mri report on ms patient

By itself, an MRI report cannot tell whether or not a person with MS is doing well. Some people have a lot of MS lesions but are doing very well clinically. Some people with just a few MS lesions can be significantly disabled. In general, though, the fewer MS lesions a person has the better.

Full Answer

Does diagnosis of MS always show on a MRI?

On the other hand, a normal MRI does not rule out the diagnosis of MS. About 5% people, who have confirmed MS based on other diagnostic criteria, do not show any brain lesions on MRI. These people may have lesions elsewhere, such as spinal cord or lesions that are undetectable by MRI.

How does MRI help to confirm MS diagnosis?

What are the accepted criteria for a diagnosis of multiple sclerosis?

• Onset usually between 10 and 60 years of age
• Symptoms and signs indicating lesions of central nervous system white matter
• Evidence of two or more lesions upon examination by MRI scan (see below)
• Objective evidence of central nervous system disease on neurological examination

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Can MRI be normal in person with MS?

“Although uncommon, at the beginning of the disease, MRI in a patient with multiple sclerosis can be normal,” says Resham Mendi, MD, a renowned expert in the field of medical imaging, and the medical director of Bright Light Medical Imaging.

How you can have MS with a negative MRI?

How You Can Have MS With a Negative MRI

1. Get copies of all MRIs and the reports. Read all the reports. ...
2. Request that your neurologist look at the images himself. If he/she won't find a new one.
3. Find a neurologist who is as interested in your case as you are. ...
4. Ask about whether the MRI will be done on an MS Protocol. ...
5. The spinal cord should be imaged on the highest MRI intensity available. ...

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What would an MRI report say for MS?

In MS, the immune system attacks and damages the protective myelin coating that surrounds the nerves. Healthcare professionals refer to this damage as lesions. MRI scans can identify lesions that occur due to MS. MS lesions can show white matter inflammation, demyelination, and scarring, or sclerosis.

Can MS be seen on MRI?

MRI plays a vital role in how we diagnose and monitor MS. In fact, over 90% of people have their MS diagnosis confirmed by MRI.

How do you confirm MS?

In most people with relapsing-remitting MS , the diagnosis is fairly straightforward and based on a pattern of symptoms consistent with the disease and confirmed by brain imaging scans, such as MRI. Diagnosing MS can be more difficult in people with unusual symptoms or progressive disease.

What does MS look like on MRI of spine?

In MS (a), MRI shows areas of T2 hyperintensity which extend for a single vertebral level, involve both grey and white matter in the lateral-posterior part of the cord and have a cylindric shape on the sagittal view and a wedge shape on the axial view.

Clinically isolated syndrome

A person with clinically isolated syndrome (CIS) is experiencing the first episode of symptoms that occur due to inflammation and demyelination in the central nervous system. The symptoms of CIS will last for at least 24 hours.

Relapsing-remitting MS

With relapsing-remitting MS (RRMS), an MRI scan will show at least two separate areas of damage that have occurred at different points in time.

Primary progressive MS

People with primary progressive MS (PPMS) tend to have fewer brain lesions, and the lesions tend to contain fewer inflammatory cells. They also tend to have more lesions in the spinal cord than people with other forms of MS.

Secondary progressive MS

Secondary progressive MS (SPMS) is a form of MS that can occur in people who have had RRMS, and it features a general worsening of symptoms over time.

T-1 weighted scan with gadolinium

T-1 scans can involve the use of gadolinium, which is a contrast dye, to look for new or growing lesions.

T-1 weighted scan without gadolinium

A T-1 weighted scan without contrast dye can show hypointense lesions, which may indicate areas of permanent nerve damage.

T-2 weighted scan

T-2 scans show the total number of old and new lesions in the brain from the onset of MS.

Why is MRI important?

With respect to treatment efficacy and treatment safety monitoring, MRI has gained more importance and is crucial for the assessment of optimal treatment response, or treatment failure, and is invaluable for the early diagnosis of PML.

Is McDonald's criteria specific for MS?

In summary, the McDonald criteria have a high sensitivity but are not as specific for the diagnosis of MS and caution is still required when confirming the MS diagnosis. MRI as a prognostic tool in MS. MRI plays an important role for the prognosis of disease development and monitoring of disease progression.

Is MRI good for MS?

Overall, the use of MRI has become a well established tool for diagnostic purposes and facilitates the early diagnosis of MS. This offers the opportunity to start immune-modulatory treatment early. Yet different pathologies need to be carefully assessed and excluded before a patient is committed to long-term treatment.

Does spin echo decrease vessel pulsation?

Spin echo sequences can decrease vessel pulsation, however given the longer acquisition time, there is an increased likelihood of motion artifacts.21T2-hyperintense lesions are more common in the cervical than the thoracic cord, and classically span the length of two or fewer vertebrae.5,22–25.

Why is spinal MRI required?

Also, if symptoms or signs could be explained by spinal cord disease, then spinal cord MRI is required to evaluate for non-MS cord pathology. Spinal MRI provides increased specificity in patients with an abnormal brain MRI and increased sensitivity in patients with a negative brain MRI.

What is the best field strength for spinal MRI?

Typically, higher field strengths (1.5 Tesla or higher) are preferred for spinal cord MRI.

Do you need an MRI for MS?

A: MRIs are not required to diagnose relapses. We do not generally obtain an MRI of the brain or spinal cord during an MS relapse if the symptoms and signs are consistent with MS and there are no atypical features. The exceptions to this rule would be if the patient is on immunomodulating therapies that increase the risk of progressive multifocal leukoencephalopathy (PML). In addition, if the patient has an altered level of consciousness or other problems such as a severe headache, sudden stroke-like onset, etc., then we would obtain an MRI as soon as possible. Patients whom we are considering switching disease modifying therapy should also obtain MRIs.

Can you get an MRI?

A: Yes, MRI should be obtained in all patients unless there is a specific contraindication for obtaining the MRI (for example, presence of MRI-incompatible pacemaker or other electronic devices). In cases where MRIs cannot be obtained, we generally obtain as much supportive testing as possible. We are more cautious regarding the certainty of the diagnosis in such patients, and rely more heavily on lumbar puncture results and other supportive diagnostic testing results such as evoked potentials and optical coherence tomography. If the contraindication for MRI is removed at a later time, we would recommend obtaining an MRI at that point.

Can you have a contrast MRI while pregnant?

A: According to the most recent American College of Obstetrics and Gynecology guidelines [12], there are no precautions or contraindications for non-contrast MRI in pregnant women. There are very rare situations that require obtaining an MRI in a pregnant woman with MS. As mentioned above, the use of contrast is generally avoided during pregnancy, although there is not an absolute contraindication to its use. As very small amounts of gadolinium (<0.04% of the administered dose) is excreted into breast milk, patients who are breast feeding do not need to express their milk after receiving contrast and can continue breast feeding as usual.

Is contrast agent safe for MS?

A: In general contrast agents are safe and we prefer to obtain MRI of the brain and spinal cord with a gadolinium-based contrast agent as an initial diagnostic strategy. Contrast-enhancing lesions assist in satisfying diagnostic criteria of dissemination in time in patients suspected of having MS.

Is orbital MRI necessary for asymptomatic patients?

Orbit MRI is not required in asymptomatic patients. However, this may be necessary to confirm optic neuritis or evaluate for other etiologies involving the visual system (e.g., sarcoidosis, compressive lesions, neuromyelitis optica). Coronal STIR or fat-suppressed T2, and post-contrast fat-suppressed T1 with coverage through optic chiasm are the minimal sequences recommended in the Consortium of MS Centers guidelines [3].

How long does it take to evaluate a report?

Readers most frequently evaluated reports in less than 2 minutes. When reports and images were evaluated together, no difference in terms of question response was observed for any reader. Reader 1 evaluated reports and MR images in 2–5 minutes; reader 2, in 5–10 minutes; and reader 3, in more than 10 minutes.

How many people are affected by MS?

Multiple sclerosis (MS) is a complex disease of the CNS that is characterized by both inflammatory and neurodegenerative processes and affects about 2.3 million people globally [ 1 ]. CNS MRI is the main tool for diagnosis and monitoring of the disease [ 2 ].

Preparing for Your MRI Results

Having an MRI test done can be a nerve-wracking experience, but waiting for the test results is even worse. If you’ve had an MRI because your doctor suspects you may suffer from MS, the wait for news might seem to go on forever. Here are a few tips on how to prepare for the follow up appointment and results.

Getting Your Results

There are three options for your MRI results. Firstly, your MRI may not show any brain lesions characteristic to MS. This is great news, and you will feel a big relief. Your doctor may still recommend another MRI later on if he or she feels that physical and neurological exams are strongly supporting this diagnosis.