Increased FLAIR activity vs. contrast enhancing lesions?

[Audrey_M]

Can someone please explaing what these terms mean and how they relate to MS symptoms?

Can one be in an active stage of RRMS without contrast enhancing lesions appearing on an MRI? Increased FLAIR signal intensity picks up at least 10 lesions scattered in various parts of white matter in two separate MRI's while I am experiencing moderate to severe symptoms, but there are no contrasting lesions.

I've read your informative posts, but cannot find a clear answer to this question.

[slightlybroken]

From what I've read, and this is my understanding of the matter (hopefully I'm correct), you can be in an active stage of RRMS without enhancing lesions. The window for the lesions to enhance is so very short (only weeks). Some people, from my understanding as well, can go years and years with being in an active stage of RRMS, and the radiologist has never been able to catch one single enhancing lesion. This doesn't mean that they aren't in an active stage, it just means the window of opportunity to catch that lesion in the enhancing stage, has past.

I hope others chime in (Quix) on the subject..I think I remember her discussing this matter before.

[supermum_ms]

bump

[Audrey_M]

First, let me apologize in advance for any typos. My written language skills are going down the tubes.

In any event, I found an absolutely great scientific publication that one can download which can help tremendously in terms of understanding scan images and results, as well as their implications. It is very long (184 pages), but if you're one to take charge of your own health, this can be a very useful document. LuLu and Quix, I'd appreciate it if you'd take a look at it and correct any mistatements that I might make.

The link is:

http://www.scribd.com/doc/8817608/MRI-Atlas-of-MS-Lesions

In terms of my original question re: increased FLAIR activity vs. enhancing lesions, my understanding of what I read in this publication is that new lesions will enhance under contrast, usually for a 2 to 6 week period. A small percentage will enhance for 3 to 4 months and rarely will a new lesion enhance for 6 months. Prior to reading this, it was my understanding that old lesions would enhance when MS was active.

One other thing I found interesting is that there is discussion about the size of MS lesions, something that pops up frequently on this forum. According to the authors, MS lesions are usually smal, but diameters can vary from a few mm to several cm.

There are loads of images in this download, which makes it really helpful in terms of looking at one's slides for comparison and understanding. In addition, they do help to explain different terms, so that you can decipher a very technical radiologist report or fill in the blanks of a vague one.

Let me know what you think!