White Matter Lesions vs. Gray Matter Lesions

Help me understand the difference between a white and gray matter lesion in the diagnosing process of MS.  Are white matter lesions less significant ?

[Quixotic1]

At present we have no easy way to visualize gray matter lesions.  Therefore, they are not currently used in making the diagnosis of MS.  We are learning that gray matter lesions are very common in MS and may also account for the disability we see.  When we can look at them well I suspect we will find out that gray matter lesions are very important.

Q

[tot_teacher]

Are white matter lesions less significant ?

[Quixotic1]

I'm sorry, I'm not being very clear.  We presently can only visualize the white lesions.  Few people are having their gray lesions visualized by special methods.  So, we can not compare the two since we only really know much about the white matter lesions.  We can't say which will end up being the most important.  

For right now the white matter lesions are the ones that have the greatest impact on whether we get diagnosed and on how it appears our disease is progressing or on whether our therapies are helping.

Your question is presently unanswerable.

Quix

[jensequitur]

I wish I could find that article... I've read so many different articles about radiology imaging and MRIs and MS that it all runs together.

Basically what I remember from the article is that they tested a control group and a group with MS.  The MS group had more 'activity' in certain areas when the T2 setting was used on the MRI, even though there wasn't a visible lesion in that area.  Their brains had something going on inside.  What I got from that is that there's invisible damage in the brain of somebody with MS, and the MRI T2 settings were helpful in revealing which areas.  

Perhaps this was showing damage in the gray matter?

[tot_teacher]

Oh, I get it it.  I was wondering if I am making a huge deal about my white matter lesions when maybe I shouldn't be ... now I see that MS patients may ONLY have white matter lesions for a diagnosis, not that white matter lesions are insignificant, but that technology hasn't caught up with visualizin them.

So sorry for the confusion ( I seem to be living in a huge brain fart these days ).

I want to show up at my PCP's office insisting on another MRI w/ contrast ... but I want to be prepared with why I feel it should be done to rule out MS.   I just don't believe MS can be ruled out quite yet.  I get so confused trying to make sense of things.

Would you say that if I had any abnormal readings on my 9/08 MRI w/OUT contrast, that it should be followed up with a contrasted MRI to compare? I have posted my MRI reports on my Member Page as a Journal Entry, if anyone could take a gander from their own perspective (as if it were their own MRI) and tell me what you believe my next step should be (in a perfect world, right?!)

Thanks for your time.

- Alisa

[jensequitur]

I think that the MRI without contrast should be thrown out, and a new one should be done.  But I'm not your neuro!  

[essdipity]

Please see Julia's very similar post a few items down. Doni has done a great job of researching gray matter lesions and has included the Web citations she found. I'm just now getting a chance to check them out.

Thanks, Doni!

ess

[doni54]

You are very welcome.  I just got curious when this subject came up and when I get curious I google........heeheehee

Some of the articles are very interesting, especially one from Italy and one from the Netherlands.

doni

[doni54]

I bumped up the thread for you that ess mentioned, one by Julia.

Hope some of the sites help.