IVSM and MRI question?
 

The last 2 rounds in the MRI machine (normally do 3 at a time: cervical, thoracic, and brain) have been less than a week after stopping a 5 day course of IVSM.

And all of them show significant progression and new lesions, and all of that fun stuff. But here is the kicker. None of them are showing up as active with the contrast. They keep reporting that they are stable and inactive. Which is funny I grew two new lesions in 6 weeks and yet they are all inactive?

How does that work? I am wondering if the IVSM can cause a "false inactive" result with the lesions.

Legzz, I'm guessing it is possible. :Dunno: I know a lot of neuros who don't like doing the MRI too close after the patient has had IVSM.

Hi Legz,
I once asked my MS Specialist about that same question. He said my lesions did not enhance after an exacerbation. I said I just finished with steroids. Is that why?

I then asked him, do you think that because the steroids reduce inflammation, and inflammation is what enhances around the lesions (the fluid around the lesion is inflammation), that that is why the lesions look inactive and do not enhance?

He said yes, steroids do take away the fluid around the active lesions, just like it would do the same for fluid (inflammation and swelling) around an Arthritic knee.

He said that is how the steroids work, to help you when you have an exacerbation. They first remove the inflammation around the lesion and then help heal them.

So quoting him, I would say yes to your question. It makes since. No more inflammation or fluid around a lesion, so the contrast does not go into the fluid and enhance it.

That was quick though. Maybe you did not have much inflammation around the 2 new lesions. Or they were starting to heal on their own before the steroids were taken.

Or maybe the 2 new lesions were tiny before, did not show up last time, so not really new ones. They can get a bit bigger and finally show up, but not as enhancing ones in that case.

As for the progression (size of lesions?), maybe the MRI machine got better pictures of the brain/cervical this time. Did you change machines or places you went to? Or do you mean you are progression?

I hope I got this explained right, the way he said it to me. I think I confused myself in this post. I went to a BBQ today and I am tired. A little brain fog setting in.;)

These are just my thoughts, or what my Neuro said. You should ask your Neuro why? He must have some answers for you. He saw the MRI's and examined you prior to the steroids.:hug:

Thanks. Well it is really confusing because she has determined I am definitely a progressive form. But she cannot tell me what kind. I have an unofficial progressive ms diagnosis now. I do know with primary progressive you are not likely to see a lot of inflammation, but again it is hard to tell since I had just stopped the steroids.

This was the third round of IVSM and the third time it did nothing to help my symptoms but instead leave me sick. The good news is she agrees that the steroids do not work for me and we will no longer be trying that route. And the ob/gyn believes that the steroids play a big role in the female problems I am having, but he is not sure if it was just the steroids or the combination of all of the meds.

You guys missed the anniversary party last month. It's been a year since my exacerbation and I got together. That numb patch on my leg started last August, so I decided an anniversary party was in order.

My neuro always wants me to get the MRI before getting IVSM. He said it can definitely affect the MRI.

Holly, that sounds logical. So why do so many neuros put you on 'roids before the MRI?:confused: Maybe they should go back to school...

Debbie For me the answer to that question is simple. Because I wait until I cannot find any other way before agreeing to do the roids. So buy the time she puts me on them my body is on full attack mode. Plus, it takes on average 72 hours to get radiology to get with the program and set you up for the MRI, for some reason my doctor does not want to wait an extra week to see what is going on.