Quix?-Anyone? About seeing MS Lesions on Spine MRI's (m)..

[spankyandrex]

I had a brain MRI yesterday (still awaiting results).  But I had 2 lumbar MRI's and 1 cervical about 2.5 years ago to check for my back/neck problems.  Do you think the radiologist would have even LOOKED for MS lesions on these if he was only looking for indications of bulges or herniations causing pain.  And if he did see any lesions of any kind, would he mention them on the report?  (I have all of my reports - but no mention so was curious if he was even looking for them).  

I don't know if I'm making any sense or not LOL!  All MRI's came out with bulging/herniations/stenosis on cervical spine and facet aropathy throughout both spines.  In other words, Degenerative Disk Disease in every way.

What I'm wondering is if he went back to my MRI's a couple of years ago, if there might be lesions on them but were never mentioned?    Just curious I guess.

[que03]

Your old MRIs dont seem to have contrast, is this the case?  If so, lesions could have been there but missed without the contrast, I think.....Que  

[Quixotic1]

You probably won't see this as I am on Left Coast time, but you need the entire spinal cord to be imaged cervical and thoracic.

The "dura" is the tough membrane that lines the spinal canal and contains the thecal sac  which holds in the CSF fluid.   Ask the neuro to explain the significance of this to you.  If something just impinges (touches or pushes slightly) on the thecal sac, it is usually not symptomatic.  You need enough pressure to  push all the way and onto the spinal cord for overt symptoms from damage to the cord.

Let us know how today went.

Quix

[spankyandrex]

THANK YOU QUIX.  I do have all 3 reports from my MRI's.  None say "lesions", especially noting the cervical report.  This is what it says:

CERVICAL SPINE MRI (Feb 2005)

Slight loss of disk signals at C3-4, C4-5, C5-6 interspaces.

Very mild intradural impressions are seen at C4-5 and C5-6. - "A disk fragment may rupture through the thecal sac into the intradural compartment" My question: Doesn't this mean that I have disk fragments indenting the intradural compartments of these two vertebrae's?

Mild concentric disk bulging is evident at C4-5 and C5-6.

Mild/moderate bony foraminal stenosis on the left at C4-5 and C5-6. Direct neural impingement cannot be clearly confirmed.
Impression: Minimal discogenic degenerative changes are seen at C4-5 and C5-6 with no significant central stenosis. Mild or moderate bony left foraminal stenosis is seen at these levels.
END

I will however, (if diagnosed today....getting anxious for 2pm) - ask for MRI of cervical region once again. In fact, since I'm being referred to a neurologist, I will ask for one anyway.

Thanks.

[Quixotic1]

Hi, the radiologists are SUPPOSED to look at all of the structures that are visualized by the MRI.  And they are supposed to report all the abnormalities they identify.  The truth is - as in all human occupations - some radiologists are better and more thorough and some are careless and lazy (or dim-witted).

It is always (ALWAYS) a good idea to get copies of your MRIs, both the reports and the actual films or images on disc.  Read the reports yourself.  We have lots of people here who have been sandbagged by reports of lesions that were never conveyed to the patient.  Also, if you are going to a new neuro, it never hurts to offer them the old films.  Yes, sometimes lesions are seen for the first time in viewing them months/years later.

The only useful one for the purposes of MS that you had would be the cervical MRI.  The spinal cord does not extend down into the lumbar area.  It ends at about T-12, the last thoracic vertebra.  So there will never be MS lesions in the lumbar area.

Quix