Forum

With or without contrast

I have tried searching on the subject as I am sure that this question has been asked umpteen times.

Had a brain and spine MRI and clear result. 5 months later I am still having issues, and potentially recently had a “relapse”

saw neuro who has re-ordered both scans this time with contrast.

I understand a lesion could now show itself as I am now having new symptoms…but what is the use of contrast for?

many thanks

Hi, I saw some threads from earlier this year that explained it.

The contrast agent shows up new active lesions that might be missed without.

http://www.mssociety.org.uk/forum/new-diagnosis-and-diagnosis/mri-contrast

http://www.mssociety.org.uk/forum/new-diagnosis-and-diagnosis/mri-scan-done-without-contrast

Good luck.

I had a brain with contrast they inject a dye and it’s supposed to be clearer. They did mine with contrast for assessing dmd’s

Thanks Jon, I cant seem to get results when I search and thanks Mike for your response also. Why would they need a clearer pic to assess for DMD’s? (I’m pretty uneducated I’m afraid)

There are criteria to get onto the higher strength DMDs. One is that there need to be “enhancing lesions” on MRI. This means lesions that show up on MRI done with contrast.

Karen x

Sorry to hijack anon’s thread … One for Rizzo probably but anyone else do jump in… If you have scans without contrast as they have been booked as ‘general scans’ by a rheumy who made no notes for radiology as to symptoms or what he was checking for, that any lesions may simply not be seen/ reported? I have a copy of my non enhanced scans and there are feint pale bits which are just very slightly lighter than the rest of the sawdust in my head and spine. The rheumy said he thought he could maybe see one on my optic nerve following my optic neuritis diagnosis but what he pointed at also just looked slightly paler. The radiologist hadn’t commented on that at all either. Ta ever so. Off to see neuro for first time tomorrow. Rheumy not impressed. Also they are ‘mates’ so I want to be a bit clued up and be careful to ask the right questions without causing offence. Cx

Thanks Karen,

Have you ever considered a career in interpreting doctor doubledutch for the uneducated masses? lol

If you have a disc copy, then you need to look at the names of the scans. If anything has T2, FLAIR or PD in the name, then they are the ones that are best at showing lesions. T1 is no good.

You also need to look and see how many images are in any T2, FLAIR or PD scans. This gives an idea of the “slice thickness” - which determines how big a lesion has to be to show up.

If you have very few T2, FLAIR or PD scans and there were not very many images, then yes, it is very possible that lesions have been missed.

If I were you, I would ask the neuro if the scanning protocol was appropriate for a neurological investigation (maybe in less technical terms though, lol: e.g., were the scans they did right for what you think might be going on?) and if it would be worthwhile doing again.

Good luck!

Kx

LOL :slight_smile: Kind of what I do on here?!

I’m lucky enough to have worked with MRI & studied neuroscience. Don’t ask me about much else!

Kx

[quote=“rizzo”]

There are criteria to get onto the higher strength DMDs. One is that there need to be “enhancing lesions” on MRI. This means lesions that show up on MRI done with contrast.

Karen x

[/quote] Hi Karen I was told they needed to see cear progression from Dx, this was a condition of tysabri. However I didn’t meet the criteria and have been prescribed rebid 44 . Mike

[quote=“rizzo”]

There are criteria to get onto the higher strength DMDs. One is that there need to be “enhancing lesions” on MRI. This means lesions that show up on MRI done with contrast.

Karen x

[/quote] Hi Karen I was told they needed to see cear progression from Dx, this was a condition of tysabri. However I didn’t meet the criteria and have been prescribed rebid 44 . Mike

Oh sorry Karen I know you know, have been a great source of info I meant anon Mike

Thanks Karen.

First appontment with neuro last week. He looked at my scans himself to check and said that they were normal, but said that some people can have MS with clear scans but there are many other things to look at first. However, given my recent ON he is sending me for a VEP test and possibly a lumbar puncture. Also testing me for Devic’s disease (aquaporin antibody blood test).

He seems a bit more clued up than his rheumy colleague. Although he says he believes I have got fibromyalgia as per the rheumy, he also says I have more than one thing going on in his opinion, as I have definate neuro signs too. His way of describing it was that ‘you hear traffic noise but you need to actually look through the window to see how many cars and what type there are out there.’ I kinda liked that!

Mike P - I’ve not been around recently. Good to see you back from your ‘holiday’ x

Cx

Rizzo, do you know how easy it is to obtain a disc copy or any images at all? I can’t see my Neuro being too keen on handing anything over to me but it would be nice to see some copies just to prove I do have a brain after all

It’s easy - just phone the MRI unit where you had your scans done and ask for a copy. They may refer you to another person/department and you will probably have to pay something for the disc, but it should be fine.

Kx

Snorkle - My rheumy and neuro are not keen on these being released apparently so I didn’t ask them. I asked the radiology department how much I would have to pay to obtain copies as I was curious to see them. She said ‘we normally charge £12 but seeing as you’re a frequent flyer (3 scans in the space of a month - mri brain, mri spine (C&T) and u/s elsewhere) I’ll copy them onto CD for you while you’re getting dressed and you can have it like a loyalty card’ :o) LOL

Cx