MRI without contrast??

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MRI without contrast??

Postby worriedincanada » Mon Aug 10, 2009 12:42 pm

I think I already know the answer to this, but my GF got an MRI without contrast and it came back clean.

If she did have lesions, can they be seen on this type of MRI (it was 1.5 Tesla). I think ACTIVE lesions need the contrast to distinguish them from dormant or old ones, but can the old ones and dormant ones be seen without contrast?

She is just getting weird symptoms now - the list is growing. She went to see a neuro and he said that she didn't need contrast - the MRI would have shown the lesions.

I guess from what I have read, it sounds like he isn't being thorough.

THoughts?

Thanks
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Postby euphoniaa » Mon Aug 10, 2009 3:45 pm

Hi worried,

I think many of us, like me, would agree that the neuro wasn't being "thorough" doing an MRI without contrast, because if there had been lesions, it could have shown whether they were active. It's definitely not needed just to show they're there, however.

The NMSS says this about MRIs & lesions:

"Because MRI is particularly useful in detecting central nervous system demyelination, it is a powerful tool in helping to establish the diagnosis of MS. It should be remembered, however, that approximately 5% of patients with clinically definite MS do not show lesions on MRI at the time of diagnosis. Also, since many lesions seen on MRI may be in so-called "silent" areas of the brain, it is not always possible to make a specific correlation between what is seen on the MRI scan and the patient's clinical signs and symptoms."

And the NMSS points out that gadolinium just enhances active lesions:

"A gd-enhanced T1-weighted MRI scan supplies information about current disease activity by highlighting areas of breakdown in the blood-brain barrier that indicate inflammation. ... These areas of inflammation appear as active lesions-meaning that they are new, or getting bigger."


In my case, my very first MRI (without contrast) showed plenty of lesions, and gave me my MS dx the next day. Ten months later I had a 2nd MRI, with contrast - so I could do an experiment taking LDN for a year. Same lesions, no change, none active. Exactly 1 year later I had my 3rd MRI, again with contrast. Same lesions, no change, none active. (If I had been taking one of the MS meds during that year it would have been considered a great success, but that's another story altogether. :) )

I'm so sorry your GF is going through this and I understand your concern. I'm one of the few, though, who feels pretty fortunate that I didn't get a diagnosis until very late. Not knowing any better, over the years I figured out dozens of ways to improve my symptoms and my health in general.

You might find this site informative - The Whole Brain Atlas. http://www.med.harvard.edu/AANLIB/home.html

If you click on "Multiple Sclerosis," you can watch a time-lapse MRI of lesions changing during a year's time. You get a different view from each angle or "slice" of the brain, and it shows how quickly they can come and go.

Good health to you both!
Dx'd with MS & HNPP (hereditary peripheral neuropathy) 7/03 but must have had MS for 30 yrs before that. I've never taken meds for MS or MS symptoms except 1 yr experiment on LDN. (I found diet, exercise, sleep, humor, music help me the most.)
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Postby oreo » Tue Aug 11, 2009 7:15 pm

The contrast is not necessary to find lesions. I had my MRI without and when I read the report it clearly stated that there were 12 high intensity spots showing. That, along with the clinical history resulted in an official DX of MS. Interestingly enough, when I actually saw an MS clinic neuro afterwards he dismissed 10 of the 12 as 'not significant' but the other 2 still made it definite.
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