My Doctor says the MRI doesn't show anything wrong is a very common problem. Here is an article that explains what some of the problems may be: http://www.nytimes.com/2008/10/14/he...syahoo&emc=rss

It could be the equipment or the person reading the scan, maybe there is something wrong. Your Doctor should probably read the MRI's themselves, mine does.

Mine reads them, too. In fact, yesterday he showed me MRI films of one I had done in April 2008 and one I had done just this past week (6 months in between). There were some differences and he pointed them out to me. These were, of course, done with and without contrast.

Bill - Was this the doctor that we both have in common?

Yes, it is 'the Rock'.

My daughter tore a ligament in her knee when she was about 10 yrs old. The specialist sent her for a MRI, and it came back "negative" for that injury, HOWEVER, he said he fully believed that it was a ligament injury.

He said over 90% of the people who "seem" to have a ligament injury, in spite of what the MRI shows, DO indeed have that injury when they do an exploratory. He was fully prepared to operate, no matter what the MRI said.

"Cortical Lesions in Multiple Sclerosis: Combined Postmortem MR Imaging and Histopathology

Jeroen J. G. Geurtsa, Lars Böc, Petra J. W. Pouwelsd, Jonas A. Castelijnsa, Chris H. Polmanb and Frederik Barkhofa
a Department of Radiology, VU University Medical Center, Amsterdam, the Netherlands
b Neurology, VU University Medical Center, Amsterdam, the Netherlands
c Pathology, Division of Neuropathology, VU University Medical Center, Amsterdam, the Netherlands
d MS Research Center, and the Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, the Netherlands

BACKGROUND AND PURPOSE: Cortical lesions constitute a substantial part of the total lesion load in multiple sclerosis (MS) brain. They have been related to neuropsychological deficits, epilepsy, and depression. However, the proportion of purely cortical lesions visible on MR images is unknown. The aim of this study was to determine the proportion of intracortical and mixed gray matter (GM)-white matter (WM) lesions that can be visualized with postmortem MR imaging.

METHODS: We studied 49 brain samples from nine cases of chronic MS. Tissue sections were matched to dual-echo T2-weighted spin-echo (T2SE) MR images. MS lesions were identified by means of myelin basic protein immunostaining, and lesions were classified as intracortical, mixed GM-WM, deep GM, or WM. Investigators blinded to the histopathologic results scored postmortem T2SE and 3D fluid-attenuated inversion recovery (FLAIR) images.

RESULTS: Immunohistochemistry confirmed 70 WM, eight deep GM, 27 mixed GM-WM, and 63 purely cortical lesions. T2SE images depicted only 3% of the intracortical lesions, and 3D FLAIR imaging showed 5%.

Mixed GM-WM lesions were most frequently detectable on T2SE and 3D FLAIR images (22% and 41%, respectively). T2SE imaging showed 13% of deep GM lesions versus 38% on 3D FLAIR. T2SE images depicted 63% of the WM lesions, whereas 3D FLAIR images depicted 71%. Even after side-by-side review of the MR imaging and histopathologic results, many of the intracortical lesions could not be identified retrospectively.

CONCLUSION: In contrast to WM lesions and mixed GM-WM lesions, intracortical lesions remain largely undetected with current MR imaging resolution."

http://www.ajnr.org/cgi/content/abstract/26/3/572

Cherie

The 21% increase in lesions found using a 3.0 tesla MRI indicate that lots of small lesions cannot be found with the more common 1.5 Tesla MRI.

JackD



1: Invest Radiol. 2003 Jul;38(7):423-7.

Comparison of multiple sclerosis lesions at 1.5 and 3.0 Tesla.

Sicotte NL, Voskuhl RR, Bouvier S, Klutch R, Cohen MS, Mazziotta JC.

Department of Neurology, Division of Brain Mapping, University of California Los
Angeles, Los Angeles, CA, USA.

OBJECTIVE: To evaluate the relative sensitivity of MR scanning for multiple
sclerosis (MS) at 1.5 Tesla (T) and 3.0 T using identical acquisition
conditions, as is typical of multicenter clinical trials. METHODS: Twenty-five
subjects with MS were scanned at 1.5 T and 3.0 T using fast spin echo, and
T(1)-weighted SPGR with and without gadolinium contrast injections. Image data,
blinded to field strength, were analyzed using automated segmentation and lesion
counting.

RESULTS: Relative to scanning at 1.5 T, the 3.0 T scans showed a 21%
increase in the number of detected contrast enhancing lesions, a 30% increase in
enhancing lesion volume and a 10% increase in total lesion volume.

DISCUSSION:
The improved detection ability using high-field MR imaging is prominent even
when sequence parameters are optimized around the midfield units. Multicenter
trials using both 1.5 T and 3.0 T instruments may be affected by these
sensitivity differences.

PMID: 12821856 [PubMed - indexed for MEDLINE]

Hey Bill, this info made me wonder about how strong the MRI's are here. Do you have any idea whether Presby and Montefiore have 1.5T or 3T? I've never asked.

My neuro could tell me what facilities had what MRIs. I didn't ask the first time I went to the one place, but did later on, and that tech looked at me like I had 2 heads and did not answer.

Another place, the tech seemed proud to reply he had a 3.0.

You could call the radiology dept and ask, or see if your neuro knows.

Yeah, but you see Bill ALWAYS seems to know this stuff, so I figured this would be the lazy way to find out!

Unfortunately, when I had my last MRI in the new machine at Montefiore I forgot to ask if it was a 3.0. The old machines were all 1.5's. I would assume the new machines are 3.0 since UPMC tries to be at the top of the list.