MRI of the spine

[wildcolonialboy]

To what degree does an MRI of the spine show evidence of MS?

[rubensmom42]

My neurologist is saying that I do not have MS because my spine MRI was negative for lesions.  My spinal fluid has restriction bands, I have periodic vision problems (a dark grey blob in my visual field), my EMG was abnormal (only checked legs), the EEG was abnormal ("slow brain").  I fall a lot, my tolerance to heat is zero.  The neuro said I definitely had peripheral neuropothy and foot drop (only right foot), but without lesions in my spine, I could not have MS.  Is this true?

[lilfoot1]

have had bad leg spasms for almost 3 years mostly at night but started sometimes during the day, sometimes hands and arms go to sleep. FINALLY my Dr sent me for a c scan, they found abnormal amounts of white lesions on right side of brain. Been waiting 9 months to get mri of spine. Any advice would help  SCARED...Bev

[maggs970]

hi just reading your post, i was diagnosed with rr ms in jult this year in march i had 1 leision at c2 area and then in july i had another few show up c3/4 and t11 no lesions on brain mri this was done with contrast on a 1.5 machine hope this helps you maggs.

[LATW]

Guess while I am talking about this I should mention I was diagnosed with an area of "acute demyelination" in the frontal lobe of white matter and one old area of demyelination.

But I had nothing in the "typical" Ms areas and a clean C-spine.

Optic Neuritis, the abnormal MRI, and abnormal neuro exam confirmed my dx of MS.  

The whole MRI lesion issue frustrates me because it causes me to doubt my dx.  

Which is ridiculous.  I have bilateral babinski sign, romberg sign, ON, foot drop, loss of sensitivity on my right side, bowel and bladder problems, and other issues.  

[jensequitur]

It depends on where the lesion is.  Lesions in the brain, especially if they're in a non-typical spot, might be discounted.  But a lesion in the spine is more indicative.  Check out the McDonald criteria (in our health pages) for the details.

[LATW]

So if a lesion showed up on a t-1.5 then it is likely a t3 will show much more?

I had a MRI of my t-spine and the girl could not get all of the dye in because my vien went out and it was done on a 1.5. Not to mention the fact that I was in pain and could not stay still.  

My elbows were rubbing up against the side of that hard machine and it was painful.  

Nothing showed up.  

LA

[mamashell1002]

my son had a mri done and it showed one lesion on the cervical cord on the upper c3. his brain showed no abnormalities. the radiologists report states probable ms. can just one lesion be classified as ms. what more should i look for as far as tests to be done i am a wooried mom my son is just 19 and in college.

[jensequitur]

Hi, and welcome to the forum!  It does sound like a big lesion.  Was that the wording from the radiologist report, or was that from looking at the MRI?  We have a couple of people here who were diagnosed with 'benign' MS, but the consensus seems to be that 'benign' is only useful as a designation after death.  There's no way to tell how the disease will progress.

Feel free to post a new thread with your question, and more details on your diagnosis.  This will make it easier for other people to welcome you to the forum and help you with your question.

[gogreece]

Hi- I have been diagnosed with beign ms- on my mri cervical shows a brighter part from bottom of c-2 thru c-6 - I am q. the ms dx- on a chat room I was told that was very big for a ms lesion- but could that be from an injury?
thanks
Suzy

[Quixotic1]

I popped on with that clarification, but didn't answer your question.  Most people, but not all, with MS will have lesions in their brainstem and/or spinal cord.  Some just have brain lesions and some just have spinal lesions (unusual).

The problem is that the spinal cord is difficult to image.  My own neuro, who I respect enormously, believes that in general the spine MRI done on 1.5T MRI machines are pretty much worthless.  His esperience seems to have been that many people have a "negative" spine MRI, but when he repeats it on a higher power machine (the 3Telsa) he suddenly finds all sorts of lesions.  

The 3T machines are newer are very scarce in many parts of the country.  Here in Portland, OR there are 3!  My own case, which may have been part of his opinion, is that I had a history suggestive for MS, but atypical because I haven't had clear attacks with remission.  I had a negative spine MRI on a new 1.5T machine, then 6 weeks later had SIX (6) lesions on the 3T unit.  So, I'm on his side with the mistrust of just how good people's spine MRI's are at showing lesions.

When lesions do show up on the spine it points strongly toward MS, because their are many fewer disorders that cause lesions in the spinal cord, than there are that cause lesions in the brain.

It is also important to distinguish between the MRIs of the spine which are often done of the bones of the spine, looking for arthritis, injuries, bulging discs etc. from MRIs of the spinal cord.  The latter is harder to get a good look at.

I hope this helps.  Quix, MD

[Quixotic1]

The spinal cord ends at T12, just before the lumbar spine, so there are no lesions below the thoracic level.  Sometimes a lesion will be seen at the very bottom of the spinal cord in the images taken of the lumbar spine, but it's just because the tech's caught the very bottom of the T-spine to be complete.  That's usually where the misconception comes in.

Quix

[jensequitur]

I thought that the spinal cord tapered off at the lumbar region?

[Heather3418]

When a physician is looking for evidence of MS, when they have seen lesions inthe brain and also having evidence of an abnormal physical neurological exam, he is more inclined to believe that MS is involved if lesions are seen in the spine.

I have heard of many doctor's that will diagnosis MS if they find lesions in the spine, along with their other findings.  Lesions in MS are usually found in the cervical and thoracic regions of the spine, although lesions below the thoracic spine are not unheard of, but less rare.

Heather