MRI, with or with contrast.......
 

Is an MRI of brain without contrast sufficient enough to dx. late onset MS, or is contrast needed?

I also had a spinal tap......negative, but I have read that one can still have MS with a negative spinal tap.

My doc said "You do not have MS." How can he say that if these tests are not concrete tests for MS???!!

I wish I could believe him, but how can I?

What is the deciding factor?
Confusion keeps creeping in......

from what i understand, you have to have the bands in your cerebral-spinal fluid (csf) or its not MS. but it could be a sneaky bastid, i dunno. heres to hoping you can get a solid diagnosis asap

i am just a noob at all this so dont take my word for it :hug:

You CAN have a negative spinal tap and still have MS.

You do not need contrast on a MRI to diagnosis MS, Contrast shows new lesions that are between 30-45 days new....but all lesions will show on a non-contrast MRI, the doctor just will not know if the are new.

I had my initial MRI with contrast....but I refuse to anymore, I don't want that toxin in my body, I have enough to deal with.

Hope that helps. Also, your doctor is looking at your clinical symptoms and your neuro exam in combination with all these test. MS is a Clinical diagnosis.

Banding isn't present in everyone's spinal fluid that goes on to be diagnosed with MS, nor do all neurologists test for it.

With that said, a positive MRI isn't present in every MS diagnosis.

If you have an MRI that's a positive and fits within the criteria otherwise for MS (for example), the spinal is sometimes avoided all together.

I'm sure quite a few folks here will tell you they never had a spinal.

If you are not in an active or "flare" phase of the disease, most Spinal taps are negative. We throw those Obands when we are eating our own mylin.

MS has been dxd many times based on symptoms (sx) alone, with and without MRI studies. The contrast will only show "active" lesions or will cause active lesions to light up.

MS is a frustrating dx for so many. You can be left on limbo island for years while chasing that rabbit.

I would find an MS center for a more reliable dx. :hug:

i was diagnosed (dx'd) without a spinal tap, however, i did end up having O-bands. i had sx's (symptoms), an abnormal neuro exam and lesions shown on MRI.

you might want to consider a 2nd opinion.
it can take time to dx MS. lesions may not show up for several yrs depending on your condition, any flares etc.

did your dr try to rule other diseases by exam or labwork?
MS can mimic other illnesses.

keep a sx journal. if you develop other sx's it may help your dr follow your history. keep sx's and dates in a little notepad.

Was your MRI positive or negative?

Approximately 5-10 percent of those with MS have a negative Lumbar Puncture (LP)/(spinal tap).

There is a criteria for diagnosing MS (McDonald Criteria).
Here is some information about diagnosing MS:
http://www.nationalmssociety.org/abo...-ms/index.aspx

My brain MRI without contrast was neg.....
 

according to neuro - Report says small white matter lesion within the right frontoparietal operculum and within the white matter of the left parietal lobe. Says likely age related.

My spinal tap and clinical observation in office were neg.

Do lesions have to be in certain areas of brain to be MS specific?

I'm not sure of the answer about brain lesions. Maybe this thread will help:
http://neurotalk.psychcentral.com/sh...ons#post212996

The CSF can show several things that are indicative of MS (and considered in conjunction with other testing).

I have MS but did NOT have oligoclonal bands even in the midst of my first flair. But I did have high IgG Index and IgG Synthesis in my spinal fluid.

My doc. also did a visual evoked potentials test because there was some question in the beginning as to whether I had MS due to a long running fever. The visual evoked potentials was on the border of abnormal in my left eye which showed a slight delay. Combined with the MRI that had enhanced and non-enhanced lesions, the high IgG Index and Synthesis, they concluded MS.

NurseNancy is right--keeping a symptom journal is a good idea! :)

Get the MRI on cd for free or $5 and look/learn yourself like I did. Play with the brightness/contrast settings to make it pronounced. My avatar is my head made by me.

That spot on mine is huge. They'll be smaller. I used that slice cause it's so obvious. Go slices up or down and there's many many smaller ones.

Some lesions are so tiny they don't show up for years. Also the doctor should write on the script, use MS protocol. the radiologist will sue a certain set of sequences, different the a regular head MRI. Also it should be in a closed MRI machine with a minimum of 1.5 telsa.

An LP can rule out other diseases. It doe not always rule in MS. If you have one lesion they may wait to see if you get more in another location. That will mean you had two attacks at different times, and spaced apart from the last one. Lesions do have many other diseases that put them there.

Location of lesion/s is important. I was dx'd before MRI's were around. Clinical exam, LP and history. Later on I had MRI's for ins purposes to go on DMD's at the time, so was Dx'd again.

A non-contrast MRI may not show very new lesions, just older ones.

Thanks eddie. i have had mine on cd for some time but gave up trying to find the lesions. i will try again

Lesions in MS are typically found in certain areas of the brain, and have certain characteristics (ie; ovoid shape). However, as others have stated, they don't always show up an MRI. AND, there there can be atypical lesions.

As other have also said, not everyone with MS will have a positive LP. And in addition to the statistics, since not everyone with MS has even HAD an LP, the stats are very misleading.

I was dxed without having an LP, and even without having a lot of sx besides Optic Neuritis. My brain MRI was enough to cinch the deal!

Mysterious, mysterious disease. Not even all MS specialists agree on things, and you'll find lots of people who have been dxed that previously got a "no MS" dx from a different doctor. Don't know if you saw a specialist, but if MS is suspected, that's the best route to take.

Off topic -- hi to all my old NT buddies! :Wave-Hello:

Hi ya BG :Wave-Hello: Welcome home. :hug: How are you doing?