Does no need for GAD mean no lesions

[mandyd82]

HI everyone,
I am a 32 year old female who has just had an MRI to check for MS lesions. My doctor put on my notes "GAD if needed." When I went for my MRI the technician said that I may need the dye, but the doctor will come in and look at a couple of scans and let them know. It turns out I didn't need the dye, so I was wondering if this means my scans were clear of any lesions? I assume they only need the dye to get a better look at any lesions they see. I don't go back to my doctor for two weeks, so it is curious if it means i am all clear.

[kwarendorf]

All lesions will appear without contrast. Contrast will distinguish new/active lesions from lder/inactive ones. If I didn't see any lesions without contrast, I would be disinclined to order an MRI with contrast.

But I'm not a doctor...

Kyle

[mandyd82]

Hi thanks everyone much appreciated.
Yeah the Radiography place here sends your letter/images straight to the doctor on an online system, so you don't get to see them.

You are right 'supermum_ms' there is no point speculating.  I think I just got my hopes up that everything was fine because my doctor said GAD if needed and the radiologist didn't think it was needed. However, my legs were spasming  all through the scan (I was a bit nervous) so they were having trouble getting clear images etc, so who knows. Anyway as you said 2 weeks isn't long to wait, so I will just suck it up and see what happens. Thanks again :)

[HVAC]

Welcome. I would wait to see what the doctor says. I have tried to figure out reports but it matters how the doctor interprets it.

Alex

[Corriel]

Hi, where I live I can't get a disc but I can get a copy of the report and my neuro typically scolls through the images of the scans during my appointment with him.

As for GAD, I think the ladies have responded with the pertinent info. I was personally intrigued at the answers because I recently underwent an MRI to determine if I was having a relapse and my neuro said no GAD. He did indicate something on the request about using limited T2 and FLAIR sequence to determine if there were any new lesions.

So many things to learn and understand.

BTW, welcome to our little corner of the Web.  :)

Corrie

[supermum_ms]

Hello fellow Ozzie and welcome to our little MS community,

There isn't really anything beneficial for you to be speculating, on the various reasons why your neuro chose not to run the GAD,  um at best it's just a guess......

Keep in mind that to diagnose MS the MRI is only one piece of evidence, symptoms are often less informative or not as suggestive of MS, as your abnormal clinical signs of it being neurological. It is very possible your MRI didn't have any lesions and it would make sense to not run the GAD if there wasn't any lesions but it's also possible your MRI was indicating something else that can mimic MS eg Chari.

Strangely unlike other countries, some neuro's in OZ don't think GAD is relevant or significant to diagnose MS,  eg only if there's a lesion in the Corpus Callosum (CC) can it be MS, so if there isn't a CC lesion then it can't be MS, that's not actually correct but another possibility. lol i can think of a few others :D

To get a copy of your MRI, often depends on where you got your MRI done, some (Aust) hospitals or clinics will only send it to your neuro, others will give you a copy if you have your neuro's consent and other's just require you to fill out a form. I know it may seem like a long time but 2 weeks is not very long to wait in neurology and it is often better to wait for your neurologist's opinion.....

Cheers...........JJ

[mandyd82]

Thanks so much everyone! Much appreciated.

[essdipity]

Also, in the US we are entitled to have a copy of the actual MRI on disk, as well as the report from the radiologist, as soon as they are ready. I don't know whether or not you can have these, but it wouldn't hurt to try. Call the center where the test was performed, and ask.

If you get these things, do not try to 'read' your own MRI images, as this is best done by a very skilled expert, but of course look at it, and take it along when you next see the doctor. The written report might be easier to understand, even with its own vocabulary. The 'impression' section will list what the radiologist saw and his or her ideas of what that might be. Most of this will mean some variations on normal.

It does sound as if on the non-GAD pass, nothing 'interesting' was seen, but still you need the disk, the report and a thorough talk with your doctor to cover all the bases.

Good luck, and let us know how  things go.

ess

[immisceo]

Gadolinium (GAD) is an element used as a contrast agent in MRIs purely to help indicate the age of lesions and the level of current disease activity. Put in simplest terms, active inflammation and lesions roughly 40 days old or 'younger' will light up during certain sequences of the MRI.

However, even without using GAD, the same lesions will be seen. In other words, with or without GAD, a radiologist can see the lesions that appear with the given parameters of the MRI. The use of GAD is most important when determining the effectiveness of a current medical treatment or the level of current disease activity.

It is also important in the early stages of a diagnostic work-up due to the way the MacDonald Criteria is set up. For example, if you have lesions that enhance in your first MRI and different lesions that enhance in an MRI six months later, you have "dissemination in space and time" and can start treatment and nail down a diagnosis. This is just an example of its usefulness.

We can't state what your doctor saw that caused them to opt for no contrast, but if you find that the two week wait is difficult, it can't hurt to ring their office and see if you can't dig up a few more details.