Question about 6-Month MRI

[kristen.gallegos]

Hey Friends,

Tomorrow I'm having my 6-month MRI from when I started my disease-modifying drug (Rebif), but my neurologist only sent orders for a brain MRI. I find this odd because my initial MRIs also showed lesions on my C-spine and T-spine.

Is it common to only following up with a brain MRI rather than all areas with lesions?

[Veronica]

You know, I don't know the answer to this, but I also only have brain MRIs even though my neurologist has told me that the bulk of the damage is in my spine. I had asked him about this last year and he said that he doesn't need that info for my check ups as the brain MRI tells him what he needs. I don't think this is uncommon to be just having Brain MRIs. Maybe someone else can chime in who knows better than me?

[ActiveMSers]

Since the brain is usually involved (eventually), once you are officially diagnosed, neuros usually just stick with the noggin. It gives them a more complete and consistent picture. And while they could do both the brain and spine, that gets expensive and doesn't provide a lot more information. From the Cleveland Clinic:

What does magnetic resonance imaging show in MS?
Magnetic resonance imaging has become the single most useful test for the diagnosis of MS; MRI is sensitive to brain changes which are seen in MS. Classically, the MRI shows lesions in the white matter deep in the brain near the fluid spaces of the brain (the ventricles). The test may also show changes in the cortex or near the cortex. MRI can also show changes in the brainstem and in the spinal cord.

There may be a loss of brain or spinal cord volume, a change which is called atrophy. Neurologists will occasionally use gadolinium, a heavy metal dye, to look at the brain more carefully. In a lesion that is active (a new plaque), this dye will leak out into the brain and show abnormalities. It is not clear how useful repeated MRIs are for following MS. However, many neurologists will repeat an MRI about a year after starting treatment for MS, or when there are unexplained changes in the patient's course that make it important to take another look. In MS, the MRI may not make the diagnosis, as sometimes the changes are not specific for MS. Other times the appearance may be characteristic of MS.

[kristen.gallegos]

Thanks for all the information, Dave!

I was able to get a hold of my neuro and she said nearly the same thing you wrote. She said that because I haven't had any new symptoms and most of my lesions on my spine were inactive 6 months ago that there wasn't a reason to have a new MRI on them, just on my brain.

I find out the results on the 17th, so send positive thoughts and prayers until then!