MRI's with and without contrast
by sf__0, Feb 14, 1998

      Re: MRI's with and without contrast

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Posted by CCF Neuro MD on February 16, 1998 at 09:47:11:

In Reply to: MRI's with and without contrast posted by s.f. on February 14, 1998 at 22:27:56:

: How much difference is there between the images of an MRI with contrast vs.
  an MRI without contrast? About four months ago I underwent an MRI of brain.
  Neurologist's orders called for MRIs with contrast and without contrast to
  rule out focal lesions. Symptoms included headaches, odor hallucinations,
  lightheadedness, stiff neck, unilateral ache in shoulder and arm, tremor,
  numbness, tremor, crawly sensation on face, etc.
  Technicians did the MRI without contrast first, obviously. When they started
  to inject the dye, they had many problems finding a vein that wouldn't
  collapse, and after half a dozen "sticks" in different locations on my arms
  and legs, they gave up and sent me home. So the MRI with contrast was never
  done. MRI without contrast was normal, according to results.Neuro didn't say
  anything about missing "MRI with contrast" when he went over results in follow-up
MRI with contrast is a more sensitive test than MRI without contrast, when looking for
certain types of abnormalities, for instance brain tumors while obvious on regular MRI are very
easy to see as the contrast (gadolinium ) is taken up by the tumor causing it to "glow'
on the final scan.
Some lesions like active MS plaques are very obvious on a contrast enhanced scan, the may be seen
on a roiutine scan but the uptake of contrtast indicated that the lesion is active and recent
as opposed to older and inactive.
In most cases abnormalities are seen on a non-contrast scan , but the
visualisation is much better and more information is obtained using contrast.
If the non-enhanced scan is totally normal the need for a  contrast image is not so
acute, so I suspect this is why your neurologist let it pass when he saw the scan.
  What might have been missed by opting not to do the "with-contrast MRI"?
  Should it be reordered if I'm still experiencing symptoms consistent
  with the reason for the first order?

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