What a Normal Brain MRI Can Miss | Dr. Michael Lipton

A brain MRI that reads “normal” or “unremarkable” can be reassuring. It can also leave you with symptoms nobody can explain.

Dr. Michael Lipton, professor of radiology at Columbia University Irving Medical Center and an attending radiologist at NewYork-Presbyterian, explains what a conventional MRI actually measures — what a radiologist can see with the naked eye — and why that misses a great deal. An expert reading a scan needs roughly 10 percent brain volume loss before atrophy becomes visible. Software measuring the same images can detect around 1 percent.

In this conversation with Being Patient’s Mark Niu, Lipton covers why psychiatric and cognitive symptoms so often come with clean scans, how volumetric imaging picks up early hippocampal shrinkage in Alzheimer’s, what his research has found in soccer players who’ve never had a diagnosed concussion, what an ongoing NIH-funded study is showing about the brain after mild COVID, and what he tells patients whose scan looks fine but who know something is off.

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