MRI Question please but not the same ole ones:)

[missy142]

Hi All,

I have a question and need some experienced opinions please!:)  I have found a very nice, I think thorough neuro, he spent and hour and 1/2 with me on consultation, talks to me on the phone, had me come in immediately when I wasnt sheduled because yesterday because out of the blue after feeling really good from the waist down after 3 or so weeks,  I stopped being able to walk again, not very well anyway, extreme weakness in the legs, cant stand for more than a few without having to sit down, right foot numb now,  tremor in my foot and a buzzing in my foot, new paresthesia I never had.  
.
He wants me to get among many other tests a thoracic MRI with and without contrast and is now concerned about MS.  I am the person with the SPINAL problems for anyone that read any of my previous posts.  

He has a place he wants me to go and specific neuroradiologists at that place that he wants to read my films that he feels are very good with MS protocol on MRI's and very good in detecting anything suspicious i believe.  He knows them and deals with them quite often.  HOWEVER the place doesnt have a 3T, they only have 1.5T machine.  

So I guess the real question is:)    Is it more important to have the 3T machine or to KNOW WHO is reading and interpreting your films and settling for a 1.5T machine?

Thankyou in advance so much:)

missy

[missy142]

Nancy,

sent you a PM of what happened.  Thanks all for the input.

[Nancy T]

Mary, on another forum there is an MRI tech who posts and he always says that the most important things are how the study is done and the skill of the radiologist, maybe the software too--I cannot remember exactly what he says, but he always insists that 3T is NOT inherently better than 1.5T, that other factors are more important.

I would DEFINITELY go with what your doctor recommends and go for the place with the radiologists that he trusts. Especially since this doctor seems to be good and taking you seriously. I wouldn't start second-guessing him and undermining trust in that relationship. You are very lucky to have a neuro concerned with your case.

One of the neuros I saw also specified that my MRI/MRA be done at a specific place and read by a specific radiologist, or under his direction. I think this had to do more with looking for a vascular loop with the MRA, as he highly suspected that in my case, but the principle is the same. You want the most skilled people performing and reading your MRI. As someone else pointed out, the 1.5T MRIs are very good. Go with your doctor's recommendation; he's the expert.

Good luck!

[missy142]

Hi all,
I wanted to thank you for all your "cents"!:o)  You all make excellent points and give good advice for sure.  All things Ive been mulling over in my mind. Still awaiting approval on the MRI from insurance as I had one not that long ago on the "open MRI" before I found all this out about the 3T on this forum I might add, no md has ever told me!

I may just call him and present my thoughts quickly and let him decide so I dont second guess myself when its over:)  Thanks so much again.

still counting coins,
mary

[essdipity]

Hi. You might be in danger of over-thinking this. You have a great neuro who is following things closely, so I think you should go along with his program, at least for now. After all, 1.5T MRIs aren't exactly chopped liver.

In your shoes I'd trust this doctor and his assessment that the neuro-radiologists he works with are top-notch. I'd let things take their course and let the doctors do their analyzing. If the results were unhelpful, there'd always be time for more sets of eyes and skills in the future. This isn't a one-shot deal.

Good luck and let us know.

ess

[Fluffysmom]

Hi there, I'm in the process of getting a second opinion reading of my 3T MRIs.  They look great, but the reports were really bad.  I called my PCP, she agreed to ask a really good neuroradiologist to do the re-read.

I called my insurance, and they said that second opinions are covered under my insurance.  If, for some reason they wouldn't cover it, she told me how to appeal the decision, and most likely get it covered.

I know someone that works in radiology billing, and they said that the reading part doesn't cost that much, it's the MRI itself that costs a bundle.  I decided that even if I had to pay out of pocket for the second opinion, it would be worth it to me.

By the way, I seem to remember our dear Dr. Quix saying that the 3T is best for imaging the spinal cord.

So, I would suggest that you call this approachable neuro, request that you have the MRI done on the 3T machine, and then take the films to his chosen neuroradiologist(s) for a second opinion.

Another two cents!

Kathy

[rendean]

I posted this earlier but it must have gone into the cyberspace black hole.

Another penny to add to the pot...did you discuss with the neuro his specific reason for wanting a 1.5 and these particular radiologists versus a 3T? Perhaps a quick call to him (and he does sound like an approachable kind of guy) to ask this question would help you decide where best to spend your healthcare dollars.

I am in total agreement about having to make these medical decisions when we are at our worst. It just plain s*cks.

Hope that some others, with more knowledge, will answer this post for you.

Best of luck!
Ren

[missy142]

Hmm, that is an interesting thought too, thanks.  I guess he just trusts this place and these mds.  I dont understand why this place doesnt have a 3T, they are quite large and have several locations.  

And its not like I can weigh traveling or access, because I think as I've said to you Lulu living in NY here is an advantage to having access, so the 3T is readily available to me.
Arggg I always feel like I make the wrong decisions.  It would be so nice if when we are all sick and going thru things that we could just recooperate and not have to worry about anything else.  Ever since this whole thing started last year with my spine, i feel like ive done nothing but go to mds, have tests, fight with insurance, lawyers, workers comp., its all soooo exhausting.  

thanks again
mary

[Lulu54]

Another contribution to the fund ..... here is two more cents

could you get the 3T done and then take the films to the neuroradiologists to get their second opinion?  Why not I wonder.........

Lu

[missy142]

Thankyou both for your "two cents":)  Every few cents adds up,  and in the end maybe I will have enough to buy an opinion:))))!

I really dont know which way to go.  If I go with the recommended place from my neuro with the 1.5T mahcine and with the 2 specific neuroradiologists that he wants to read my films and nothing shows for anything, I will think, "Well I should have gone to the 3T, maybe its just not showing".  And if I go to the 3T and a radiologist thats not a certified neuroradiologist reads and its not a well written and detailed report no matter what the outcome, I will say "Well I should have trusted the neuro and went where my md told me to go"!:)

Of course he looks at at the films himself but ideally you would like the radiologist and the neurologist to work together.  UGH!!!  WHY CANT ANYTHING BE EASY!!:o)

U both make excellent points, thanks again.  Anyone's else thoughts are much appreciated as well.

thankyou
missy

[Lulu54]

Wow Missy, that is a really tough call.  My dx was done off of films from a 1.5T but my lesions are very obvious.  For those of you that have more subtle signs and lesions that aren't going to be obvious, I would go for the highest strength MRI around.

That said though, its hard to beat a neuro who is good, thorough and maybe willling to diagnose CIS and starts dMD's without seeing a single lesion.

I know I just talked in circles here and surely that didn't help a bit.  

Sorry I can't contribute more than 2 cents as well,
Lulu

[rendean]

Congrats on finding a good neuro! My understanding and I'm sure I'll be gently corrected if I'm wrong, but the software is as important or more important than the strength of the machine. At least that's what my old neuro told me.

As for the neuroradiologist, if he/she is unskilled or inexperienced in interpreting films looking for MS lesions I would definitely vote on the skilled doc and the 1.5 machine.

My two cents worth,
Ren