Radiologists consult

[Maple25]

I went to get a brain+c spine and t spine MRI done about a week ago. I got the disk and of course was very curious to have a look at home. I haven't seen any active lesions as much as I could tell. I got a text message from my doctor's office that I was scheduled for a visit on 7/2 and I was really happy that I get it over with. I was so surprised when his PA called me to say that he looked into my MRI+report and has to consult the radiologist to compare it to previous imaging and they will cancel my appointment. I am freaking out. I was always of the impression that neurologists know how to evaluate MRI's just by looking at them. I was diagnosed 6 years ago and have been on Copaxone for about 4 years then more off then on it. Now trying to get on Gylenia. The previous MRI's show lesions in the corpus callosum and the frontal and temporal lobes and they pretty much never moved. I had a few that came and disappeared in other brain regions, so, it is pretty much proof of disease activity. I just don't know why all the sudden he needs to have a consult. Can anyone please explain?

[pennstater]

Your neuro should know how to read an MRI. However, the radiologist report usually contains reference to prior MRIs so they know if any changes from prior point in time. If the MRIs showed new lesions, this would indicate that you may want to change DMTs. If no changes, they would consider this, along with your neuro exam, and may decide clinically stable.

The other possibilities are different machines or different techniques used in imaging.

I wouldn't get too excited. But I would let them know you want your appointment ASAP. If you are really anxious, call the PA and ask if there is something specific that is of concern on the report.

I had a new radiologist read my MRIs. They reported on something non-MS related, that two other radiologists over 10 years, never did. But radiologist report didn't indicate it was same as before. I had my original MRIs, so neuro looked at these, saw always there. I only had them because I switched neuro and he asked me to bring images from initial diagnosis, current MRI, and the one immediately prior to current.

So there can be lots of reasons. You can also ask your neuro to review your MRIs with you to alleviate your concern on his/her ability to read one.

[Maple25]

mris

Pennstater,

thank you for your explanation. He has all my previous MRI studies or should have. But I have to say that the quality of the recent MRI isn't as good as previous ones. I had two other sets taken on the same machine and the ones before were much clearer…
I am currently not on any DMT, I stopped Copaxone as it hurt my joints too much. He did this MRI as a baseline for Gylenia. I hope I can get on something soon as I am having a lot of issues lately and I just want to slow things down a bit.