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Re: radiologists/CINE MRI

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If the neurosurgeon can't interpret them himself, you'd better find another

neurosurgeon.

> radiologists/CINE MRI

>

> What do you do if your neurosurgeon can't interpret them himself? How do

> you know if the radiologist's report is accurate? Thanks, Jeanne

> (still waiting for report for CINE-MRI done Dec. 22)

>

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In my opinion, it's not just radiologists who sometimes don't know how

to read CINE MRIs - neurosurgeons are in the same boat - we had several

NSGs miss the CSF flow restriction in our daughter.

It seems the problem is that Milhorat and perhaps a few others know to

look in the cerebellar cisterns, perhaps having to measure the width of

them - most docs don't consider this significant or even know about it.

They always look to see if the opening of the spinal canal (foramen

magnum) is blocked by the tonsils. Well, in people who have large

enough herniations, this does occur and anyone can plainly see the

blockage.

However, in the no or minimal herniation cases, docs think there's

plenty of room for CSF to flow, and this may be true to some extent.

However, an underdeveloped shorter occipital bone causing a small

posterior fossa will cause the cerebellar cisterns to be compressed -

perhaps, this is not obvious when look at an MRI but Milhorat has noted

that this is significant - it would've been nice had they put the

measurements in the " Chiari I malformation redefined " article to give

some perspective. That's the way I understand it.

Anyone who has a clearer understanding, feel free to comment.

Unfortunately, it seems the only way to be sure about CINE MRI results

is to consult with an expert.

Eurico

> What do you do if your neurosurgeon can't interpret them himself?

How do

> you know if the radiologist's report is accurate? Thanks, Jeanne

> (still waiting for report for CINE-MRI done Dec. 22)

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