MRI?

[Nancy L]

I am scheduled to have an MRI done of the C-spine, T-spine and L-spine in a couple of weeks.  My question is what exactly will this MRI show?  Are there certain diseases and or medical conditions that can be diagnosed or eliminated through this test?  Thank you for your time

[CCF Neuro[P] MD, RPS]

your welcome.

CCF Neuro MD

[Thank You CCF Neuro MD]

Thank you.

[CCF Neuro[P] MD, RPS]

Dear Roberta:

A CT scan uses x-ray beams to create an image.  It is useful to use to diagnose boney abnormalities, bleeds, gross changes in structure of the brain, calcifications, etc.  MRI is based on radiofrequences and are useful to denote structure anatomy (much higher resolution than CT), blood flow, myelination, bleeds, etc.  They both have their niches in neurological diagnosing.

CCF Neuro MD

[roberta]

What is the difference in the CT Scan and MRI?

[CCF Neuro[P] MD, RPS]

thanks for the comments.

CCF Neuro MD

[DENISE]

To the person who is experiencing the tingling, pins & needles, and numbness sensations.  I'm wondering if you have had xrays done.  I friend of mine experienced the same symptoms and more and went undiagnosed for six months and during this time, xrays were never taken.  Her husband finally demanded xrays when things got to the point where she was in a wheelchair and unable to walk.  The xrays showed bone cancer in several areas and after some further test, she was diagnosed with Multiple Myeloma which is an incurable disease involving several cancerous cells throughout the body and is usually found in patients over 60 (she was 27).  She died shortly after.  I'm sorry that this is scaring you but, when looking up Multiple Myeloma in a medical book, the symptoms it described were identical to those my friend had for six months (and those you are describing).  I was appalled that her symptoms didn't trigger one of the 5 doctors who tried to help her.

D.

[CCF Neuro[P], RPS]

Dear Cassandra:

I think that he just must of been in a hurry.  The deja-vu aura is classic temporal lobe seizure.  Furthermore, unless there was a high resolution voxel acquistion of the MRI, a migrational lesion might have been missed (might be missed anyway) and this could accound for the deja-vu aura.  You are correct in some partial epilepsies have only the aura, some have aura and partial symptoms (seizures) and never generalized.  In fact, most of the generalized seizures following partial onset are generalized tonic/clonic and not myoclonic in nature.  Do what your neurologist is telling you, but if the neuro-opthalmogical exam is normal, then push for an EEG.

Sincerely,

CCF Neuro MD

[cassandra]

Dear Dr RPS / CCF Neurologist

Well I had a quick neurological assesment on Wedsnesday as planned. Unfortunately there was not ime to talk about all the symptoms, this is the good old British NHS we are in

the upshot was that he said I am symptomatic but he  was not sure of the impications predictably, his view is that the MRI and symptoms do NOT explain the eye problems (which I feel might be neurological or neuro-muscular)

he was not really interested in the deja vu which surprised me as it is the reason I do not drive, he sid if it is a partial seizure I would have had a generalised myoclonic one by now added to whoch the temporal lobe on the scan was normal

I thought that some partial seixures never generalise?? I was surprised by the lack of interest as it is totally steretyped and I become very detached from my surroundings etc  oh well

he wants a full assessment of memory and attention from a psychologist , rea;;y as a baseline for the future, but no EEGs or anything

so now I have to see an ophthalmologist as the neurologist said the problem with eyes (field defect and weakness ) must ne in the orbit maybe the retina

I don't know what if anything you make of all this, I would appreciate a comment if you have time

the rreal question is what -  if anything - now neurologically, shpuld I push for an EEG or leave well alone??

I am feeling very "over medicalised" and have gone 5 steps forward and 10 back with this

with thanks

Cassandra

[Terri]

If they give you an MRI and do not use any dye, would the beginning or any of multiple sclerosis show up?  If you slept thru the MRI as I did. would it make any difference?  Also, my Neurologist said I have nerve abnomallys and  they are similar to multiple sclerosis.  What would you call that?  Also, would an MRI show an anerism at the time they were looking for MS?Could I still posibly have a light amount of MS or the beginnings?  I am 42 yrs old and have fibromyalgia  and asthma too.  Thank you, Terri

[cassandra]

Dear CCF Neuro MD

Thank you RPS for your comment on my abnormal (?) MRI following breast cancer and treatment and subsequen tvisual problems

My appointment with a neurologist is on 10 Novemebr, at least a preliminary discussion, after which I should know more about what they are all thinking

The field defect (picked up on routine screening) was left superior, more or less in the middle and a little to the nose side, in one area only;

on follow up it had spread further towards the centre of the eye from the original defect and had also started in a very similar place in the right eye but it is not as significant on that side, it is not symmetrical but the test is not perhaps that sophisticated

in terms of my medical history, I have never smoked and have always drunk alcohol very moderately and neither have I taken drugs or been obese (not even slightly overweight)

however I have had other neurological signs for many years, they are only really troublesome when I am tired or feeling unwell, but they are

1) extreme clumsiness and

2) whatIi belatedly realised are partial (simple) seizures, with deja vu and a horrible feeling of foreboding (something terrible has just happened or is about to happen) it is very unpleasant but short lived

In addition when I was in my late teens I was forced to have ECT, a total of 16, most bilaterally (does ECT  do detectable organic damage??  I have never heard that it does and would have thought that the anti - ECT lobby (me!!) would have broadcast that fact if it were so

I think the neurologist will find this very inrteresting!

trouble is I feel as if I have now acquired another illness without necessarily having resolved the problem with the eyes

you commented on the person who read the MRI..I do not know him but he was a neurological radiologist , I do not as yet know what details were put on the referral which was made by the surgeon not the ophthalmologist follwiing an inter-nicene dispute!!

thanks for your time, this service is really valuable, and helps during the stresful time of waiting for assessment and results etc

with thanks, I will post a message after the consultation with the neurologist on Wednesday

Cassandra

[CCF Neuro[P] MD, RPS]

Dear Cassandra:

Alot depends on the neuroradiologist who read your MRI.  If they are good then they would have looked very definitively at the optic nerve and it's radiations.  Assuming they did, I would say that your symptoms might be a number of things.  It is difficult to tell you without examining you.  Your neurologist should be able to shed more light on your problem.  Your MRI sounds normal (but I can tell for sure without looking at it) and mild atrophy is worrisome but it might not be abnormal depending on what you have done in your life and your age.  We have seen people who are smokers, drinkers, drug users, obese, etc who have had atrophy, and also just normal folks without any inducers.  

Your symptoms do sound like you have a neurological deficit.  What did your neurologist say?  How wide was your field defect?  Has it changed over time?  Has your visual acuity changed lately?  I think that I would press your neurologist for some answers.  We always worry about mets to the brain in breast cancer.

Sincerely,

CCF Neuro MD

[cassandra]

Dear Neurologist

I thought I would expand on my earlier message which was left shortly after I had heard about the abnormal MRI and I was obviously upset and the rest

I am 42 years old and found a lump in my breast over 3 years ago but was not diagnosed until 2 years ago (don't ask!)

2 years ago was diagnosed with invasive breast cancer and since then have had surgery inc axillary clearance, chemo (CMF) and radiotherapy

I was also put on Tamoxifen 22 months ago but it was stopped after 16 months

In April 99 I went to the optometrist as I had blurred vision adn was aware this could be the Tamoxifen, the tests also showed a visual field defect on the left

ophthalmological referral followed and the field defect has slowlt spread and there is also a small area on the right which  shows visual loss - in addition I had quite a severe almost myaesthenic type of muscle weakness which at times made it impossible to read

the ophthalmoogist did not know what to make of it all, the field defect does not seem to have regresed since the Tamoxifen was stopped but the weakness is better as when I realised the link with exercising the muscles I stopped reading and close work and when I limit it (to a level not rreally compatible with a profesional job) it is manageable

I still see floaters inc big black ones and also flashes of light etc  and also have pains in my eyes

the oncologists have said they would be surprised if it were a brain secondary at this stage and feel it might be separate from the cancer although the timing does seem coincidental and apart from short sight and astigmatism I have never had eye problems and there is no relevant family history either

finsall I has amN MRi with the outcome i previously described so of course I am now very upset indeed

over the last few months I have had additional neurological symptoms, several times I have nearly lost my balance for no apparent reason (my friends have noticed) and sometimes at night I wake up and my left leg is dead and then has a kind of pins and needles

however I have to say that for several months I have been "sensitised" to neurological things so might be noticing things especailly the leg thatIi would not have before!!

SO the questions are really what is your general comment about the MRI ...the ventricles were normal which I am trying to use to reassure myself, and there was no comment about the gyri so presumably they were normal too

as well as general comment about the result, does it explain the visual loss??

what extra tests should be done with these signs and symptoms??

also is an MRI definitive for a tumour or should a CT be done too

can the whole optic nerve be seen?? would a metastasis in the end of the optic nerve be seen on an MRI??

what now??

with thanks in advance for your comments

Cassandra

the optometrispand ge:

n

[C Jenkins]

Dear NL:

Ask for ear plugs to soften the clanking and riveting sounds and when they say, "This sequence will be 3 minutes.", count to 60 3 times and the whole thing will be over with in no time flat.

I've had and read too many MRI's to count.  If there's a problem, you'll get the correct diagnosis.because layering is the name of the game (hence, sequence). If your doctor has ordered it with contrast, the gadolinium will light up the problem like a Christmas tree.  Good luck and hang in there.  Your diagnosis is just around the corner.

C Jenkins

[Twyla Snodgrass/15]

I need to know how you are affected when you have tumors on the brain and if you can tell by an MRI or a cat scan

[cassandra]

What are the implications of the following MRI report on patient with breast cancer and (one year post treatment) visual field defect and focal muscle weakness - extra-orbital muscles and ? neck muscles)??:

"ventricles normal" but "perivascular space very prominent" and "for age the cerebral sulci and cerebellar sulci are consistent with mild degree of atrophy"  

  neurological referral made but would like to know now - no lesions seen but aren't these signs and symptoms consistent with new intracerebral growth??

thanks

[CCF Neuro[P] MD, RPS]

Dear Bill:

Thanks for your comments.  The only problem with the open MRI machine is that resolution is not optimal.  If one is looking for fine detail, the convential MRI machines are far better and perferred.

CCF Neuro MD

[CCF Neuro[P] MD, RPS]

Dear Nancy:

Sorry to hear about your paraesthesias.  I am not sure what your internal medicine physician is looking for?  Without knowing your entire medical history and not being able to do an examination it is impossible for me to really narrow things down, but you probably know this.  It might be good to have a base line normal MRI of the spine (hopefully it will be normal).  Since the EMG etc have been normal, likely the MRI will be normal.  It might be a good thing to get another opinion as it looks like a concrete diagnosis is lacking.

Sincerely,

CCF Neuro MD

[bill]

NL, I'm not a physican, but I have had MRI's in 1998 and 99.  In 98 I had what turned out to be a severe retinal migrane (I was functionally blind in both eyes for almost an hour) and an MRI die study was done of my head to look for swelling and other posible abnormalities.  In August of this year I had an MRI of my cervical spine to help diagnose worsening symptoms in my left arm.  The detail in the pictures was amazing.  I had 2 ruptured discs - C5-6 and C7-6 - one of which (6-7) was impacting significantly on my spinal cord.  Th MRI clearly showed the intrusion and displacement. It also showed a severly narrowed neural foramen where the nerves to my left arm lead out of my spinal cord.  X-rays cannot usuually show soft tissue, MRI does it well.  I only wish the tools for viewing the MRI data were better.  The software weenies need to apply virtual reality techniques to the data to allow physicians to visualize the resultant data in 3-D.  Hopefully it will come.  For me the first experience was difficut because I am over 6 ft. tall and weighed over 350 pounds at the time.  I spent over 2 1/2 hours in the MRI machine and, while not a clostrophobe, was beginning to get anxious.  Since last year I have lost 90 pounds and the last MRI was easy.  It can be loud but it has a good purpose.  If possible, you might want to ask if open sided MRI will do the job.  That would make the experience easier for you.  Good luck.
P.S. Had anterior discetomy and fusion 4 weeks ago and am completely free of all symptoms - even a slight bit of numbness and tingling in my hand from opening the neural foramen.  Feels GREAT!

[Nancy: RE NEUROLOGY CCF-PLEASE RESPOND]

Ive seen 2 neurologists.  One thinks my symptoms are not neurological..  The other said I have" benign parasthesias" (whatever those are), and prescribed elavil which raised my heart rate enourmously!  My internal medicine doctor is the one who ordered up the spinal MRI.  Should I seek out a third opinion from another neurologist?  And please, are there any web sites that you could recommend for looking up spinal chord disorders?  Sure wish I could come to your clinic or that you all could recommend a neurologist in my area.  Thank you again.

[CCF Neuro[P] MD, RPS]

Dear NL:

It is difficult to tell you what might be causing your symptoms.  The knowledge that all your tests have been normal thus far is encouraging.  Many times we find that a tincture of time is needed for the etiology of a disorder to become clear.  I suggest that you follow what your neurologist is trying to do and be patient.  Most of the time, we find the cause of symptoms.

Sincerely,

CCF Neuro MD

[NL Re: Charlene]

Thanks for your comment.  Im just a little nervous about the whole thing and I am really hoping that this MRI will give me some answers!  I do have trouble with my lower back and neck area (they noticed some disk degeneration in both areas on an x-ray)  I feel im too young to be going through this (27) and I have 2 small kids at home.  I just want to get to the bottom of all this.  Thanks again for the comment

[NL RE Neuro CCF]

I am having the MRIs done because everything else has been looked at and they arent sure what else to do.  I have tingling, pins and needles sensations, burning and some occasional numbness throughout the body.  Every test imaginable has been ordered including a brain MRI, EMG CT blood work for everything from thyroid to AMAs, Denver panel, lupus, etc.  I also get cramping in the hands at times but no swelling.  I was just hoping to get an ideas of some conditions that could show up on an MRI.  Is there a web site that I could check into to get more information?  Thanks again for all the answers.  You all provide  a very important service and I hope you know how appreciated you all are.  If you ever take free clients at your clinic, let me know-id love to be re-evaluated!  I live in VA so Cleveland is a little far (and expensive) to get to!

[charleen]

Hi NL,

A MRI can show soft tissue, muscle and nerve tissue. IT also shows bones just like a normal x-ray, however this is not generally the main purpose for having a MRI.  I am lumbar spine sufferer with 3 spinal surgeries under my belt.  My orthospinal surgeon told me that MRI's are great for showing nerve tissue, which is what doctors want to look at when spinal conditions are involved.  IT can detect nerve fibers, the seperation of nerve fibers as they leave the nerve root itself, and whether anything is impinging on the nerves.  It is also pretty clear for disc involvement.

Not the doctors, but thought I could offer the insight of a fellow spiney.

Good luck and the doctors here are great.

Charleen

[charleen]

Hi NL,

A MRI can show soft tissue, muscle and nerve tissue. IT also shows bones just like a normal x-ray, however this is not generally the main purpose for having a MRI.  I am lumbar spine sufferer with 3 spinal surgeries under my belt.  My orhtospinal surgeon told me that MRI's are great for showing nerve tissue, which is what doctors want to look at when spinal conditions are involved.  IT can detect nerve fibers, the seperation of nerve fibers as they leave the nerve root itself, and whether anything is impinging on them the nerves.  It is also pretty clear for disc involvement.

Not the doctors, but thought I could offer the insight of a fellow spiney.

Good luck and the doctors here are great.

Charleen