1.5 Telsa MRI

[Angie9798]

Hello-

I have had 3 seperate MRI's...one of the brain, one C-Spine and one T-spine.  No lumbar.  All 3 were done to look for signs of MS.  All 3 were normal without contrast.

My question is...is this 1.5 Telsa machine strong enough to pick up lesions?  I have been sympomatic since January.  Kaiser will not run contrast UNLESS the normal MRI shows abnormalities.  I think the concept is backwards!

My neuro says he doesn't think I have MS based on this, but I have a hard time believing it.  He says that this may all be anxiety driven.  I totally disagree.  

Aslo, if this is MS...how long will the symptoms stay?  I have leg tingliness, heaviness, CONSTANT muscle twitches, achiness (like I'm chilled to the bone), tiredness, etc...

My neuro says he sees no sign of damage; I am still completely strong & very happy about that.  I am having a hard time dismissing how I feel.  I am typically a very hyper 34 year old stay home mom of 2....and I mean hyper.  Everything has changed...even my neck gets heavy!

Looking for advice....

Thanks,
Angie

[Lulu54]

Hi everyone, I'm just catching up with this conversation.  

If my memory is correct, there is little need to image the lumbar region if the doctor is thinking MS.  The lumbar would be imaged, such as mine was, in the initial dx process to check for possible causes of lower limb problems. In my case, I had numbness in my leg.  The MRI was done to look for other problems.  

The lumbar spine does not contain white matter, which is where the MS lesions occur.  The lumbar spine should be checked for other problems, but will not show signs of MS.

MS in the spine is only going to occur in the cervical or thoracic sections.  

The spinal tap is done in the lumbar region because the spinal cord ends before that section.  This minimizes the risk of damage from the tap.  This is different than having spinal fluid accessible through the lumbar.

AshleyPT has given a very good explanation about the anatomy of our spine.  Thanks for this answer.

as always, Lulu

[ashleyPT]

I just want to clarify something about the spinal cord debate and this comment about hence the lumbar puncture.  

A normal spinal cord in adults ends at the level of your L1/L2 vertebrae, although there is some variation among healthy adults (a little higher T12 - a little lower L3 ).  The nerve fibers beyond this point are peripheral nerve roots that are referred to as the cauda equine (horse's tail).  

It seems that whether or not they image the Lumbar spine to diagnose and monitor  MS is physician specific.  My 2 previous neuros imaged it, my current one did not.  But someone else may know more about that.  Ususally a thoracic spine MRI images low enough to capture the end of the spinal cord.

The lumbar puncture is typically done in the space between your L3 and L4 vertebrae or between L4 and L5.  It is done at this level because there is less risk associated with damaging a nerve root than with the spinal cord.

[gheko]

I am awaiting diagnosis at the mo, but in suspected MS category as do have relapses but yet to show any lesions.  They do MRI the lumbar for MS, spinal cord does go into that area, hence the lumbar puncture.  I had my lumbar area checked.  

[Angie9798]

Hi Melissa-

I am at Kaiser in Vallejo, CA.  You?

Who do you see?  Who do you like?

I could use some help in this area...

Thanks

[Ginosmommy]

Which Kaiser facility are you at? I have a wonderful Neuro that did all the testing within less than a month (well I have had problems for about a year but never suspected MS so there was a lot of testing already done for her at the time also)

When I had my MRI, Kaiser had no problem doing it with and without contrast because that is how my doctor ordered it and she was just the ophtamologist! You really are hit and miss with doctors at Kaiser, I have found many great ones and trust me have been through many duds also.

Welcome to the board and I hope you are not in Limboland for long!

MeLissa

[Angie9798]

Hello-

I mainly get the muscle twitches in my legs.  I have however has them other places.  I feel them mostly at night but am aware of them going on during the day too.  I think as the day progresses I get them more.

Funny you should mention the hand...I have one that has been going on in my right hand for about 2 days.  It comes and goes and irritates me.

Do you have MS?  Or how are your twitches explained to you?

[gheko]

Do you get muscle twitches everywhere?  I ask because i too get muscle twitching, have had a constant one in outer hand for months but twitch in legs, arms back etc.

[Angie9798]

Hi again Ashley-

I've been struggling with the vertigo since about xmas time.  

Some days are better than others, which is true of all symptoms.  Like today, I am only dizzy and tingly.  It's actually a nice break.

Some days the dizziness is like the spins which is the way it has been the past week or so.  Other days it's like I'm walking on a boat.  Sometimes laying down makes it worse and sometimes it just doesn't matter.  I think the more tired I am, the worse it is.  That's a bummer because I am so super tired lately.

I'm not sure exactly what they do to look for the vertigo.  I have had a couple of complete nuero exams but my doc doesn't comment on them.

Thank you so much for asking, do you have any more thoughts???

[ashleyPT]

How long did you have the vertigo/dizziness?  What sorts of things made it worse or better?  What testing did they do to look into the dizziness?

[Angie9798]

Hi Ashley-

My other major symptom is/was the vertigo/dizziness.  And that one is sticking around too!!  YUCK!

Any more thoughts?  I just wish I could be done with all of this...

[ashleyPT]

Do you have any other symptoms?  I'm just trying to figure out the thought process here.  As a medical professional - if someone came to me with ONLY leg symptoms and no other complaints it would take a lot of ruling out other things before I even thought about MS.

[daisy.girl]

Angie....
A lumbar spine MRI is not looked at for MS.....the spinal cord ends before that area.

Diagnosis of MS is a combination of many things. Including the neuro exam, your history/symptoms, Evoked Potentials, Lumbar Puncture, any history of Optic Neuritis, MRI's and blood work to rule of mimics.

Hope that helps.

[Angie9798]

Hi Ashley-

It does seem crazy that they have yet to do lumbar!!!  My symptoms started in my right leg but within 3 weeks were equally in both.

Any advice???

[Angie9798]

Hi Sarah-

How long have you had symptoms?  I hate all this crazy stuff.  I keep telling everyone that I would have a hard time believing that anyone could feel the crazy sensations I have...like I feel like my feet are vibrating!

How old are you?  I know age is considered a little with ms.  I am 34, close to 35 UGH!!!

How are your symptoms now?  How are you handling all this?  Do you have a good support system?  I ask because I know this is all so hard.  THE WAITING GAME!  UGH!

I had the VEP test a about 6 weeks back.  Mine was normal.  I keep asking my neuro what else could be the cause of all this weird stuff....no answer.

I also have a big test on April 1st...I have my EMG.  My kids (11 and 12) keep asking if it can all turn out to be an "April Fools."  Boy do I ever wish they are right.

Love to hear back from you,
Angie

[daisy.girl]

Angie,
I didn't answer your question. The lumbar spine is not looked at for MS....the spinal cord ends before that area....

My first visit to the new neuro was in Dec 2009 and I was DX Jan 2010....quick I know. I did not ever think MS....I was going to see him for severe migraines and blurry/double vision. Oh yea....I forgot, I had optic neuritis too. I had balance issues, but I thought that was due to the migraines and/or all the medication I took.

[daisy.girl]

Angie,
I had the following results:
hyperactive deep tendon reflexes
positive babinski
positive hoffmans sign
clonus
absent abdominal reflex
ataxia
abnormal SSEP
low vit D
low B12
normal LP
my first brain MRI was normal on the 1.5 T magnet.
second MRI on 3T showed lesions

I went to a new neuro....he is the one that reordered the MRI....I picked the radiololgy dept...because I had researched, like you, the stronger the magnet the better.

but my new neuro thought it was MS from the beginning, even though the first MRI was normal....he said my neuro exam and history pointed strongly toward MS.

I did have contrast with the second MRI....but ALL lesions will show up on a MRI without contrast...the contrast only shows which lesion are newer ones (within the last 30 days or so)

[Sparkysarah]

I am also new to this site and it feels like we are in a similar place. I am waiting for lots of results..hopefully this week. I had a brains scan done to look for an acoustic neuromas originally as I had experienced some mild hearing loss and numbness on one side of my face. This scan showed brain scarring on right hand side but was not as detailed as a neuro scan. I have subsequently had scans done of head, neck and spine and results are sitting on Consultant's desk waiting for him to read and come back to me. I had all my blood tests done last week and these should be through next week also. I have to wait for evoked eye potential test on 1st April. This waiting and being in limbo is the hardest bit and I know it is essential to eliminate everything else, but it is frustrating when symptoms are increasing (probably due to anxiety) and there is nothing that can be done. I feel fairly ignorant about all the different scans that have been mentioned so will be interested to find out what sort I have had done. My first radiography report suggested demylination and my neuro has indictaed that it looks highly likely and this is before any of the new tests have been. the unknow is a difficult place to be.... xxx

[Angie9798]

So, your 1.5 came back normal?  How did you get them to run the 3T?  Were either or both with contrast?

What do you suggest I do??   How long did your DX take?

Thank you!

[Angie9798]

Thank you all so much!  It's amazing to get som much feedback!   I love this sight!

First, yes, all blood work has been done.  The only def. I have is D....of course.

I don't know what the heck my neuro is thinking!  Like I said, he started at the brain about 2 to 4 weeks into this thing and every other week or so he adds another mri...STILL NO LUMBAR!  It is so frustrating!  He said lumbar isn't needed because the EMG will pick up on whatever is going on there.  You would think they would start with lumbar, RIGHT???

I also had the visual evoke test, and it was normal.  My primary care wants to have the lumbar puncture done.  At this point the sooner they can maybe rule all this out the better...I HATE being in limbo...I'm sure many of you understand.

So, the 1.5 is all normal...but still no lumbar and no contrast.  I am wondering if it would pick anything up.  Believe me, I am not hopeful that this is MS but an answer would be good.  I don't think it's anxiety.  

I was nervous about ALS but my neuro says that comes on totally different.  Do any of you know???

Thank you all so so so much!  Please let me know what you think.

Angie

[ashleyPT]

Angie,

You symptoms are in your lower extremity and they started with a brain, cervical, and thoracic  MRI?  Is that correct?  When you say leg - are symptoms in both or one?

[daisy.girl]

hi angie...
no..the 1.5 T showed no lesions. The 3T showed about 10 small lesions.

Also, you asked if your lesions may be too new to see. No...if the MRI can pick them up, the new ones show up on the MRI without contrast too....they just are not able to tell that they are new ones. The contrast lights-up the lesions that are 30-40 days old. (they enhance).

Hope that helps.

Blessings

[Jifr]

Hi Angie:

a 1.5T is strong enough to pick up lesions that are large enough to been seen on a 1.5.  Sounds plain enough, right?  But, like some others have mentioned, you could have smaller lesions that can not be picked up yet.

BUT....

MS is a diagnosis of EXCLUSION.  There is no "MS" test.  There is the "it's not this, this or that and there are signs of this, this and that.....soooo, let's call it MS".  (Plus or minus a this or a that and throw in a couple of VEPs, NCVs, EMGs, spinal taps...etc)  :-)

So - your doc should run every blood test and rule out other diseases that mimic MS.

Have you had your thyroid tested?  Your calcium levels?  I would start with those two things since deficits in one or both of them can cause some of the symptoms you mentioned.

I hope you get some answers and get them soon!

.jifr.

[Wobbly]

welcome to the forum, I got Dx on a 1.5T  it showed 20 or so lesions in different areas of my brain.  it still took 4 years to Dx this as they wanted to see changes etc... they also wanted to watch my symptoms and see how I felt for a year or so.

it's not an easy Dx to find at times.  My LP was neg.  VEP was neg.. etc. so it took awhile to get a Dx..changes on my MRI did it and Neuro exam showed changes

have you been checked for mimics of MS... autoimmune ??  Have you seen other Dr.. had bloodtests?  

don't forget to ask for copies of all your results, MRI, bloodtests..etc..etc.. it's good to have them for your records...for other Dr or other things. OK.. get a CD of your MRI as well.

take care and let us know how thing go
wobbly
dx

[Angie9798]

Thanks for all the great advice.

If I am in early stages, will no lesions show?  Like if they are too new or still too active?

This is all so new to me.  Symptoms started so weirdly.  FOr two weeks off and on tingles in one leg, then it just went on from there.  I developed all these other weird things.

So far, MS is the only thing that makes sense.  Not that I want it, I really just wish this would all just end.  Is there any way that it could be all missed on the MRI.  Also, doc still hasn't done lumbar.  I don't know why the MRI's are all being done seperately.

So, I guess 2 ??'s...if MS, is it to new to see since this is the first ever sign of my symptoms.  And...if MS how long will these unwanted symptoms stick around?

Thanks again.  So much of what you said helped!