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Difference between enhancing and non-enhancing lesions
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Difference between enhancing and non-enhancing lesions

Hey all -

Just a quick question that has been plaguing my mind.  Does anyone know anything about the differences between enhancing and non-enhancing lesions with MRI contrast?  None of my lesions (9 w/ only one > 3mm) enhanced with the contrast.  At first I thought that this was a good thing, but now I'm worried because I have read that the non-enhancing lesions are more consistent with PPMS, and no offense to all of you who suffer with that type, but I am very fearful of PPMS.  Do all lesions enhance with RRMS or only new and active ones?

Thanks in advance for any info!

Katie
p.s. I'm sitting here getting my third and final dose of Solumedrol IV - so far, so good!
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572651_tn?1333939396
Hi Katie, this is a great question and I think one of the most misunderstood things about getting an MRI.

Many times people think it is essential that you have contrast for the MRI to make the lesions appear.  That is not true.

The contrast agent will make relatively new/young lesions enhance and that helps the doctors to see if there is current disease activity The timing on lesions to enhance is thought to be about 40 days.  Once they get older than that they no longer enhance.

Whether you have contrast or not, the lesions will still be visible on the MRI (or at least if they are going to be visible, they will be seen with or without contrast.  

Having none of your lesions enhance is a good thing and has nothing to do with whether you have PPMS or not.  It simply means that your disease is not in a active state.  

Where it does become significant whether lesions enhance or not is if you are trying to meet the McDonald criteria.  If you have lesions that do not enhance and also have lesions that do enhance, it qualifies as a separation of time.  Once we are diagnosed, the contrast is used to see activity and to help determine if the current therapy is doing its work and keep the MS quiet.

I know all this is kind of talking in circles - I hope this make sense. Please ask for clarification if it doesn't.  Glad to hear you are almost done with the solumedrol.  

be well, Lulu

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I think Quix's health page on lesions will answer your question better than I can.

http://www.medhelp.org/health_pages/Multiple-Sclerosis/How-MRIs-Show-Lesions-in-MS/show/23?cid=36
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572651_tn?1333939396
Hi Katie, this is a great question and I think one of the most misunderstood things about getting an MRI.

Many times people think it is essential that you have contrast for the MRI to make the lesions appear.  That is not true.

The contrast agent will make relatively new/young lesions enhance and that helps the doctors to see if there is current disease activity The timing on lesions to enhance is thought to be about 40 days.  Once they get older than that they no longer enhance.

Whether you have contrast or not, the lesions will still be visible on the MRI (or at least if they are going to be visible, they will be seen with or without contrast.  

Having none of your lesions enhance is a good thing and has nothing to do with whether you have PPMS or not.  It simply means that your disease is not in a active state.  

Where it does become significant whether lesions enhance or not is if you are trying to meet the McDonald criteria.  If you have lesions that do not enhance and also have lesions that do enhance, it qualifies as a separation of time.  Once we are diagnosed, the contrast is used to see activity and to help determine if the current therapy is doing its work and keep the MS quiet.

I know all this is kind of talking in circles - I hope this make sense. Please ask for clarification if it doesn't.  Glad to hear you are almost done with the solumedrol.  

be well, Lulu

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Avatar_f_tn
Thanks so much for your fabulous explanation.  I feel much better about the whole thing.  It might sound crazy, but I think that I've convinced myself that I can handle RRMS, but that if it turns into PPMS, I'm going to have to jump off a cliff or something.  I had my c-spine MRI on Friday and they told me to call for results on Tuesday.  I don't want to call.  Knowing what is there isn't going to do anything but scare me, and not knowing is going to drive me crazy.  I wish that I had a magic 8 ball that would be able to predict the exact course that my disease was going to take.

With respect,
Katie
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Dear Dr.

Last month, I found a lump on my son's buttock. He did a MRI.
And this is the report.
Cluster of T1 hyper intense, fat suppressed, non-enhancing lesion is seen at parasagittal area of right buttock, inferior to coccyx, Findings may represent lipoma. It measures about 2.4x1.7x3.4 in size .Surrounding T1 and T2 are notes, may represent fibrosis. No rim enhancing lesions is seen to suggest perianal abscess.

His Dr. suggests an operation to remove it. But due to his situation then remove area will be very large.
Is there any other way for the treatment?
sincerely

Mrs. MOK
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I think you found us by mistake (probably a direct link from a google search, yes?) None of us are doctors here, and the only ***** we ever discuss are some of our neurologists.

The good news is lipomas are common and benign. Other than that, I can't comment.
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Avatar_m_tn
Hi,
My nephew was having headache and pain in eyes. The reports of the CT scan says "Non enhancing lesion (4.7cm * 3.3cm) showing csf density appears to arise from Lt. sylvian cistern, S/O Arachnoid cyst". My nephew is about 7 years old. Please let me know how severe it is and how it can be removed. We are trying to avoid any surgery. Can this be cured using medicines only.

Thanks & Regards,
Shailesh
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1831849_tn?1383231992
Hi Shailesh - Welcome to our group.

This group is dedicated to multiple sclerosis. There are no doctors here,just regular folks who have or think they have MS.

I looked up sylvian cistern and from what I could figure out, it seems to be more related to blood vessels than nerves. MS is a disease that attacks nerves in the central nervous system.

You may get a better response in the MedHelp Brain Health forum. Here's a link to it.

http://www.medhelp.org/forums/Brain-Health/show/1582

Kyle
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