Anyone know how long it takes a lesion to be vieable on MRI?

[Buffy1970]

I have MS symptoms but no definite MS lesions (all attributed to other causes).  I have had symptoms on/off, mostly on, for almost two years.  The Mayo Clinic rec'd follow-up MRI but I am self-pay and don't can't afford to waste money getting tested too soon.  Does anyone know about how long or how severe the symptoms need to be before they show up on MRI?  I started new facial/tongue spasms and was going to get MRI but they settled down after a couple weeks.  

I don't want to get MRI too soon or too late.  I seem to be stuck in limbo land.  I have other symptoms but they were around when first MRI came back negative.  Anyone know or faced this situation themselves?

[Buffy1970]

Thanks for the information.  Both of you have given me something to look into and I do crave answers.  

Thanks for the link Mary.  I haven't had time to explore this site yet and that link was helpful and interesting.  There are some days I can't spell the word "coast" (seriously) and easy to understand info is most appreciated.

Sorry to read about your sister, Mary.  It is terrible to wait for something like that but, as you say, you have the time together.  Take care.

[twopack]

There's a Health Page about spinal cord lesions and the symptoms they often cause.  Some of the problems can be caused by conditions other than MS so keep in mind that these are not symptoms that necessarily mean you have MS.  They are MS symptoms that indicate spinal demyelination likely exists.
http://www.medhelp.org/health_pages/Multiple-Sclerosis/Spinal-Cord-Lesions/show/764?cid=36

The Health Pages are full of LOTS of information.  You can find an index of them toward the bottom of the column to the right.

I hope you get some answers - and better yet solutions - soon.
Mary

[COBOB]

Happens all the time.  Verbal conversations are not part of the medical record, but radiology reports are.  Doctors will often discuss things that never end up in the chart.  

There have been studies that show MRI misses lesions.

"Immunohistochemistry confirmed 70 WM, eight deep GM, 27 mixed GM-WM, and 63 purely cortical lesions. T2SE images depicted only 3% of the intracortical lesions, and 3D FLAIR imaging showed 5%. Mixed GM-WM lesions were most frequently detectable on T2SE and 3D FLAIR images (22% and 41%, respectively). T2SE imaging showed 13% of deep
GM lesions versus 38% on 3D FLAIR. T2SE images depicted 63% of the WM lesions, whereas 3D FLAIR images depicted 71%. Even after side-by-side review of the MR imaging and histopathologic results, many of the intracortical lesions could not be identified retrospectively.

CONCLUSION: In contrast to WM lesions and mixed GM-WM lesions, intracortical lesions remain largely undetected with current MR imaging resolution."

http://www.ajnr.org/content/26/3/572.full.pdf+html

Bob

[Buffy1970]

Based on what you and maxthecat have posted a follow up makes more sense.  I thought the lesions came and went fairly quickly.  Do you have the hug?  Have you ever had it halfway?  I have had constriction about where diaphragm (sp) is to varying degrees.  What I'm curious about is sometimes it only seems to cross left side of ribs/chest.  Once it actually felt like someone was trying to tuck the left side of my lower ribs under.  I have possible footdrop and on/off problems raising toes on left foot.

What issues do you attribute to spinal lesions?  

[Buffy1970]

Interesting stuff.  I'll look into it.  That would explain why some think MS even without obvious MS lesions.

Have you ever heard of radiologist and neurologist discussing MRI but not putting concerns in print?  I had an MRI done of C-spine but radiologist mentioned abnormalities (verbally to neurologist) in brain (contrast showed very intense areas - insurance only authorized c-spine).  When I asked neuro about intense bright areas that I could see he said that yes, the radiologist had mentioned it to him but it wasn't anything... ?

[maxthecat9196]

Welcome Buffy,

I'm glad you found this place, but I am sorry you needed to.  Limboland is not a fun place to be...

I'm not sure about how long it takes to for a lesion to become visible, but there is great information in the health pages about MRI's, and so many other things.  This is such a great place for information, and support.  My neuro says that sometimes they are just not visible.  Or perhaps the software or MRI strength is a problem.  For example:  I have multiple lesions visible in my brain, but none are visible in my spinal column.  Nevertheless, my doctor is quite certain I have spinal lesions based upon my symptoms.

The mystery will eventually be solved, but it can take a very long time.  Hang in there.
Tammy

[COBOB]

Complicated question with some pretty unclear answers.

Tissue (myelin) damage shows up on T2 sequences.  Microscopic damage can cause physical manifestations, but microscopic damage will not show up on existing MRI technology.  (1.5, 3 or 7 Tesla MRI.)  Same thing happens with GAD enhancement for active lesions.  The damage needs to be visible on T2 sequences and the leak in the blood brain barrier has to be enough the it allow GAD into the damaged tissue to enhance in the T1 sequences.  Much of the damage caused by MS is "occult" and not visible with standard MRI, but can be easily detected with Magnetic Transfer MRI (MT-MRI).

There are studies that show that damage in the brain may start  years before a lesion may become visible in T2 sequences using Magnetic Transfer - MRI.   MT-MRI is a special technique that is related to how healthy tissue transfers magnetic energy to other tissues.  

http://www.ncbi.nlm.nih.gov/pubmed/12937086

The take away should be that T2 hyperintensities and T1 GAD enhancement are important in helping diagnose MS.  So are positive VEP and the presence of unique oligoclonal bands in CSF.  None of these is more important than the physical exam, patient history and the ruling out of mimics.  

[tiffanie1316]

i was just diagnosed with ms I am 20 yrs old and I would like to know more about the follow ups and all that

[cjtmn]

Hi Tiffanie,

I'm sorry to hear of your recent MS diagnosis. Your comment is tacked onto a very old thread. Would you please start a new post so that we may try to answer your questions?

Cheryl