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Old 11-01-2007, 02:25 PM   #1
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when should ms patients have a spinal MRI instead of brain

when should ms patients have a spinal MRI instead of brain

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Old 11-01-2007, 02:35 PM   #2
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Re: when should ms patients have a spinal MRI instead of brain

IMHO, certainly a c-spine MRI should be included at least at the beginning of any dx process. My specialist also ordered a t-spine MRI as a baseline which is good he did because although I didn't have any lesions on my c-spine, one WAS found on my t-spine.

My follow-up MRI is soon and I know it's only of the brain so in terms of follow-up spinal MRIs, I can't say how often since I am relatively newly (8 months) dxed. It does seem to be though that it should not be a one time only thing! Also, there are many who have only had their c-spines done and not their t-spines. (I don't quite get that.)

The question of follow-up spinal MRIs was raised recently on another board I follow. The question at hand is how do they really know (whether it be clinical trials or to follow up on drug efficacy) that there really are no new lesions unless spinal MRIs are included? It is possible to have lesions just on the spine and not on the brain.

Old 11-01-2007, 03:07 PM   #3
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Re: when should ms patients have a spinal MRI instead of brain

Speaking strictly from my experience only, I had a c and t spine MRI done because I was having an exacerbation (numbness which started at my pelvis and radiated up to my chest and then started going down my leg) and my neuro wanted to know if it was due to inflammation in my spine. And it WAS the cause of my symptoms. So he gave me something strong to bring down the inflammation, which helped tremendously. I haven't had any follow-up MRIs on my spine though because I haven't had any additional exacerbations.
Of course, I don't see my neuro regularly because I'm not having any problems. Once a year is when I see him. Again, this is just my personal experience.

Old 11-02-2007, 10:33 AM   #4
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Re: when should ms patients have a spinal MRI instead of brain

My very first MRI during diagnosis was of the spine and the brain. This was a good thing because originally I had no visible lesions on my brain but I did have them on my spine in the neck area. In my following MRI's I have only had them of my brain...I'm not sure why they don't follow up in the neck area.

Old 11-02-2007, 11:14 AM   #5
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Smile Re: when should ms patients have a spinal MRI instead of brain

Hi Stacy-
I am an MRI tech so I see MS all the time on patients. Usually physicians will order a plan brain MRI first due to insurance issues and so forth, and since the plaques show up alot in the brain. However, I've seen docs order everything from full spine and brain (which is what i had), to combinations of brain/cervical spine and alot of thoracic/cervical spine combinations. If the MRI of the brain is negative showing no evidence of demyelinating disease, neurologist will then order usually a cervical/thoracic MRI combination to check for plaques or demyelination within the actual spinal cord. If these are all negative, your neurologist or doctor may order a lumbar puncture or spinal tap to look for what they call oligoclonal bands. Doctors are not going to order the whole series usually at first if they can confirm a diagnosis off a single study since MRI's are very expensive 1000-2000 dollars per scan depending on whether or not contrast was used. Contrast is usually used to look for enhancement of these so called plaques. MS can be diagnosed without contrast but once confirmed, is usually followed up with contrast exams periodically to check the progression of the disease. (plaques will always show up on certain sequences). The plaques will "highlight" or enhance on images after the injection if they are considered active, whereas non-active plaques will not generally enhance. Therefore your doctor can monitor your treatments effectiveness with MRI. Hope this helps.


Old 11-02-2007, 10:51 PM   #6
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Re: when should ms patients have a spinal MRI instead of brain

I am about to have a MRI as soon as my doctor can get it scheduled, and I was wondering the same thing because she only ordered a brain, not the spine...I have a previous MRI from 3-06 when I had oral cancer that I have looked and tried to tell if it look like anything. I"m also a radiographer (Tara) but I have worked away from the hospital for so long I can't make heads or tails of MRI's really.
I have been having severe fatigue, worsening muscle weakness, spasms when I do use my muscles, and problems with my eyes for several months so I'm getting it looked at now, I"m only 37. So any tips on the type of MRI I should ask for would be great, thanks!

Old 11-03-2007, 05:39 AM   #7
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Re: when should ms patients have a spinal MRI instead of brain

Gee and i thiught my MRI scans were the norm.. All my scans have always been Brain, Neck and spinal. looks like most of you get either one way or the other. Guess it deends on our Neuro's huh ????

Old 11-03-2007, 06:43 AM   #8
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Re: when should ms patients have a spinal MRI instead of brain

I had the brain MRI, with contrast and then when I had lesions, it was followed by the neck MRI, which did not show lesions. I am going for a six month follow up MRI of brain with contrast on Monday to see if anything has changed, and then my GP is sending me for a second opinion as my symptoms have worsened and he feels having another neurologist would be helpful. MS was initially ruled out, due to a finding of APS, however my left side hands and feet have progressively worsened, and my right side have stayed the same. I am happy with this, even though I was okay with my first neurologist's findings. I am due back with him in January for follow-up so I don't feel like he blew me off, but I'm happy I don't have to wait that long either.

My question is, when is a spinal warranted? Do O-bands definitely mean MS? Especially if you have lesions on your brain? I don't really want to have that test, but if it would help with a DX, I think I could suffer through.

Old 11-03-2007, 01:08 PM   #9
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Re: when should ms patients have a spinal MRI instead of brain

Hi there. A spinal is warranted because it rules out other things which also mimic MS. Spinal Fluid can be sent to Igenex, a lab in california which can definately rule out Lyme. It can rule out types of menigitis and other brain infections and yes, if Obands show up it is MS.
Everyone is terrified of a spinal tap. Ive had two and I can honestly tell you, the first one was worse because I WAS SO SCARED! THe test itself, was over in 20 minutes, I had no headache, no side effects at all....the second one was over in 10 minutes and I had NO PROBLEMS AGAIN.
The key is to do what they say, lay flat the entire 8 hours afterwards (I laid on the couch and watched TV all afternoon and went to bed) and to drink a ton of caffeine (soda/coffee/tea) before and after the test....its not a big deal really. but the worrying about it is unneccessary!
To give you more info, I had over 50 lesions on my brain, nothing in my Cspine and negative Spinal Taps (the first one was done before they suspected MS about 3 years before I actually had MS) the second one was done once my Neuro referred me to an MS SPecialist, just to be sure it was MS..
My dx came within 2 weeks of my symtoms starting, and my sytmoms, like yours, started with tingling fingers and hands...over one year later, I still have those symtoms, but started REbif the first month of being positively dx, and have never had anotehr lesion show up or any other terrible sytmoms which didnt go away..
good luck, and dont be scared. Have the test.
RRMS- dx 05

Old 11-03-2007, 07:36 PM   #10
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Re: when should ms patients have a spinal MRI instead of brain

I just thought of something. My insurance will only pay for one MRI a year. So when I got my spinal MRI, I had to pay out of pocket for my brain MRI.

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