolinium would have been given)?

An actual film should have a "Gadolinium" sticker on it.
Customer: replied 6 years ago.
It is on a CD and I do believe now that is is with Gadolinium, because the film before it is marked with Gandolinium and the time stamped on the film was 11:04am and the time on this particular one I am questioning is time marked 11:08am
Expert:  Dr. Mark replied 6 years ago.
OK. So now this is an area that could "enhance" with the gadolinium contrast.

Unfortunately now, what one has to do is look at the pre-gadolinium (without contrast) T1 sequence and compare the two areas, e.g. does this white spot only appear on the gadolinium-enhanced scan?

If so, this would be an "enhancing lesion" and could represent a small collection of blood vessels, or a small mass lesion, and in people with a history of cancer, could be suspicious for a malignancy. Of course it could be nothing at all ("artifact"), which could be the bony floor of the skull, or something else not related to the brain.

But the radiologist is the specialist in these matters, so instead of worrying too much about it, I would wait for their report.
Customer: replied 6 years ago.
The white spot only appears on the gadolinium. Two more, quick questions, Thank you for your time: I was in a rear-ended collision 2yrs ago, where I did have injuries (TMJ) and altered consciousness, could this be something from the trauma? Is it possible it could be a MS Lesion? Just wondering if these could be possibilities also. I am more curious than worried! Again, thank you for your answers.
Expert:  Dr. Mark replied 6 years ago.
It could be from that trauma - a small "contusion" of the brain could be something that you see on the scan.

Typically a MS lesion does not show just a single small area on Gadolinium T1 sequences; more likely to show on the T2 sequences (the image that looks "reversed" black and white on your MRI).
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience: U.S. Physician/Surgeon in Neurosurgery
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