How many MRI and CT Scans are too many?

[Udkas]

Hi Guys,
I have suffered from numbness/weakness and sensory issues, bladder issues etc. for a long time now without any medical test every confirming a diagnosis, for me this is so frustrating.

Along my diagnostic journey I have undergone a myriad of tests, including 3 CT scans, 7 MRI scans, about to undergo number 8, lumbar punctures, nerve conduction studies and the normal blood tests.  So far not one diagnostic test has indicated anything that would even remotely suggest MS, although my pattern of symptoms and they way that they have presented to me is almost text book MS, and this was also told to me by first neurologist, who did tell me he was certain I had MS, until my testing failed to confirm it and subsequent testing down the track failed to confirm.

I now have a new neurologist who "believes" I have had an episode of Transverse Myelitis, but from my reading TM usually only occurs once, but can occur again, but is rare, I am showing two separate areas of damage, all drs agree on that, I also give an abnormal examination, hyper reflexia, clear sensory line, positive babinskis, clonus fail figure nose test etc. but again repeated MRI on T3 machines fail to show any sign of anything to explain my symptoms.  Current neuro still sticks by his diagnosis that I have had an episode of TM, that the lesion/s are there but just not visible to technology.  I want proof, I never wanted to get worse, but I feel like such a "drama queen", or hypercondriac. for having symptoms and problems that are not visible but however do affect my life and how I function etc.

Well I had a bad fall 8mths ago, got tossed off a horse, I was unable to do much for weeks and weeks, but never had a scan because my Dr was concerned about the radiation in CT scans and I was not aware that MRI was accessible to me from a GP, I have been going to a physio for my back pain and she found when she pressed on L5 it sent my leg numb, (i think she called it immobilisation) now she pushed for me to go back to my GP and get my back re looked at, so I did and he said he didn't want me to have a CT scan as I have had too many!! Gulp, then he told me about the 3 times radiation bit, why was I not told this before!!!  So I am having a lumbar and sacral spine MRI.

So everything i read on MRI is that it is thought to be safe?  Is it safe, I have had a lot done?  It has been 2 years since I have had my thoracic and Cervical done and 8mths since I had my brain done.  Hmm and I still wonder if the sensory issues i am getting in my back and butt are legs are prob tied up with my ???? mystery disease.  This one is not to check for MS or Transverse Myelitis, it is to check my back complaint so it will be lumbar and sacral only.  I am thinking it will show nothing "as usual" and so therefore I am tempted not to go, I get myself so hyped before I have a test, then deflated when the results fail to show anything for my spasms, numbness etc. etc.
Ok, sorry for the ramble.

So are MRI safe? Especially when I have had so many?
Have i really made my cancer risk high from having so many CT scans?
Everything I have ever had done has always been related to my nerve pain/TM/MS??
Does anyone know if Transverse Myelitis can occur in the lumbar spine, I have been trying so hard to find out about that but my friend google is not being helpful.

SOrry I am venting my frustrations too.

Cheers,
Udkas.

[HVAC]

It is all risk benefit. In they old days they would have to cutyou open and do exploritory surgery which has risks. That is what they used to do for my Cancer is surgery after surgery it left a lot of scar tissue. I worry more about my kidneys with all the contrast. The main thing is to wash the contrast dyes out with lots of water. I drink a gallon after a Scan or a MRI.  I have a CT Scan every 8 weeks but I already have Cancer. I have had 8 MRIs and too many CT's to count.

Alex

[mr68gto]

No one knows for sure how much radiation is too much. They base the risk of getting cancer from radiation on the Hiroshima/Nagasaki bomb victims and how much they took - then how many got cancer years later. But they took all their radiation in one big shot.

I have seen where some 'experts' say 75mSv of radiation is the upper limit of safety. Other's have said 100mSv.  Atomic power workers are limited to 20mSv per year or in emergency 50mSv in a given year but no more than 100mSv over 5 years.  Others even say 100mSV should be the lifetime limit.  Still other experts think that some radiation is good for you as it promotes the bodies ability to heal itself.   There are places on earth that will give you 20mSv of background radiation per year (places in Iran and South America) and none of those people have shown ill affects over their lifetimes.

An Abdominal/Pelvic CT will give the average person around 14 mSv of radiation just for comparison.  I have had 100mSv of radiation based on 6 abdominal/Pelvic CTs, Flouroscopies, IVPs and other radiation.  So I'm up there.

[DC38]

Any advice on haning and mri w/wp dye or a ct scan w/wo dye for abdomen and pelvis for hemateria?

Thanks I have done nothing yet and the uro wants a scan and did no cystoscope procedure or ultrasound.

Meanwhild a nuro wants aan mri of the spine is that too many if I need both now?

[Udkas]

Thanks everyone for their replies, today they seem to mean so much more, as I am so confused and fed up!!

To Bob, thanks for making me understand that a little more, now I am even more undecided if to go or not to go!  Mind you a month ago when I was on holiday (it was hot) I had nothing but trouble every single day was horrible, but that was my "other stuff" but my back goes numb as soon as I carry some groceries to the car in a couple of bags, the physio was keen for it be imaged and I think the GP was if it was getting worse. Hmm.

I know Kelly if my MRI shows the cord or something pressing on a nerve it won't give all my answers as my physical examination to date has always showed that my problems are upper motor not lower.  

Thanks Laura for always being so supportive, wish you could be my neuro, I am afraid to go and get another opinion for fear that I will get someone who just tells me I am insane..at least TM is a diagnosis and my neuro does listen and seem like he cares, which is important to me right now.

I will keep you posted, very undecided if to go, so Bob this is MRI number 8, on a T3, at least I know now why they want to know how much you weigh. Thanks for that very factual answer.

Cheers,
Udkas.

[MonkeyMom4]

Hey there,

Thanks for the post on my last question/rant. I understand what you are going through. As for how many CT scans is too much, I'm not one to say.

I recently had an MRI (yes, the recognized me there too) of the thoracic and lumbar.  Thoracic looked fine and they did find some issues with the lower spine! GREAT I thought...FINALLY something, ANYTHING!! LOL.

I have a fracture in the L5, mild loss of disc height, and quite a bit of swelling.

My neuro referred me onto a pain specialist and I have since done two rounds of injections in the lower back, which did nothing to help, and they are also having me do some aqua therapy which helps for about a day or two.

I thought I had the answer to my lower leg weakness and numbness but sadly no.

As usual I end up with more questions than answers.

Hope you get some answers with your next MRI.

Take care.

-Kelly

[COBOB]

There is a risk associated with the nonionizing radiation from MRI, especially with 3T an 7T units.  The FDA has established limits  for exposure to MRI electromagnetic radiation that causes heating of human tissues.  Last I knew, the limit was 4 Watts per Kilogram total body mass in the US.  That is why they ask you how much you weigh before an MRI.  

To get within these limits, 3T and 7T units uses "gradient echo" (less than 90 degree flips) sequences where 3.5T and smaller units can use "spin echo" (90 degree molecule flips) sequences. This is one of the reasons 3T units only improve the image quality by 30%-60% for twice the energy.

It is not like like x-rays ionizing radiation, but this is very similar to the cell phone "brain cancer" and power line debates that have been in the press.  There is a lack of research on excessive and repeated exposure to high power electrical & magnetic fields (in physics, these are refereed to as "V cross B fields." .  

Yes, it seems MRI is safer, but it is not risk free.  It still requires a prescription and the doctor should weigh the diagnostic value of the study over the potential risks.

Bob

[Lulu54]

Not everyone has lesions show on the MRI, as you already know.  I am so sorry you have yet to find a neuro who will use his/her brain, look at your clinical signs and understand that the whole picture is there.  That's just my opinion, and I'm not expert as you know.

Go for this next MRI - there is no damage from repeated MRI's.  CT scans are a different story and you should be limited on the number of exposures you have n the CT scanner over your lifetime.

They shoudn't use contrast with have they are looking for in the lumbar and sacral spine - I hope they find what's causing your pain.

keep us posted, ok?

Lulu

[Udkas]

This is neuro number 2,
first neuro said MS had me in hospital for a week with IV steriods, when MRI failed to show it he said I could not rule it out, but it was a wait and see, when subsequent MRI did not show he told me he thought it was neurological but didn't know what, he sent me to another senior neuro and she said similar, but was left with no real answers.
So went to current neuro for second opinion and am where I am now, but what more can they do?  My tests are all normal, my examination isn't.  My eye specialist also thinks I have had ON as i have palor in discs and abnormal VEP. Hmmm  Fruit knows!!! I am over it all. Sorry I am feeling depressed today!! Must be the dog, my bro, everything..  SOrry.

[Udkas]

Thanks Alex,

You really have made my day, made me cry but made my day, I must be feeling extra emotional,  I am lucky, I can walk, I can function, I have a brother who has just been diagnosed with lung cancer and another one who is an incomplete quadriplegic, I am lucky and I am grateful, but I just wish I had an answer.

Thanks for understanding, I am not sure that many people would understand, but when you know you have all these things that effect you and what you can do of cause you want an answer.  Hope your doggy friends are well, our dog has lymphoma too, so it's a bit sad around home at the moment. sorry more whining,  I need to cry, I find having MRI so stressful, wanting an answer for something. Not that I want a bad back. I live in a very small community and the MRI tech's remember me, this makes it worse, it's  "oh you again"
You feel like a money and time waster, i think this is what is getting to me the most!!!

[Guitar_grrrl]

Udkas, you've been through the wringer!

MRIs are much safer than CT scans, and give much more info regarding lesions, black holes, etc.  Alex is right about the contrast, though.  I agree with drinking lots of water afterwards.

I'd find another neuro, too, FWIW.

[HVAC]

CT's can be bad for radiation. I do not know how many is too many. As far as MRIs the only issue I know of is if you have kidney disease the contrast is not good. I do drink over a gallon of water after contrast to flush my kidneys just to be safe.

You really have had a tough time. I sure wish they could find an answer.

Alex