quick question- MRI

[JenB12]

My Doctor order an MRI scan on my head to check for a Pituitary Adenoma, but she told me to only go in when I was having headaches. I was having headaches all weekend but I feel better today, and probably wont be able to go in for a few days since I need to make an appointment first. Will it matter if I have a headache or not when I go in? If there is an adenoma, won't it show up regardless? I'm just trying to figure out why I should wait?

[SarahB79]

ok... so apparently neither of my MRI's were dynamic if I am reading this correctly.  

My first was 1.5 Tesla with a little cage around my head and they came in after about 40 minutes and injected me and ran more scans.  

My second was 3.0 Teslas with a helmet on my head and not allowed to listen to music, but required to wear ear plugs.  (different place)  and again after about 40 minutes came in and injected me and then continued doing scans for about 15 minutes.

Both times my endocrinologist ordered "pituitary mri w and w/o"  

Will they do dynamic at our request or will the dr. need to specifically order it that way?  

[JenB12]

Too funny about having to listen to Celine Dion!!!!  LOL!!! I would not have been able to stand that! I would not be able to remain still, i'd have had to make them re-do it. I got to choose what music to listen to. Everything on the music list was salsa, merengue or ricky martin.... lucky there was a selection called "relaxation" which they said was "mostly Enya" so i chose that one.... Unfortunately the scanning was so loud I could not hear the music. ::sigh::

Thank you for the advice! Next time I will at least know what to ask for in advance!!! I really do appreciate your time to answer all of my questions. It's a weird time.... that is, wondering what is going on and not having all the answers.  Doctors don't really have the time to sit around and discuss every little detail with you. So...I really appreciate your help!

[rumpled]

I also have to pay a portion of all my MRIs as well, so I understand your frustration. Next time ask before you have the scan - ask when you make the appointment. If they do not know what "dynamic" is, then find another place. I travel to different places. I did find a place once that did dynamic but the tech did it so badly (there is a rate of adding the contrast, too fast or too slow will make it too bright or too dark) and alas, my pics were very dark... I was so bummed. They also did not take pics of my entire sella so when I compared them to a previous MRI, it was as if they did not do all of my pituitary!

I did not go back there even though it is close.

I found another place with a 3T machine, that does dynamic, and they did a nice job with the pituitary as well as they did the entire brain as their protocol. I was in the machine forever, but since I have had cripes, 10-12 scans at this point, I am ok with that. I saw that the scan is nice and clear and the dynamic was done nicely. My only gripe was that he made me listen to Celine Dion during the scan *bleah* LOL but next time I will get different music.  It is about 40 minutes from my house - but worth the trip.

Call around. It may be that your next scan will be better. It bites though - when they are going to judge you on a less than satisfactory scan.

[JenB12]

Thanks! I called today and my results are not ready yet! so i'm getting anxious. My MRI order from my Dr. did say specifically "MRI special view- Pituitary" but I don't know what pics they ended up taking at the MRI center, i'm a little frustrated because it cost me $310 (the insurance covered the other 600) but that is a lot of money to pay for the wrong scan..... My medical insurance only covers me in Puerto Rico so i dont know what I will do if i need to go to a pituitary center in the US. I need answers though because i'm not doing well at all.  

[rumpled]

Nope, that was not dynamic so they did not do the proper pituitary protocol. They did "with and without contrast"... if it is dynamic, they set up a thing that looks like something from the movie Tommy (think the Gypsy Acid Queen, or at least some of them do to me look like that LOL) and it will inject when they press a button from the control room and the MRI is going when the injection is pressed.

If the doctor orders dynamic, they do it, but if the center does not know how, or they are not a pit center, then they do not know how. Some centers will see a pit MRI and do it by default as well, that is and should be how it is done. It is the best way for the small lesions to show up.

[JenB12]

Thanks! I'm hopeful that if there is anything it will be found... i'll be seriously upset if i go in 6 months from now to a tesla 3 and they find something....

They put a catheter in my arm and injected saline and first they did a scan with no dye injected and then after about 15 minutes, they injected the dye and did another series of scans for 15 mins.

I do not know if it was dynamic or not? how do you know if it is going to be dynamic? Is it based on type of lesion they are looking for or does it depend on the machine & technician?

[rumpled]

I can depend on technician, on if it was dynamic or not (if they injected dye and took pics while taking pics)...
I had a hidden tumor show up on a 1.5 and it had been lost for 12 years - a dynamic showed it.

[JenB12]

I finally had my MRI done today! Since it took a week for my insurance to pre-approve it. However, the place i was sent to only had a Tesla 1.5 machine and i was really disappointed in this. Will it make a difference?  or if i have a lesion will it still show up on the 1.5,  or does this all depends on the technician and other factors????  

Thanks....

[SarahB79]

awesome! Good luck and please let us know the results! :-) Usually you can even ask for a CD of the images, it's kindof fun to look at your brain even if you don't know what you are looking at. lol.

[JenB12]

I called and the screw is titanium, which apparently is fine. Only things that are magnetic will be an issue!

Thanks again Sarah! I'm getting my MRI on wednesday....

[JenB12]

Sarah, thanks so much i will definitely ask to see what power of machine they use. I have another question that dawned on me after making my appointment. They asked if i have any metal in my head which I immediately said no. But then when i got home I remembered that i have a small screw in my jaw but didn't think about that at the time. Does anyone know if that is important, or are they just referring to something that could block the results of the MRI?

[SarahB79]

it should show up no matter what... keep in mind though that the scans are about 3mm apart and if it's is small then it is possible it will miss it or only see part of it and the radiologist could miss it.  

Try to call around and find a place that offers a 3.0 Tesla machine... at the very least a 1.5 with the latest software updates.  

Good luck!