They use the gad to see if there are any active lesions, which are seen either way ... with or without gad. The active one's just show up brighter to indicate active inflammation.
It is explained better by Rex, who is a radiologist or technologist (sorry Rex) in the following thread:
http://neurotalk.psychcentral.com/thread86519.html
Gad is not necessary though.
Cherie
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I am not a Neurologist, Physician, Nurse, or Hairdresser ... but I have learned that it is not such a great idea to give oneself a haircut after three margaritas
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