MRI T2 versus MRI T1 Quix??

[Udkas]

Hi Guys,
I have a technical question for you.  I have had loads of MRI done over the years of my brain and they have all been using the MS protocol but never with gadolinium.  Weighted T2 images and some with echo spin? I think.

But I have profound hearing loss in my right ear that has been confirmed to be nerve damage from either the nerve pathways to the brain or the brainstem.  Now the Ear, Nose and Throat specialist will do an MRI of that area and the brainstem and brain but they use T1 images and gadolinium to look for small benign tumors and other things that might be causing the hearing loss.

MS lesions can cause hearing loss and apparently given my numbness in my face etc. could also be a possibility but lesions have never shown up on my past MRI scans.

QUESTION:  Will this technique be more likely to find a smaller lesion in my brainstem for example than my previous MRI or will it miss MS lesions completely?  I thought maybe this technique might be better for looking at smaller areas and might yield some answers for my vertigo and facial numbness.

Any insight would be helpful.

CHeers,
Udkas.

[Udkas]

Hi there,

They are both interesting articles and from my understanding of reading them that both will pick up MS lesions but the T1 is maybe better for the progressive/slow type of MS that is more likely to cause black holes and atrophy?  I hope I am understanding this correct.

I have not had a brain MRI for almost 3 years (last one was Sept 2007).  I found my report from my spinal MRI which was done in January last year.

The imaging place used both Sagittal T1 pre and post Gad, and then sagittal flair along with axial T2.  I have several probable schmori nodes in my thoracic area (what are these?)

Hey Q, i have forgotten loads of things, especially when I have lots going on with pain, medication etc., it happens to us all both diagnosed and not!   At least you have an "excuse" that you can use, I don't.    Jen your write up is so easy to read and understand, thanks guys, I am always trying to extend my brain and learn new stuff but sometimes it goes in the door and out the other.

Cheers,
Udkas.

[jensequitur]

Naw, it's still there - just wrapped around in that lint you pull out of the dryer.  

It was weird re-reading my MRI writeup - I do remember writing it, but the information I had stuffed into my head to write that article has long since drained out of my head.

[Quixotic1]

BTW - that Health Page has been accessed almost 28,000 times.  It was weird reading my own words.  I wondered where you got that information.  I am definitely losing my mind.  It's being slowly washed away, I'm afraid.

Q

[Quixotic1]

Yes, Jen's article an MRIs is a better description on the science behind the MRI technology.  It's a good read.

Quix

[Quixotic1]

Did I write that??

Reminds me of the story where the two elderly women were driving to a lunch date together.  The passenger noticed that her friend ddrove right through several stop signs.  "Elsie," she said, "Did you know that you have just run through four stop signs without stopping?"  

"Oh, dear,"  Elsie replied,  "Am I driving?"

:))

[jensequitur]

If you're curious, I've written an article on how MRIs work -

http://www.medhelp.org/health_pages/Multiple-Sclerosis/How-does-an-MRI-work/show/79?cid=36

[Udkas]

The T2 technique is best for showing mature, dense, scarred lesions, where the oval lesions look brighter than the surrounding brain. This is where the term, "T2 hyperintensities" comes from. All T2 hyperintense lesions are not necessarily from MS. Other disorders like migraines, hypertension, small strokes and others can also cause them. On the other hand, the T1-weighted imaging technique is best for showing the old, reabsorbed "black holes" where the lesions once were. The FLAIR is a little easier for me. It stands for Fluid Attenuated Inversion Recovery. It is part of the T2 imaging, with a twist. It is another miracle of pulses and signals. Its purpose is to distinguish things that border on areas of fluid ( for our purposes, CSF in the ventricles). Apparently a lesion right up against any pocket of fluid, like the ventricles, can blur out and be missed. The FLAIR technique recovers information and through a miracle makes the lesion visible. There! Here is the link that made my brain hurt:

Here is the link to the entire article written by Q.

http://www.medhelp.org/tags/health_page/7687/Multiple-Sclerosis/How-MRIs-Show-Lesions-in-MS?hp_id=23
this answers most of my questions

[Udkas]

Well thanks for making me laugh, if nothing else!!!  And Thanks for the response, I appreciate that you took the time to read my post, as I know you are not well.  

I will ask my daughter's partner, he is a radiologist but his best friend does the MRI at our hospital so he should beable to tell me.  In the mean time someone else might have an idea.  

I am pretty sure it means that they are finer slices so therefore they might find smaller lesions not normally found but because for MS they are doing the whole brain they are slightly bigger slices but this is just an uneducated guess!!!!

Thoughts anyone?

[Quixotic1]

I am so sorry, Udkas, but I don't have a clue.  Not even an educated guess.  Actually no thoughts at all going through my head....Look! There's a squirrel!

Q