Understanding Frightening Language in CT & MRI Reports

This page is for anyone reading a CT or MRI report and worried by its wording. It explains common phrases in plain language.

A CT or MRI report is one radiologist's description of shades of gray. Imaging shows shape, size, density, and how tissue takes up contrast (a dye given to make some tissues show up more clearly). In most cases, doctors need a biopsy to be certain that you have cancer (National Cancer Institute). The radiologist is describing how something looks, so the wording is often kept open. Read alone on a phone screen, open wording sounds like bad news being softened. Your care team can tell you what the wording means for you.

Most reports follow a fixed order:

1. The exam type and date.
2. The clinical history, or the reason for the scan.
3. Any earlier studies used for comparison.
4. The technique.
5. Findings.
6. Impression.

Findings is a list of everything visible, including things nobody was looking for. Impression is the radiologist's summary and recommendation. That is the part your oncologist acts on.

This phrase often describes the limits of the scan: this test cannot rule a possibility out for certain. A list of possibilities records what the pictures can and cannot settle. Ask your care team what it means for you. That way, whoever reads the report next knows exactly how much certainty they are being handed.

This is a request for information the radiologist does not have. The person reading your scan often never meets you. They may not know your symptoms, your medication list, or your surgical history. So they ask the clinician who ordered the scan to put the images together with those facts. It is a handoff note between colleagues. It is not a hint that something worrying was seen and left unsaid.

Words like indeterminate, nonspecific and ill-defined generally mean the images alone cannot name the finding. They are not a measure of how serious something is. Ask your care team what the next step is.

These do carry weight. They are used when the appearance genuinely points toward one diagnosis. Even then, they are a call for the next step, not a diagnosis in themselves. That next step is usually tissue sampling or a more targeted scan. In most cases, a biopsy is needed to be certain.

Scans can turn up things unrelated to the reason they were ordered. RadiologyInfo.org says many incidental findings will cause you no harm, but your care team decides which need follow-up.

If an earlier scan was available, the report will say so. RadiologyInfo.org says older exams can be very helpful to the radiologist for spotting changes over time. Ask your care team what any change means for you.

Results now often reach your portal before your clinician has looked at them. If a phrase frightens you, note the exact wording. Check whether it sits in Findings or in the Impression. Then send one specific message rather than a general one. Quoting the sentence and asking what it changes in the plan gets a far more useful answer than asking whether the scan was bad. If the report recommends a specific next step or follow-up interval, that recommendation is the practical part. Confirming it has been scheduled is usually the most useful thing you can do while you wait.

• American College of Radiology - Reporting and Data Systems
• HealthIT.gov - Patients prefer immediate access to test results