3T MRI

[IUMOM2]

I've done some reading on the 3T MRI and I know they can pick up lesions that the older MRI's can't. However, I've also read (on another board) that there really isn't that much difference between the 3T and the older, less powerful unit.????

Quix I think I read that you had more lesions show up on the 3T. How did it come about that you had an MRI on the newer machine? Was it at your request, or your neuros?

I'm asking all of these questions because the MS Center I will be going to has a 3T MRI. It's been last December since I had any MRI's (I was having them every six months). I'm wondering if it would be worth having another set of MRI's done there.

I've always just had the four small lesions in the brain, and none in my spine. I have to wonder if there aren't some hiding there considering some of my symptoms.

Has anyone else had a 3T MRI that showed lesions that weren't picked up on the 1.5 machines?

Any opinions on the 3T machines?

Thanks a bunch!

[suspiciouscombo]

Scroll to Quix's post.

[suspiciouscombo]

Bumping this up for aspentoo :)

[kwarendorf]

Our favorite MD, Quix, stops in from time to time but is mostly away from the forum these days. I just didn't want folks to think she was ignoring them :-)

Kyle

[Buddhafull]

Thank you.

[Sonj27]

Hi,

Thank you for all the definitions of the MRI Report medical terms. It's like trying to read another language! My cousin has MS lesions but has had no major episodes or symptoms. Her mother had MS with two major episodes. Can you address something regarding having MS Lesions but not many or mild symptoms? Also what is the latest research on the chances of MS being inherited?
She now has "well-differentiated fibrillary astrocytoma" (WHO grade 2) tumor that was removed by surgery. She has had an MRI every two months and it has been difficult for doctors to make a definitive diagnosis/progress report/ treatment due to the presence of MS Lesions.
Thanks,
Sonj27

[Quixotic1]

Hi, I have a semi-informed opinion on the topic.  I came across a good back-to-back comparision of the 1.5T MRI versus the 3T MRI on MS patients with known multiple brain lesions without enhancement.  They did an MRI using the MS protocol of  thin slices.  The neuroradiologists reading the films were not told which machine they wer done on.  The 3T machine consistently picked up more lesions - on average 25% more.  

Now if you already have 8 lesions, and we know most brain lesions are not "eloquent", that is, they don't cause recognizable symtpoms, who cares if  there are 8 or 10?  In the vast majority of cases the increased number of lesions picked up does not affect the diagnosis, the treatment, or the prognosis.  So there isn't a huge rush to convert to the newer and more expensive machines.

However, I make a big deal of the issue here for the reason that several of us, including me, have languished without a diagnosis because of having "no" or "not enough" lesions on the MRI.  If you are in diagnostic limbo and everyting you are suffering from screams "Multiple Sclerosis", but the MRI is not diagnostic, you need every bit of increased sensitivity you can get.  Even several of our neuros have told us regretfully, "You might have lesions that are just too small to be seen."  WELL??

I again tell the same, old story  about this spring.  I had ZERO spinal lesions on a 1.5T machine in March. In April I developed a fairly severe L'Hermitte's sign (lighting zaps down my left leg when I fllexed my neck)  This is a common in MS, but non-specific sign of  cervical spine nerve lesions.  My neuro ordered a repeat MRI ofr the spine on the 3T MRI.  Suddenly there were SIX old (non-enhancing) lesions.

T-Lynn had no lesions, but classic disease for years.  Suddenly she had "brain atrophy".  Her first MRI sign was the accumulation of so many old, reabsorbed (and invisible) lesions, called "black holes", that when the brain tissue contracted around them the MRI showed loss of brain volume!  After this diagnosis they did an MRI on a 3T machine and she showed lesions thoughout the brain.

Granted it's only two cases, but it is two cases where the diagnosis was delayed and we were dismissed b y the neuro's as being crocks.  In the faced of the "undiagnosed" that small increase in resolution becomes very important.  When someone looks at the pictures, like a tech, they may not look that much clearer.  What the tech does not see is the comparison back to back on old and on new machines, and what the appearance of just a few more lesions can mean clinically.  There's no way they could see this.

It is more than the art of interpretation, though that clearly makes a difference in the overall picture.

When it comes time to repeat my brain MRI, I will request the 3T.  So far my poor malfuntioning brain has only showed a single, classic lesion on the older machines.  My old neuro never entertained the thought that IT was important, nevermind the thought that my weakness, clonus, spasticity, fatigue etc, etc, might indicate "invisible lesions" on the older machine he relies on.

I think a lot of doctors do not want to admit that they have been missing diagnoses, even if the reason is beyond their control.  They don't want to admit they don't have access to better equipment, so they deny it is better.  Yes, I have sat in the doc's lounge and heard discussions and rationalizations for more than twenty years.  Doctors in general, and neurologists in particular, can have huge egos and need to "save face."

Final word (really??) If the signs and symptoms are suggestive and the MRI bafflingly negative - why not go for an image with a better resolution.  Quix

[6-paq]

I'm confused too.  I've seen on another board where a radiologist tech said that there's not much difference also?????

Maybe, burbanchick could give us some insight?

[alchris]

Just a thought I was doing searching on the 3tMRi it seems no matter what article i looked at the pictures are supposed to be much clearer and pick up more.  Why doctors disagree on that i dont know, but in my experience tyring to find answers to my own probelms they all seem to disagree, I came to the conclusion testing and results are not a science but mere interpatation of results.

[oncetri]

I tried for a facility that had a 3T machine.  The insurance company wouldn't cover it.  And the doctor said it was not medically necessary.  He said there was no difference in output, but being an engineer, I tend to believe that can't be true.

From my reading, I also found taht the 3T picks up more lesions, but it seemed to also state this was correlated to contrasting agent used.  Since there was no conclusive study that I read stating that the 3T vs. the 1.5T with the same contrasting agent, I am with you on the question of if it is truly better.

All I can tell you is that my neuro felt there was no difference.  I personally believe there is a difference, and what would it hurt to try the new facility at the MS center.  Besides, these are your doctors now, so I would go, it couldn't hurt to give the other facilty a chance, especially if there has been no change in the MRIs for awhile.