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MRI WITHOUT contrast and MS
Hello all,
I just wanted to tell you guys and ladies ( all of whom have OFFICIALLY) been diagnosed how strong you guys are and how great you are for taking the time to answer other limbo'ers questions.
First off, I've had symptoms - weakness, tingling, numbness in all my limbs. I've had blurry and double vision and experienced dizziness for the past 8 months that comes and goes.
I've been tested for everything else under the sun (B12, B6, Lyme, RA, Lupus, anything with ANA, Sed Rate, thyroid, RA, polio, etc)
I've had an MRI of the brain WITHOUT contrast done on a Tesla 3 machine done a week ago and the results came back normal.
Do I need to have contrast for them to be able to distinguish MS lesion?
What if my MS lesions healed and disapeared and nothing showed up?
Is it too early to do an MRI on the brain or do I need to have symptoms for a certain number of years before they show up on the MRI?
Any opinion, answer, concern, comment would be greatly appreciated.
Thank you for your time.
Anna
I just wanted to tell you guys and ladies ( all of whom have OFFICIALLY) been diagnosed how strong you guys are and how great you are for taking the time to answer other limbo'ers questions.
First off, I've had symptoms - weakness, tingling, numbness in all my limbs. I've had blurry and double vision and experienced dizziness for the past 8 months that comes and goes.
I've been tested for everything else under the sun (B12, B6, Lyme, RA, Lupus, anything with ANA, Sed Rate, thyroid, RA, polio, etc)
I've had an MRI of the brain WITHOUT contrast done on a Tesla 3 machine done a week ago and the results came back normal.
Do I need to have contrast for them to be able to distinguish MS lesion?
What if my MS lesions healed and disapeared and nothing showed up?
Is it too early to do an MRI on the brain or do I need to have symptoms for a certain number of years before they show up on the MRI?
Any opinion, answer, concern, comment would be greatly appreciated.
Thank you for your time.
Anna
COMMUNITY LEADER
Hi and welcome to our little MS community,
I noticed you've also had a spinal MRI that was also normal, so that changes some of what tests I was going to suggest you consider, although you've mentioned you "had blurry and double vision", so getting your vision tested by an ophthalmologist would probably be a good idea.
MS actually has numerous mimics, which are generally much more common than MS. Some clinical sx's are more 'suggestive' (unilateral, nystagmus, Optic Neuritis, diplopia, clonus, patches of numbness etc) and other's are too generic or un-typical (symetrical, bilateral, spreading, presenting in both upper and lower motor tracks, accumulating sx's rapidly, all peripherals etc) and they are more likely due to one of the mimics.
Q:Do I need to have contrast for them to be able to distinguish MS lesion?
A:Contrast basically highlights or makes new and still demyelinating lesions stand out from the older no longer demyelinating lesions. There is a window of approx 30 days from when the attack starts and the lesions are still able to light up, having both new and old lesions would indicate 2+ attacks.
Q:What if my MS lesions healed and disapeared and nothing showed up?
A:It is possible for MS lesions to disappear but i doubt 'all' would and considering your sx's are multiple, there would need to be more than 1 to have disappeared for that to have possibly happened.
Q:Is it too early to do an MRI on the brain or do I need to have symptoms for a certain number of years before they show up on the MRI?
A:Possible, though not very likely for it to take years, for the lesions to show up on an MRI. What is more likely is that a person's clinical signs of lesion damage, shows up before they are detected by the MRI, which could be due to MRI strength, slices between etc. Its more common for someone to have their MS present as their first attack, because they have clinical sx's suggestive of MS and their MRI does find lesions, though not necessarily specific or enough for dx yet.
For what its worth, the only sx's you've mentioned that I would consider is more consistent to MS is your visual issues (blurred and double), the others (weakness, tingling, numbness in all my limbs) are more typically red flags that its not likely to be MS, because its 'presented' symmetrically in all peripherals, which is very uncommon due to how MS works. I'm thinking if you have no MRI evidence on a 3T, coupled with your sx pattern of being all peripherals, then MS is less likely than more but getting your vision assessed may really help work out what's going on.
Cheers.........JJ
I noticed you've also had a spinal MRI that was also normal, so that changes some of what tests I was going to suggest you consider, although you've mentioned you "had blurry and double vision", so getting your vision tested by an ophthalmologist would probably be a good idea.
MS actually has numerous mimics, which are generally much more common than MS. Some clinical sx's are more 'suggestive' (unilateral, nystagmus, Optic Neuritis, diplopia, clonus, patches of numbness etc) and other's are too generic or un-typical (symetrical, bilateral, spreading, presenting in both upper and lower motor tracks, accumulating sx's rapidly, all peripherals etc) and they are more likely due to one of the mimics.
Q:Do I need to have contrast for them to be able to distinguish MS lesion?
A:Contrast basically highlights or makes new and still demyelinating lesions stand out from the older no longer demyelinating lesions. There is a window of approx 30 days from when the attack starts and the lesions are still able to light up, having both new and old lesions would indicate 2+ attacks.
Q:What if my MS lesions healed and disapeared and nothing showed up?
A:It is possible for MS lesions to disappear but i doubt 'all' would and considering your sx's are multiple, there would need to be more than 1 to have disappeared for that to have possibly happened.
Q:Is it too early to do an MRI on the brain or do I need to have symptoms for a certain number of years before they show up on the MRI?
A:Possible, though not very likely for it to take years, for the lesions to show up on an MRI. What is more likely is that a person's clinical signs of lesion damage, shows up before they are detected by the MRI, which could be due to MRI strength, slices between etc. Its more common for someone to have their MS present as their first attack, because they have clinical sx's suggestive of MS and their MRI does find lesions, though not necessarily specific or enough for dx yet.
For what its worth, the only sx's you've mentioned that I would consider is more consistent to MS is your visual issues (blurred and double), the others (weakness, tingling, numbness in all my limbs) are more typically red flags that its not likely to be MS, because its 'presented' symmetrically in all peripherals, which is very uncommon due to how MS works. I'm thinking if you have no MRI evidence on a 3T, coupled with your sx pattern of being all peripherals, then MS is less likely than more but getting your vision assessed may really help work out what's going on.
Cheers.........JJ
Are you being followed by a Neurologist? Normally they follow you over time if they see anything Neurological. Like every six months. More important the MRIs are the Neurological exams, reflexes, following a finger, etc. They can tell if and where you have Neurological damage from that.
Not only is contrast important but MRIs done with MS protocol are important. That determines the "Slices". More slices finds more lesions. I have had all my MRIs on 1.5 Tesla machines with contrast and MS protocal.
Insurance companies do not like to pay for spinal MRIs unless the Neurologist has evidence you may have spinal lesions. I was diagnosed in 2009 and I had my first spinal MRIs this year. I did have spinal lesions which were old, they did not light up with contrast.
I was followed by Neurologists for two years before I was diagnosed. I had MS lesions on my first MRI in 2007. I had five MRIs all with MS lesions. I finally had a positive Lumbar Puncture so I was diagnosed with MS.
Neurologist time is slow. Until I came on the forum and found this was the norm I thought these Neurologists were nuts. I made myself crazy worrying about whether I had MS, of Lymes, or Lupus.
I decided the Doctors were nuts and there was nothing wrong with me at all. I was about to go on and live my life when the Doctor finally said I had MS. I did not understand how he could say no its not MS and looking at the same tests say yes I sure its MS. Basically it was MS when he said it was MS.
Alex
Not only is contrast important but MRIs done with MS protocol are important. That determines the "Slices". More slices finds more lesions. I have had all my MRIs on 1.5 Tesla machines with contrast and MS protocal.
Insurance companies do not like to pay for spinal MRIs unless the Neurologist has evidence you may have spinal lesions. I was diagnosed in 2009 and I had my first spinal MRIs this year. I did have spinal lesions which were old, they did not light up with contrast.
I was followed by Neurologists for two years before I was diagnosed. I had MS lesions on my first MRI in 2007. I had five MRIs all with MS lesions. I finally had a positive Lumbar Puncture so I was diagnosed with MS.
Neurologist time is slow. Until I came on the forum and found this was the norm I thought these Neurologists were nuts. I made myself crazy worrying about whether I had MS, of Lymes, or Lupus.
I decided the Doctors were nuts and there was nothing wrong with me at all. I was about to go on and live my life when the Doctor finally said I had MS. I did not understand how he could say no its not MS and looking at the same tests say yes I sure its MS. Basically it was MS when he said it was MS.
Alex
Hello Anna and welcome to the forum.
Firstly, you don't need contrast to distinguish an MS lesion. All the contrast does is distinguish between active and non active lesions.
If your lesions have healed and disappeared, you would be left with 'black holes' on your MRI which eventually result in a decrease in brain volume that can usually be seen on MRI.
I don't know how long lesions need to be 'present' before they are seen on MRI but if you've been having symptoms for eight months and it's MS, lesions should show up.
Some of the symptoms you mention would originate from spinal lesions in a person with MS so it could be worth your while looking into whether you can get a spinal MRI.
Lastly, have you actually seen the results yourself? My first MRI was reported as 'normal' yet it had numerous lesions on it that were put down to small vessel ischaemic change because a suspicion of MS wasn't the primary reason for the MRI. Therefore the radiologist couldn't put MS in the differential dx.
Hope this helps you.
Best wishes
Poppy
Firstly, you don't need contrast to distinguish an MS lesion. All the contrast does is distinguish between active and non active lesions.
If your lesions have healed and disappeared, you would be left with 'black holes' on your MRI which eventually result in a decrease in brain volume that can usually be seen on MRI.
I don't know how long lesions need to be 'present' before they are seen on MRI but if you've been having symptoms for eight months and it's MS, lesions should show up.
Some of the symptoms you mention would originate from spinal lesions in a person with MS so it could be worth your while looking into whether you can get a spinal MRI.
Lastly, have you actually seen the results yourself? My first MRI was reported as 'normal' yet it had numerous lesions on it that were put down to small vessel ischaemic change because a suspicion of MS wasn't the primary reason for the MRI. Therefore the radiologist couldn't put MS in the differential dx.
Hope this helps you.
Best wishes
Poppy
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