Gray Matter Lesions - Has your doctor used the new MRI techniques?

[Wind_and_Water]

Has anyone gotten an MRI done, using the newer techniques that can better show Gray Matter Lesions?  Please share, was this helpful toward a diagnosis?

In no particular order, here is a list of the new "gray matter lesion" techniques I have found in my research (please add to the list, if you have feedback, corrections, or additions):

"Magnetization Transfer" (MT MRI)"

"Diffusion-Weighted" (DW MRI)"

"3-D FLAIR"

"combination of double inversion recovery (DIR) with phase-sensitive inversion recovery (PSIR) images"

"single-slab 3D DIR sequence"

"gradient recalled-echo (GRE) sequence"

"2-dimensional fast low-angle shot (FLASH)"

"T2-weighted spoiled gradient-echo"

"T2-weighted turbo spin-echo (TSE) images"

[Quixotic1]

Well, you are giving me far too much credit for expertise.

Here are my best guesses at your answers:

A)  Yes, I would think that "Diffusion" does refer to the "Diffusion Weighted" technique.

B)  I haven't a clue.  anyone?

C)   No, T2 is a technique all by itself.  It is the mirror image of the T1 technique.  When FLAIR is done along with T2 imaging, lesions that are in proximity to fluid (in our cases, CSF) become clearer.  I think FLAIR is always used in the T2 imaging.

It's not that the neuro must request that certain techniques be used - in general.  Whether they are used depends on whether they are available on the MRI machine.  I bleieve that these other techniques are a function of the software being used.  Remember that the real advances in MRI machines are not so much in the Tesla strength of the magnet, but in the sophistication of the software.  A fabulous state-of-the-art 1.5T image with the best software is likely superior to a basic humdrum T3 machine.

I would think that the techiques requested in the MS Protocol for that image center would be a result of what the neurologists using it have agreed upon.  The basic Protocol (that we all know and love) is merely the "minimum set of techniques and settings.  To that extent your neuro could have some imput.  The Protocol should be used for the MRIs ANY time MS is in the differential diagnosis - in my never-too-humble opinion.

Quix

[Wind_and_Water]

Julie, thanks.  I agree this seems a very promising area.  Especially for "limbo-landers" (such as myself).

Quix and all...

(1)   Is it reasonable to expect an MS neurologist at a major hospital (such as NYU) to routinely use newer techniques (such as DIR and DW), without being asked to do so by the patient?  If not, how does a patient make such a request without offending the doctor?

(2)   May I please impose upon you for some help in understanding my 3T MRI report?  It says, "Sagittal and axial FLAIR, axial diffusion images with ADC maps, susceptibility and T2-weighted images of the brain were obtained."

My specific questions are...

(A)  In the context of my report, does "Diffusion Images" mean "Diffusion Weighted Images"?

(B)  What is meant by "susceptibility"?

(C)  And what is meant by "T2-weighted images"?  (Isn't this an incomplete description of the technique used?  Does it mean T2-weighted FLAIR images?)

[Quixotic1]

I know that my MRI reports include comments on whether they see gray matter lesions or not.  And they are using the Double Inversion Recovery and Diffusion weighted techniques routinely.

Thanks so much for listing these for us.  It wouldn't be a bad idea to list these in the appropriate Health Page.  I'll try to do that.

Quix

[Sarahsmom46]

What an intriguing topic to bring up.  When my neuro suggested that he felt there was gray matter lesions, I mentioned this to the doctor's in a research institute where I was in a study protocol.  The neuro there said that they have the means to image the gray matter, but didn't tell me any more about it. It is my understanding that this is still largely a research tool, but hopefully that is wrong because I would love to get the gray parts of my brain images to see if my MS neuro is right.  

I'll be watching to see if one of our science guru's drop with some helpful news.  Thanks for bringing up this interesting topic.  

Julie