Lesions that do/don't enhance with contrast?

Morning all,

Could anyone tell me what it means when lesions DON’T enhance with contrast after an MRI?

Also, what does it mean when they DO?

What does this mean in relation to disease progression?

Thanks :relaxed:

I think that lesions that enhance with contrast are inflamed at the moment. So your immune system was attacking your myelin on the day that the MRI was done.

Lesions which don’t enhance with contrast are scars from attacks that have happened in the past.

My understanding is that neither type of lesion has much to do with progression. Progression happens when nerves die because their lining has been attacked in the past. An MRI can show you that it is likely that a person has lost function (ie they have disease progression) if their brain has shrunk and has less volume than it did on previous MRIs. That’s what happens when the nerves die - they are reabsorbed and your brain gets a bit smaller.