Will 3T MRI see spinal lesions 1T miss?

[kerrtelli]

I was googling 3T MRI in CT yesterday because i remember people saying that it could see lesions other MRI miss.

I was thinking how the ms specialist said if I had a spinal lesion he would overwhelmingly think ms but since I didn't have lesion on spine, but many brain lesion, he changed his tune.

And, most of my symptoms would seem to stem from spinal lesion.

There is a 3T MRI machine in Hartford hospital which is close enough for me.

The catch is that my insurance most definitely will not pay for this machine.

So my question is, what do you all think of me trying to PA for it myself and the likelihood that it will show up.

I know not anyone can say if I will have a lesion on my spine but what are the facts on how often spinal lesions are missed on regular MRI's.

Thanks for your input.  I am interested to hear what you all have to say on this.
I could just wait for the lesions to show up but I don't know if that would be very smart.

Thanks,
Kerri

[kerrtelli]

Hello and thanks so much for the explanation.

In the doc notes he said that M
my clinical exam showed abnormalities consistent with spinal lesions and if I had a spinal lesion he would overwhelmingly say it was ms.  My abnormalities were primarily on my left side.

He then sent me for the MRI of brain and spine.

My brain MRI showed over 21 lesions but said they presented as atypical for ms.  

The spine MRI showed two slightly bulging discs in the neck.
But there were no lesions.  After that he said I was probably didn't have ms but he had no explanation as to what my problem was.

He did say he wanted to keep following my case.  I found that odd if he didn't think I had ms.

Either way, after reading the forum for almost a year, i know that I can't just sit around waiting for the doc to say what it is.

That is why I located the 3T machine and asked the question.

Problem is my Medicaid.  A lot of doctors don't take it.
I am going to look into it further anyway.

If it is pretty likely that I have a spinal lesion, I will make payment arrangement with the hospital to get the test and pay off the bill.

Thanks,
Kerri

[Quixotic1]

oops

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Measuring-The-Tendon-Reflexes/show/157?cid=36

[Quixotic1]

For the most part 1T MRIs are antiquated and may miss a lot of stuff.  

I agree that the average 1.5T MRI ahould be fine for picking up lesions in the brain, but your question deals with the spine.  Just in case you don't understand the language that Bob uses, here is the reason you want the best MRI machine you can get to (and have paid for, lol).

Certain things make it hard for an MRI to get a clear image and, thus, pick up small lesions.  Some of those things are movement and nearness to fluid.  The spinal cord is a small amount of tissue surrounded by spinal fluid which has nearly the density of water.  All of it is close to water.  Thus, the lower power machines with older software, like a 1.0T, get a lot of what we can call "interference" and may miss small lesions.

Also, there is a great deal of movment along the spinal fluid and in the chest.   Sources of this movement include the rhythmic pulsations of the spinal fluid itself.  Have you ever seen the soft spot on a baby's head pulse with its heartbeat?  That's what I am talking about.

Another movement is the pulse within nearby large blood vessels, especially the heart and aorta.

A third source of movement is our breathing.  We can't do much about these.  That is why we need the best machine available.

You have probably heard my story where I had a spinal MRI on a 1.5T and was told I didn't have MS.  No lesions were seen.  Three weeks later I had the MRI on a 3.0T and there were 6 (SIX) lesions as clear as day.  My diagnosis was made that day (along with lots of symptoms and a positive LP).

So you need a pretty good and up-to-date machine to show the lesions of the spinal cord.  Major academic medical centers are more likely to have the better machines AND the better neuroradiologists (the subspecialty of radiology that read the images)

I have another question for you.  Do you have symptoms or abnormalities on your neuro exam that suggest or prove spinal lesions?  For example do you have incontinence from a neurogenic bladder (as opposed to stress incontinence)?  Do you have abnormal deep tendon reflexes that are different on one side versus the other?  If so, there is little doubt that you have spinal lesions, no matter what the MRI shows.

Your neurologist may be just too rule-bound.

Here are two Health Pages to read:

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Spinal-Cord-Lesions/show/764?cid=36

and

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Spinal-Cord-Lesions/show/764?cid=36

Hope this helps.

Quix

[kerrtelli]

Thanks.  Maybe I should just see if I can get an appt through my insurance at that hospital.  It's worth a try.  A this point I have nothng to lose.

I am in the works trying to see another ms specialist closer to me but he only takes my insurance (Medicaid) on a case by case basis.

I know eventully the answers will come.

I had to start my neurontin again because the myclonic jerks returned.
I can't handle the Bqclofen.  It messes with me too much.
I just deal with the spasms.

You are veery helpful.  I appreciate it.

[COBOB]

3.0T MRIs make a difference in spinal imaging, but, in my opinion, they don't make that big a difference in white matter brain imaging,  A 3.0T has twice the Larmor frequency of a 1.5T MRI.  There is a big difference in the signal to noise ratio in "narrow gradient" environments (like the spine.)

One of the bigger advantages of having the study done at Hartford hospital is that they have some very good nueroradiologists there.

Bob