What kind of MRI?

[alice44]

We are taking our daughter to get some MRI's to test for MS.  They told us it's up to us what we want to get done but we want to know if we should get the MRI's  "with gadolinium agent" or without. It's alot more money to get it with that stuff but if it will show more lesions, then it's worth it.  Does anyone know? Also does it matter if its a 1.5T or 3T machine? I've read conflicting reports on whether the 1.5T is useless, which is why I ask.

[Sumanadevii]

Plus, because MS is hard to dx...It would be hard to prove him at fault.  I do know what he thought...He saw my husband that is very protective of me.  He saw me falling apart.  I do believe he felt it was a "game" we played as a couple.  Husband cares for sick wife.  Wife plays the part.  

I will say it still stings.  The way he treated me.  Especially when he laughed as I tried to explain the exhaustion I felt at trying to get my bra on....I know today that is called fatigue but had no idea then.  Of course, it only made me not tell him more about what was happening.

[Sumanadevii]

Alice, no we did not take legal action.  At first I was angry enough to think of it but after hearing stories of others here....some going to neuro after neuro...I felt blessed to have found my present neuro on the second go round.  She is wonderful.  Plus, I do know my first neuro is responsible for his mother and her little dog.  We are in a small town.  Her home is right next to his office.  I know he takes good care of her.  It would be hard to sue someone that ...I dunno.  We all have both good and bad qualities.

[alice44]

Thanks Addi, Bob, Julie, Lulu. Good info!

[Lulu54]

My diagnosis came from a 1.5T scan of both the brain and spine.  Demyelination was seen on both of those and clinched my diagnosis pretty quick.

As for the use of contrast, it is not necessary., It is somewhat confusing to understand, but all lesions will show up if visible without contrast.  The gadolinium shows lesions that are less than about 40 days old as enhancing - they take on a type of glow.  This helps the neuros to know if the disease is in an active stage.  If you are having to pay for it out of pocket, for now that is one thing you can skip.

There is an assistance fund through the MSAA site that will pay for the diagnostic MRI for people trying to determine if they have MS.  you have to get this approved BEFORE the MRI .... this is for the non-insured or people who's insurance has denied an MRI.  The information can be found here:


http://www.msassociation.org/programs/mri/


If you have to pay for this out of pocket, be sure to negotiate the cost of the MRI in advance of the test.  If you can go to a teaching hospital to have it done, that's even better.  

I hope something in all these answers helps you - good luck and keep us posted.

Lulu

[jujuminx]

I am one of those who had a 1.5T MRI of spine and they found lesions and hence got a MS dx.

My neuro said pretty much same as Bob, 1.5T's better for brain but certainly can find lesions on spine. As far as the enhancement agent, that helps see new/active lesions.

Julie

[COBOB]

3T MRIs have some limitations.  While they improve spine imaging, they have to use different techniques (like gradient echo vs, spin echo sequences) to stay below the maximum SAR.  If they are doing brain imaging, I'd say 1.5T is very suitable.  

A 3T uses twice the magnetic field, but requires more RF energy at higher frequencies to generate usable images.  This can cause excessive tissue heating in some folks.  For all this added energy, the images are only 30-60% better than the 1.5.  

Bob

[addicted2harleys]

Hi, Alice-

I think I would want more information before giving an opinion on what kind of MRI's to have done.  I have to question why any doctor would leave it to the patient/parents to decide on what to get.  Is this doctor a neurologist or a general doctor or another kind of specialist?  How old is your daughter and what symptoms has she been having?  Are you paying for these MRI's completely out of pocket?

If you feel comfortable doing so, could you please tell us more about what is going on with your daughter, what tests she has already had, what kind of doctors she has seen, what led you to where you are now...that sort of thing.

MS is a diagnosis of exclusion.  Meaning there are many, many diseases/disorders that mimic MS.  Many of these need to be ruled out before an MS dx can be made.  This is done with a lot of other tests besides just the MRI.  

I am really sorry that you are finding yourself in this position and so very sorry for your daughter.

Hugs,
Addi

[alice44]

Good link! That helps. Thanks!

[alice44]

Sumanadevii: Were you able to take legal action on the first neuro who did nothing? That sounds terrible I'm sorry you had to go through that! Also, did they have you do the contrast agent with yours?

doublevision1:
Yes that helps. Thank you! It looks like you have a good doctor.  

[Sumanadevii]

Here you go...from Quix our resident doctor.  She is a retired pediatrician and has MS.  I hope you find it helpful.

http://www.medhelp.org/posts/Multiple-Sclerosis/3T-MRI-Clarification/show/645037

[doublevision1]

ps: click on the Health Pages button located on the top right hand corner of your screen; you'll find a number of articles and explanations posted by forum members re: the use of MRI in diagnosing and monitoring MS.

[doublevision1]

Sorry it sounds like your daughter's physician didn't give you enough info to make an informed decision, given they are leaving the decision to you?  

It's true that the higher the resolution the clearer the image, and that might make the difference between a speedy diagnosis or not, especially if she has mostly if not enitrely spinal cord lesions.  I will comment that I was dx'ed based on, among other tests, brainstem and spinal lesions revealed on a 1.5T, without and with gad.  I have several c-spine lesions as per MRI as well as corresponding clinical signs and symptoms.  

However, my neuro is confident in documenting that I also have thoracic involvement due to my history of MS hug at that level of my spine, even though it's never shown up on MRI.

Gadolinium will indicate whether lesions are active or inactive to determine recent history of disease activity and whether a relapse is currently in progress.

Hope that helps.

[Sumanadevii]

A 1.5t MRI is surely not useless.  It has been used to dx MS for years and years.  It is excellent at showing lesions on the brain.  The problem comes in with the spine.  A 3t has a much higher resolution.  The spine is a very tight space.  Doesn't it make sense that a higher power machine might find lesions on the space more so than a 1.5?  

I am sure some here will say that the 1.5t showed their lesions...Well, I am one that it didn't.  I was already an MSer without a dx when my first neuro (I really hate calling him that..I would rather call him an idiot) ran a 1.5.  Mind you, I was already using a wheelchair for any distance and had been for two years.  The 1.5 found no spinal lesions and just one tiny "age" related lesion on my brain.

My body lost more and more strength.  Three and a half years later when I lost the use of my dominate hand, I went to another neuro.  She looked at the 1.5...Her exact words were it wasn't a high enough resolution to tell her anything.  The following morning I had an 3t ran and by noon I knew I had MS.  My spine lit up like fireworks.  Do realize how much damage has been done to my body.  I won't ever be walking any distance.

Wanna take the chance?