Can MS lesions be seen in plain MRI

Hi. Can MS lesions be seen in plain MRI? I am 37 male. My sexual dysfunction is becoming worse and worse. It started a few years ago with numbness in penis and loss of spontaneous erection. Then recently my semen volume went drastically low. Along with that I experienced hot flashing in my face and fatigue. Blood test then verified my testosterone levels as very low, beneath the normal range, prolactin levels as above the normal range and cortisol levels as below the normal range. The endocrinologist suspected prolactinoma. The plain MRI scan came back with a “suspicious nodule behind pituitary gland” but the endo diagnosed it as a non-functioning calcification, not a tumor. Hence the endo concluded, from the low cortisol levels, the low testo and the high prolactin must be caused by the atrophy of my adrenal glands due to my long term usage of prednisone for my cystic acne.

However I only used the prednisone on and off, albeit sometimes i use very high doses like 40mg. I have been tapering off it, but there is no improvement in my condition. Now I fear it might be multiple sclerosis thats causing the sexual dysfucntion and hypogonadism. One factor is because my mother also has it.

Can someone help me, because I am in fear of the future and I don’t know what I should do now, I worked so hard to change my life for the better but things just getting worse especially my health.

Can MS lesions be seen in plain MRI? The plain MRI I did shows no lesions. So if MS lesions can be seen in plain MRI then perhaps I’m cleared of MRI. I would rather have a pituitary tumor because at least it can be shrunk by medication or surgicaly removed. I already spent alot on consultation and the plain MRI and I can’t afford to do a contrast MRI at the moment because in my country the price is exorbitent. So can someone please help answer my question so I can know how much time I have left.

Hello Kaffee

I think you need to be guided by your doctors with regard to whether MS is possible or not.

If the only reason you suspect MS is because your mother had MS, and your doctors haven’t brought the question up, then you probably/possibly don’t have MS. But if you have symptoms and perhaps have had a neurological exam which makes a neurologist suspect MS, then it’s possible. Generally, if you’ve been examined by a neurologist who strongly suspects MS from your history and the examination, they might prefer that you have a brain and spine (maybe just a cervical spine) MRI with contrast dye.

Contrast dye is used to highlight current inflammatory activity. Older lesions caused by demyelination would be like scars which followed inflammatory activity.

So, why not ask the doctors who have seen you and have seen the scans as to whether they consider MS to be a possibility?

Good luck.