when i was dx'd 11 yrs ago i had mine with contrast and wasn't questioned.
that's what the dr ordered and that's what was done.

medically it may partially depend on your sx's and presentation. i would think if you're a new pt, early in the dx or very symptomatic that you might benefit from contrast. it can help the dr "see" more active disease (lesions). i would let your neuro decide and have them go to bat for you.

i fear that in today's world insurance comp's will try to penny pinch medical costs and micro manage to save $$$. i wish they'd leave medical decisions to the dr/pt. just imho.