MRI contrast and MS protocol

[nanadebby04]

I have read alot about MS Protocol for MRI's, is it right that gadolonium is only use on MRI of the brain, not used with MRI of C or T spine?  
With my last MRI's they used Magnevist, is that appropriate?

Other than the contrast and higher tesla for imaging anyother suggestions for the next MRI?

Thanks guys
Debbie

[jensequitur]

I've posted one link to the study, several months ago - it was quite interesting.

Unfortunately I'm unable to find the original link to the study, but here's a post from Lulu that talks about the same thing.

http://www.medhelp.org/posts/Multiple-Sclerosis/MRIs-and-gadolinium-contrast/show/1096679?personal_page_id=2546&post_id=post_5066039

"There was talk about the use of contrast agents in MRIs (gadolinium) and both neuros were emphatic that timing with the contrast is everything  .They talked about technicians rushing to finish the MRI's, but it is important to wait long enough for the gad to circulate and enhance active lesions.

When I asked how long that wait  should be, the answer was unanimous that it should be 10-15 minutes after the injection before the next series of images are taken."

Like you, ess, I have never had a technician wait for the gadolinium to circulate before the second set of MRIs were taken.  I have to wonder how much information they'd get if they just waited a little bit.  Heck, the last MRI I had, the tech had a hard time finding the vein.

[essdipity]

Jen, where did you learn that contrast dye needs 15 minutes to be effective? I've never heard that. All my MRIs have had w/wo contrast, but there was no time lapse.

In general, all MRIs where MS is suspected should be done both with and without contrast, of brain, cervical and thoracic spine. Spinal lesions can certainly enhance. Most lesions, however, will not enhance, regardless of where they are, because the window of opportunity is rather small.

ess

[sllowe]

Hi there - welcome!

To me, anything they can do to check for active lesions in both brain and spine is good -  considering they both make up our CNS.

Did you read up on the protocol from our health pages?

We've not met, so hello to you and see you around!
-shell

[Fluffysmom]

Debbie,

My last MRIs were on a 3T machine, with gadolinium.  Previously, I had them done on a 1.5, also with contrast, both times the brain and spine all together.  Nothing enhanced, and I don't know if that's simply because nothing was active, or that they administered that contrast and immediately began scanning.

I found that although I requested MS Protocol. not all of the series were done with 3 mm slices on the previous set.  Last time was at a different facility, and I asked ahead of time, to make sure that the 3 mm slices would be done, and was told that they don't recalibrate their machines there; all MRIs of the brain and spine were done with the smaller slices.  They also told me that the contrast spreads so quickly throughout the body that they don't need to wait.  I didn't argue, though I had read otherwise.

My new MS specialist was very disappointed by the quality of their spinal imaging.  The brain imaging was plenty clear to lead to my diagnosis and beginning of treatment.  When we do a follow-up, I know that this neurologist will make sure that they are done to give the best images possible. I've learned that the software used with the machine is as important as the strength, but that is something that your neurologist should know about when he sends you to an imaging facility.

If you know that your neurologist has your best interest at heart, then you don't need to discuss his MRI orders with him.  You might check at the imaging center to make sure that they have those orders correct, that they use the smaller, contiguous slices.

Kathy

[slightlybroken]

Hi,

When I've had MRI's of the spine, they have used contrast everytime. I guess it all depends on the doctors. I've read that spinal lesions don't enhance as well as brain lesions, so I guess some doctors might not order contrast for this reason, but I've had contrast ordered everytime I've had an MRI of the spine.

I looked up Magnevist and it seems (hopefully I'm right), that this is just the brand name for a contrast solution. It is a gadolinium-based contrast agent, so it would worked the same, if not be the same, so it was appropriate. It stated on it's website that it could pick up on lesions in the CNS system with regards to MS.

Take Care

[jensequitur]

I've heard two schools of thought on this.  Some say that gadolinium will not enhance lesions in the spine.  The other guys say yes, it will.  So personally I'd say better safe than sorry.  Always ask for gadolinium contrast from the MRI tech - if you can, check with the clinic before your MRI and make sure that you're scheduled for gadolinium.

With gadolinium, they should wait 15 minutes after administration before they begin the 2nd set of MRIs.  It takes a while to get into the bloodstream and work, and with the wait period, it can show a lot more.

Magnevist is a constrast agent used to make blood vessels and other non-bony structures to show up in your spine.  I've never heard of it being used for MS protocol, but others may be able to help with that.