MRI with vs without contrast dye

[Momto2js]

Will lesions always show up with contrast dye?  My neurologist was convinced I had MS several months ago.  We have done several MRIs where white spots have shown up, but they do not seem to be there with the contrast.  He goes through things so fast I am not even sure what he is showing me.

[Hmalexa1]

Thanks for your reply. I am new to this forum and was not sure how to find if someone replied to me. So, is this common for white spots not to show up with contrast but show up without contrast? I am 27, but I have been having issues since I came down with Mono when I was 16. I have baffled doctors ever since, so I really just gave up on getting help, but 6 months ago, I gave birth to a baby boy and since then, my symptoms have become much worse and there are new symptoms that are quite scary so I decided to ask a general practicioner about the new symptoms and here I am with my two MRI's one week later. The general practiioner acted very surprised that the spots did not show up on the dye, but like you said, he was still on top of things. If no lesions showed up, does that mean I am not currently in a "flare up" because I very much feel like I am. The neuropathy (that is what they are calling it) is really scarring us a lot.

[kwarendorf]

Hi H - Welcome to our little group.

The contrast agent will cause lesions that are actively inflamed to "light-up". It's sort of like all squares are rectangles, but not all rectangles are squares :-)

All lesions will appear before the contrast agent is administered, regardless of the current level of activity. When the contrast is added, those lesions that are currently active will brighten greatly. The rest of the older, inactive lesions, will still appear, just not all lit up.

It's great that your Doc is cutting right to the chase and sending you to an MS specialist!

Kyle

[Hmalexa1]

Memory problems, constant UTI's, headaches, fatigue is terrible, and I have always exercised but lately it makes me very sick.

[Hmalexa1]

I had an MRI that showed white spots. The next day I had the same part of the MRI done without contrast (Signal) and then with contrast. The doctor said the spots showed up again but not when they put the dye. He is referring me to a Neurologist who specializes in MS. My symptoms are burning, tingling, in left foot, right hand and left side of face. feels like glass is in my heel sometimessometimes

[Momto2js]

Thank you both very much.  I guess I have to wait it out and see what comes up next year.  It is just frustrating to feel like this and have nothing come up as new.

[johnniebear]

its just like debgen said,  all lesions will show up on the MRI, active lesions are 30-40 old.  Its just a piece of the puzzle for Neuro

             this is from our health pages

and the link
http://www.medhelp.org/health_pages/Multiple-Sclerosis/How-MRIs-Show-Lesions-in-MS/show/23?cid=36


The Need For Contrast

For the most part all visible lesions can be seen without contrast.  They show up as T2 Hyperintensities just like all lesions.  The problem is that the neurologist can't tell if a lesion is old or new.  So new activity will be missed and the MRI may be erroneously dismissed as "unchanged" or "no progression."  In the inflammation of new lesions there is a breach in the blood-brain barrier. Wherever there is a break in the blood-brain barrier, the contrast will leak into the brain tissue and the areas will "highlight" or "enhance." They show up as even brighter than the brain around them and brighter than an old, scarred lesion. So new lesions will appear as "enhancing," or "active." Also, older hyperintense lesions that have undergone a new attack at their adges or margins

take care
JB

[debgen]

It was explained to me that an MRI shows all lesions but the lesions shown with the contrast  dye are active lesions.

Deb