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429949 tn?1224691579

CT scan vs MRI

I had a sudden onset of neurological disfunction on April 2nd 2006. Five days later at the ER I had a CT scan

that came back negative. It was five months before I was sent to a neurologist and had an MRI. The MRI

showed multiple scattered white matter abnormalties appro-6-10 lesions. First neuro said I had MS with only

this MRI and an abnormal VEP. He said I have had MS for a while to have this many lesions. I asked why I had

never had any symptoms before this one attack if I had it for a long time.  He said I had it but just did'nt know

it. Second neuro says all lesions are the same age, Indicating that they happened all at the same time. He is

leaning toward ADEM because of the lesions being of the same age, a negative spinal tap and no new lesions,

or attacks for two years.

My question is if I had that many lesions on my brain why did'nt the CT scan show any of them. I know that

the MRI is more sensitive, but wouldn't something show with such a mass amount of lesions?
7 Responses
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373367 tn?1246402035
www.ajronline.org/cgi/reprint/132/2/213.pdf

Apparently CT is just not reliable for detecting WML's
Helpful - 0
429949 tn?1224691579
Thanks for the resoponse. That is what I think too, but I put a post on the forum for Quix.

Santana8
Helpful - 0
420469 tn?1217647363
As far as I know, lesions don;t usually show up on CT scan. Now, that being said, that doesn't mean (to my knowledge) they can't, but I don't think it's the norm.

Quix will know better.

Christine
Helpful - 0
429949 tn?1224691579
They done the CT scan because I came into the ER complaining of sudden onset of vision dysfunction. I had at this early stage distorted vision( things looked out of shape, and out of line) and photophobia( light sensitivity). And also pretty sevier mental status changes. I had been abruptly taken off of Zoloft and Xanax and switched to Paroxetine( generic Paxil) six weeks prior to this attack. I had been on the Zoloft at 100mg for 14 years and the xanax .25mg for eight months. I was not tappered off and on for this switch. I suspected the recent medication change at that time.

They done the CT scan looking for tumor , stroke or anything abnormal. They said it was negative. I think maybe the lesions may have not been there then as I continued to deteriorate over the next three weeks. Maybe this is when the lesions were developing. I did have a lot of pressure in my face,eyes and head.

I don't know how he determines the age of the lesions. He does do contrast on every scan to look for enhancement, but I don't think that is how he can tell. I think that just shows new lesions or ones that are active. I had a open heart surgery to fix a birth defect when I was 18 months old and had to be on a breathing machine for the Bi-pass surgery. He said this could have caused these lesions, but something caused the sudden onset of neurological disfunction in April. The same exact lesions have remained on MRI through 6 repeat scans and remain unchanged. In ADEM I have read that either they disapear or remain unchange

Eventhough I am glad that there has been no more lesions or attacks in two years, I still worry about MS because he can not completely rule it out yet. The longer it goes with nothing new the more he leans toward ADEM. I hope it was ADEM ,but I have seen others on this forum who have went years without change and then have another attack. IT is like standing around and waiting to see if the sky is going to fall down on you! He said from the start that thier was something quirky with  me and that I did't fit  the classic MS diagnosis. I don't know why he thinks this, maybe because he can't find anything on bloodwork and spinal tap. Maybe because of my strange onset with the alteration in conciousness, or maybe because, like he said with Ms he would have expected to see something by now. I just don't know!

Santana8
Helpful - 0
373367 tn?1246402035
That does seem strange to me also.  My largest lesion is 5.5-7mm and I have about 13.  Maybe Quix would know more about lesions showing up on CT scans.  I mean I am just guessing about the "low attenuation" being the wml's on my scan. They were actually looking for an aneurysm when they did mine.

I have seen 3 neurologist and not one of them has ever mentioned the "age" of my lesions-??  Do you know if this is something that can be read of all WML's?

Are you thinking that you might have had ADEM at the time of your CT scan and it just didn't show up because it was too early and the damage had not been fully done yet?  It is great that you haven't had any new lesions or attacks in 2 years!  I am sure that you (like a lot of us) would like a definite diagnosis so you can completely move on w/your life.

Stacey
Helpful - 0
429949 tn?1224691579
I did get a copy of the CT scan later on, and it said no abnormalties. The MRI was done
five months later that showed the scattered white matter lesions. I was wondering why the CT that was taken on the fifth day after the attack didn't show anything. I know that it will not show all that an MRI would show, but with that many abnormalties it seems that something would have shown up on the CT. I was right in the first week after the onset of symptoms when I had it.

Santana8
Helpful - 0
373367 tn?1246402035
I was told that my CT scan (at the ER) was normal.  I also went on to have an abnormal MRI a few weeks later.  It wasn't until I actually got my report that I knew that it did note "areas of low attenuation" in the subcortical white matter.  I am no expert on all this, but I assumed that what they were seeing were all the white matter lesions.  The report did say something like "no mass findings" (which was true for me--nothing huge).

Did  you actually get a copy of the report?  I wouldn't have except I had my 2nd MRI at the hospital and when I requested the films and reports, they included the CT scan from months before.

Stacey
Helpful - 0
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