Trust MRI results on 1.0T machine?

[Pinto440]

I just found out today that the MRI I had in Sep 07 which showed no brain lesions was done on a machine with only 1.0T magnet strength.  I was a little surprised as I thought the old machines were at least 1.5T and this was a very large reputable clinic that I was at.  Just finding out about MRI magnet strength on this site.  Any comments?

[Quixotic1]

Hi, and welcome to the forum.  We don't get many visiting physicians.  I have to ask about your recommendation that people seek out a OPEN BORE MRI machine.  I have never heard anyone recommend an open bore over a closed bore machine.  Information and data we have received from trusted neurologists and radiologists all that equivalent Tesla closed bore machines are uniformly better than their open counterparts in imaging the often tiny lesions in MS.

The MS studies of which I am aware all use closed bore machines.

Intuitively, given how MRIs work, this makes sense to me.  But, we would love to have evidence that an open bore can deliver detail sufficient to provide adequate resolution.  We look for sound information, so can you point us toward any data or studies that demonstrate this?   The claustrophobic among us would be delighted.

Welcome again,

Quix, MD

[MsWobbles]

Addendum to prior post here (I ran out of room).  

I also wanted to say that if you are not satisfied with the reading of your MRI films, you can always have additional physicians of your choice interpret them.  Remember, the interpretation of any given film is only as good as the person interpreting it.  In my own experience, I have had my 1Tesla MRI interpreted as just "negative" by a couple of MDs and then, from another group of MDs, I gained further information from the very same film such as "parietal atrophy not normal for age group".  I am aware of a woman who was told her mammogram was "negative" but then when it was accidentally read by another radiologist, she was found (correctly) to have cancer.  Another example is a man told that his abdominal films were negative, but, remaining symptomatic six months later, he sent the films to an acclaimed facility which found (correctly) that he had pancreatic cancer.  You may be able to send your films to a well-known institution and pay to have their radiologists read them for a second opinion.  That is an option to re-doing the exam.  I still say, insist on the highest magnification you can get:  3Tesla or more!

[MsWobbles]

"Hi" to all the other limbolanders!

After reading about the MRI experiences of others on this website, I have come to a few conclusions:  

First, it is important to use a neurologist who truly specializes in MS to order your MRIs because she/he will know the right protocol to order for optimal imaging.  Do not waste time and money with a GP who is only halfheartedly pursuing your answer or who worse, really thinks you're a crock and essentially is just ordering the MRI to effectively get rid of you as a patient!  Do not waste time with a "phoney" MS neurologist who only states he/she is a specialist.  Go to the excellent website
msneuroratings.com (created, I believe, by the incredible Quixotic1) which, judging from the ratings of MS neurologists in my state, is truly an incomparable resource for choosing the right MS neurologist for you - one who truly knows and specializes in MS! Use that MS neurologist to order and review your MRIs!

Second, it is important to get the highest power MRI magnet available:  A 3Tesla for sure!  Why not find out if you have lesions right away, rather than languish for years with negative 1 Tesla MRIs?  Yes, your lesions might show up on a 1 Tesla - but what if they don't?  Then you're stuck with a possibly false negative that will haunt every future visit with different neurologists, possibly prejudicing them from the outset that you don't have MS.  

Third, make sure that in the doctor's order for the MRIs, it is stated that they are to be done on 3Tesla!  Then don't pay in full before the tests are done.  The medical community should be like any other service provider:  They should be held accountable.  If things aren't done to specification, they should not be paid!!

[Nerve_Wrecked]

Thanks Quix,

A good read, and an excellent help with understanding some of the words written on one's MRI report.

I wish I knew what technique they used for my MRI, but I no longer have my report, I'll have to get another copy.

Christine
(un-dx)

[Quixotic1]

I'll be back later to talk about this, but I would like you to read the Health Pages on two topics

How MRIs Show Lesions in MS

and

What is the Difference Between the Old MRIs and the New Ones?

These explain some of the basics on the T1 (as opposed to 1T - 1 Telsa) or T2 and on some of the differences in lesion indentification as the "resolution" of the machine increases.  For example a 3T machine will pick up about 25% more lesions in the brain than the 1.5T machine.

For me the 1.5 machine picked up NO lesions but had tiny patchy areas (to my neuro) of signal increase, but a 3T machine (one month later) picked up 6 clear lesions, some of them coinciding with the "patchy" areas.

Realize as you read the articles that T1 and T2 are imaging "techniques."  

The strength of the machine will have the number before the "T."  Yes, it is confusing.

Quix

[Ley5792]

Thanks for that info on the MRI machines!

~Ley

[Fluffysmom]

There is a difference between the machine numbers and in image numbers.  The MRI machines are 1.5 Tesla, 3 T(esla), etc.  

The numbers on the images are what type of imaging was done for that series of images, as T1 weighted, T2, Flair, etc.  I'm no expert, so excuse the lack of proper terminology, but I have learned a few things in my quest for answers.

I'm sure there's a more thorogh explanation of all of this in the health pages.

I'm working on getting an 3 Tesla MRI of my brain with and without contrast.  I'm going to ask for a MS protocol, but my regular doc is ordering it and she doesn't think I have MS,  and I've been through two neurologists that don't have answers, both of them rather rude about the whole thing.  My 1.5 T MRI of my brain showed multiple small lesions, but my LP was clear and my spine MRIs showed only patchy areas of increased signal.  I was wondering if the neuro had ordered MS protocol.

How do you find out if the MS protocal has been followed?  Did I miss something on my films that showed that?

May we all find clear answers!

Kathy

[Pinto440]

Thank you.  I agree.  I'm considering getting another MRI, but of my spine this time.  This is where my sister (that has MS) is showing her lesions.  She has no brain lesions. Good info.

[Ley5792]

I was told that all of my images done in Fall 07 were on a T2 machine. While some of the images show T2, some also show T1.

The images I just had done in Spring '08 were said to be done on a T3 machine. (Hopefully its all T3 this time.)

Either way, with as much cash we pull out of our bums to pay for all of this testing....it'd be nice if they could just perform the strongest tests that show the best results.

I don't know about all of you, but I definitely have more important things to spend my money on.

~Ley

[Pinto440]

Thanks for the "slice" info.   I did read Quix's journal where she was misdiagnosed and lesions were missed.  I've been referred to rheum., psychology, etc.  Even told for years I had Cushing Disease, right up until the last urine collection that didn't show the high levels of cortisol in my system they expected.  Told I needed a back surgeon and he (last month) referred me back to neurology.  Back to square one!  At least this time I will be armed with some of my own info. so that I will be asking the proper questions BEFORE any future testing!!!  Good luck to you!

[julia111]

Evidentally, the size of the "slices" done on the MRI matter too!

I think MS Protocol calls for 3 mm Slices.

My MRI on the .23 Tesla appears to have been done in 6 mm - 7 mm slices. I am guessing that is looking at "larger chunks" of my brain?

Maybe we should start a new thread and take a poll of "MRI Strength Stories" ??

I find all of this fascinating!  : )

Julia

[Nerve_Wrecked]

I'm interested in the answer because my MRI (without contrast) back in August'07 was done on a 1.0T machine as well.

I wonder what difference it really makes, if any.

Christine
(un-dx)

[julia111]

Hi!  Wow, what a coincidence!  I just found out today that the MRI I had in Oct 07 which was "normal" was done on a machine with .23 Tesla and no contrast.

At that time, with the onset of right sided facial numbness and toe numbness, my GP did not request MS Protocol for the MRI, as he was really just looking to rule out a Stroke or Tumor at the time.

I've been marching around from doctor to doctor with these "useless?" images - and even the Mayo Clinic accepted them as "clinical evidence" that I DO NOT have MS.

I'm sure other's will chime in about their experiences.  

There is lots of great information on the MS Health Pages found on this site

- and reading Quix's own journal entry of how her MS diagnosis came about is a must!

Best Wishes!
Julia