I'm wondering if anyone has had more than on spinal cord MRI, and if the results had changed since the prior one?

I had two large lesions the last time I had a MRI of my spine (*2003), which was several months after I had the attack that came with my C-spine lesion. I had had a prior attack, in 1991, that indicated a T-spine lesion, and that one was also still there in the 2003 MRI.

(I have since had a flare-up of the same lesions, I think, so I was expecting to hear this MRI that the lesions (plaque) had just gotten bigger.)

Someone mentioned that they believe their spinal lesions actually disappeared from one MRI to the other, which comes as a bit of a surprise to me. I understood they might shrink (or grow), but they were not like inflammatory brain lesions in that they may disappear completely.

Rex, have you followed a patient that this has happened to?

Has anyone else ever gotten their MRI reports from the radiologists/technician, stating that their spinal lesions went away?

Cherie

Hi Cherie,

I just had a repeat C spine MRI set and my previous lesion was not visible. It hadn't been a big one, pretty tiny actually (but caused lots of havoc at times), but it was completely gone from the films this time.

Sometimes I question whether some spinal lesions were ever real to begin with. They vary quite a bit in appearance and I think it's possible to over-call them, i.e., false positives. This is an area where, contrary to the brain (for which I think mid-field is fine), high-field scanning is best...and by high-field, I mean 1.5T or higher. 1.5T is great because it is very high quality with fewer flow-related artifact issues than 3T.

I can't recall following a patient with spinal lesions, Cherie.

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They say that something like 75% of us (or more?) eventually have spinal lesions, but I think they base that on symptoms that appear to result from the spinal cord "damage". I think spinal lesions can actually be quite sneaky to detect, and/or alternatively (visually) "over-called".

Honestly, I don't know how you guys can spot spinal lesions anyway, especially if they are not enhanced with gad. He showed me my "big" one's and I couldn't tell that anything was different on the image.

With me, they "estimated" my first spinal lesion would be found in the upper T-spine, but I didn't have a MRI at the time because I refused a MRI. They estimated the second spinal lesion was about C-3, and it was a few months later that I finally had a MRI. The lesions were found at T-2 and C-2/3 . . . almost right on the money. My symptoms were VERY obvious though, as I had had Transverse Myelitis attacks.

I don't think they do spinal cord MRI's for MS patients, at least not nearly as often as they do brain one's. Seems to me a lot of people have "regular" brain MRI's, but spinal one's only intermittently (as required?). I guess you wouldn't have that many patients that came back for repeat spinal MRI's, at least not in a short'ish time span.

I've only run into one other person, who absolutey has spinal lesions (extremely large due to NMO) and she said her "scarring" remained after the inflammation died down. I guess that's what I'm expecting to see.

This is why I haven't had another MRI . . . makes my brain hurt.

Thanks for the feedback, Wiz and Rex.

Cherie

Thanks Wiz.

What was the timing of when they spotted it to when it disappeared? Did you have more than one MRI that confirmed it, and then it went away? How long did you have it for, based on your images and based on symptoms?

Thanks

It wasn't there in September 2001 when I had my first set of MRIs. I had it when I was hospitalized in winter 2003 after being on Avonex for about 7-8 months. They did repeat MRI in spring 2005 when I was hospitalized again and it was still there and the neuro mentioned some spinal narrowing. This time it looked fine, like there was nothing there.

You are so right, Cherie, about regular spinal MRI's. My neuro who is the director of the largest MS clinic here doesn't believe in them. He says it is too hard to image with accuracy. He will not send me for a spinal MRI but writes up that I have a degenerative spinal cord syndrome in the C-Spine. He can see evidence of the damage on exam, but doesn't believe an MRI would show anything.

A previous MS specialist also told me that he saw evidence of spinal cord lesions in my neuro exam and he did send me for spinal MRI's and said that the fact that there was nothing showed up meant nothing to him. He said it just showed that it wasn't a disk problem. He felt that there were sub-MRI level lesions that just couldn't be seen.

This is fascinating. I didn't know that spinal lesions were so difficult to find (makes sense when I think about it) or that they don't need much. I was sent to get a C-spine MRI after my diagnosis, which showed 7 lesions. I haven't had any MRIs since then, of anything. When I do, it will be interesting to see if those 7 lesions are really there, and if they've changed. From the little that I know, it seems that most of my symptoms could be due to spinal rather than brain lesions, but who knows?