7988864 tn?1396039334

MRI without contrast

maybe you can help me.
at first, I’am from France so excusez le mot my bad English.

Yesterday I had my first MRI. My neurologist wants to exclude ms. The tech told me that they probably would use contrast, but after 25 minutes he told me I was ready.

Strange or normal? Bad news or very good news? I assume it’s good news because they sure would do the T1 scan if there were lesions… wright?
Or is it the other way around - enough lesions on T2 so no contrast needed?
Best Answer
Avatar universal
There are times when lesions are not seen on MRI, though this is seldom, according to conventional thinking. It happens if they are simply too small, for one thing. Also it can happen when visualizing the spine, because spinal fluid gets in the way, or we insist on breathing or having our hearts beat.(Big smile here.) This movement can interfere with optimal results, though over time if there are lesions that should become more clear.

I also meant that MRIs in MS can see only white matter lesions. It is believed that MS involves lesions in the gray matter as well, but today's technology has not found a way to see these.

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5112396 tn?1378017983
Do you have an appointment with your neurologist soon to discuss the results? An MRI without contrast can still tell your doctor a lot of information, it just won't tell them if any of the lesions are currently active.

I would try not to guess if your experience means something good or bad. It's very difficult to know why certain things happen during tests, but I certainly understand your concern!

Hopefully you can see your doctor soon and they can explain your experience and your results. It might be a good idea to write down these questions so you remember them when you see your neurologist.

And your English is perfect!
Helpful - 0
7988864 tn?1396039334
thks for your answer!
I will visit my neurologist the 9th of this month.
So hopefully, within one week i'll know what's going on.

Let you know!

again, thanks!!!!

Helpful - 0
Avatar universal
Hi there. I wouldn't worry at this point about whether or not contrast was used. What's more important is the actual imaging. This includes the strength of the MRI magnet, ideally 3Tesla but at least 1.5, and the imaging techniques. The 'MS protocol' calls for slices, meaning increasing depth of images, at 3mm, and other requirements. If your scans were done this way, the likelihood of finding MS lesions, especially in the brain, is very high.

This does not mean there are no lesions, but it does mean that MRI can't see them. Of course there are a great many other factors at work, and other tests. None are diagnostic for MS, but the more evidence they turn up the more likely it will be. I think that perhaps most important of all is a thorough neurological examination, which takes a good while. If the doctor finds abnormalities in this, he or she needs to determine what might be causing them. There are other conditions besides MS to account for these, so the 'big picture' is needed for a diagnosis.

Good luck.

Helpful - 0
7988864 tn?1396039334
Thanks Ess,

What do you mean by "This does not mean there are no lesions, but it does mean that MRI can't see them" ?

In our hospital they have a MRI 3 Tesla (2011), so no worries about the quality i believe!

The one and only thing i can do is relax and forget dr. Google...

Helpful - 0
1831849 tn?1383228392
Hi PG -

A little more info for you to digest :-) 3T MRI's are the best. Even with 3T, spinal lesions can be difficult to see. So it is possible to have lesions that do not show up on an MRI.

As to contrast or no contrast, all visible lesions will appear on an MRI done without contrast. If contrast is added any lesions that are active, or have been active in the last 30 days, will "enhance". This means that they will light up. If you have some lesions that light up and others that do not it means you have had at least 2 episodes.

All of this MRI info should help understand how they are a part of an MS diagnosis, not the whole diagnosis. Let us know how you make out next week.

Helpful - 0
7988864 tn?1396039334
So, correct me if I am wrong. The ms dx CAN be given although they did not use contrast? (hmm, is this a normal English sentence?)

But if a tech sees lesions on a T2 scan, why shouldn't he use the gadolinium?

Patience is not my strongest virtue ;-(
Helpful - 0
Avatar universal
Hi there! I have only had one MRI so far and it was done without contrast, that, along with a lot of blood work and a spinal tap was enough for my diagnosis. I think I required the tap because my symptoms were not typical for MS.

Bonne chance avec le neurologue!
Helpful - 0
7988864 tn?1396039334
C'est très gentil à vous, Corrie, merci beaucoup!

Bonne nuit pour toi!
Helpful - 0
667078 tn?1316000935
1.The Telsa is the strength of the Magnet either 1, 1.5, 3.

2.MS protocol is the way they take the pictures how many slices in each segment.

3. Contrast dye whether they use it or not.

I had my first MRI 1 Telsa not MS Protocol with dye. They found MS anyways

Helpful - 0
382218 tn?1341181487
Bonjour! Just to further elaborate on Kyle's statement:

"If you have some lesions that light up and others that do not it means you have had at least 2 episodes."

The reason why that can be important is that one of the requirements for a diagnosis of MS is 'dissemination in time.' This means that there has been more than one episode of symptoms. So if some lesions light up, they are new/active, and if others do not light up, they are older/inactive = fulfilling the dissemination in time criterion.

The other criterion is dissemination in space. This is fulfilled when the MRI shows lesions in at least two different parts of the central nervous system, eg: brain stem and cervical cord.

I hope your appointment is informative and provides you with the answers to your questions.

ps: I am in love with your city! and your country! I'm envious of you. :)
Helpful - 0
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