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Can a CT scan detect MS lesions?

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    Can a CT scan detect MS lesions?

    Can a CT scan detect MS lesions, can someone explain to me why or why not?

    during my first episode with dizziness, I went to the ER. age 19. year 2005. They ordered a CT scan of my head. The ER doctor referred me to a neurologist because they found "spots." When I asked them what that could mean, the ER doctor said it COULD mean the beginning stages of "Multiple Sclerosis."

    so I went to the Neurologist who repeated the CT scan, this time with contrast, and he said it was fine, that maybe I moved my head too much during the first one.

    I later went back with more symptoms and he ordered an MRI, but by the time I got in for the MRI I was symptom free and so cancelled the MRI...never got the MRI.

    Wondering if the ER doc may have been onto something, although the repeat CT scan came out normal, does this mean I could still have lesions that maybe an MRI will detect?

    #2
    Originally posted by Boon View Post
    Can a CT scan detect MS lesions, can someone explain to me why or why not?

    during my first episode with dizziness, I went to the ER. age 19. year 2005. They ordered a CT scan of my head. The ER doctor referred me to a neurologist because they found "spots." When I asked them what that could mean, the ER doctor said it COULD mean the beginning stages of "Multiple Sclerosis."

    so I went to the Neurologist who repeated the CT scan, this time with contrast, and he said it was fine, that maybe I moved my head too much during the first one.

    I later went back with more symptoms and he ordered an MRI, but by the time I got in for the MRI I was symptom free and so cancelled the MRI...never got the MRI.

    Wondering if the ER doc may have been onto something, although the repeat CT scan came out normal, does this mean I could still have lesions that maybe an MRI will detect?
    If you are still having symptoms you should go back to see your neurologist and request an MRI. A CT scan is not nearly as detailed as an MRI. It "only takes pictures in the horizontal plane and does not adequately give a good picture of the posterior brain and brainstem, both sensitive areas in MS.

    The MRI is also very sensitive in giving a good picture of damaged myelin that is specific for diseases such as MS that a CT scan cannot do.

    So, while something may have shown up, whether it was artifact from movement, or some sort of lesion, it was not reproducible on the second scan.

    An MRI will show smaller white matter lesions and gives a good differentiation between damaged and normal tissue.

    Bring a list of your symptoms and timeline back to the neurologist, and request another MRI. Even if you are symptom free at the time of your exam, lesions will still show if you have something there.
    Disabled RN with MS for 14 years
    SPMS EDSS 7.5 Wheelchair (but a racing one)
    Tysabri

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      #3
      Thank you for this detailed explanation. I will keep everyone updated...

      Gotta call a neurologist Tuesday (tomorrow is Labor Day)... I am going to call one recommended by the National MS Society.. they sent me a list of neuros with experience with people in MS.

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        #4
        Some can...some can't.

        I was in the hospital recently and they did an MRI. The on-call neurologist came in and said, "Where did you get the idea that you had MS? Did someone tell you that?"

        Later I went to my MS neurologist who sends me to a special radiological place. My MS neurologist had told me that I had one large lesion and three smaller ones.

        It was time for my annual MRI so when I went to the "special" place for my MRI I asked them. They told me that their machine was specific to pick up small changes. They told me that their machine was five times stronger than the one they use in hospitals. Hospitals use the cheaper more, general MRI for more pronounced disorders and malformations.

        The machine they use on me is the stronger and the do two runs. One with contrast dye and one without contrast dye.

        My MS Neurologist showed the video of them to me and there they were, very clear. Even I could pick them out.

        Just some incidental information: the three smaller lesions have disappeared over time and the larger one is still there. He tells me it could be a MS lesion or a silent stroke lesion. So we are still investigating the larger lesion.

        In any case when I have a relapse I am no longer able to understand words, topics or talk. The larger lesion is located in the "Speech/comprehension" area. So I trust my Doc.

        I hope this helps you. I didn't know there was a difference until I pressed the issue and got info from multiple sources that matched.

        Dave Tampa, FL
        "Journeyman"

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          #5
          Journeyman is so right. I had several MRIs done at a smaller hospital early on in my diagnosis before I was referred to a research center. They were done on a standard 1.5 Tesla.

          I had symptoms, new ones, of pontine lesions, but none showed up on the 1.5 MRI. When referred, they repeated the MRI on a 3 Tesla and 3 brainstem lesions showed up that could not be seen on the 1.5.

          Larger hospitals have these machines in their centers and automatically use them for MS patients or to rule-out MS.

          They are just more sensitive.

          This does not mean that the 1.5 is not effective, the 3 T is just more so, especially for small lesions.
          Disabled RN with MS for 14 years
          SPMS EDSS 7.5 Wheelchair (but a racing one)
          Tysabri

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            #6
            Technical Specifics

            I love how you guys share technical specifics about machines, labs and stuff. That kind of thing fascinates me in general but what a help to all of us looking for a diagnosis or to rule one out. Thank you so much for sharing your wealth of knowledge.

            Shelby

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              #7
              How do you know which MRI machine was used. 1.5 or 3???

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                #8
                Originally posted by Light68 View Post
                How do you know which MRI machine was used. 1.5 or 3???
                For the most part you will not know until you either ask or when you get a copy of your CD, pop it in your computer and it will tell you if it is 1.5 T or 3 T on the T1 and T2 series.

                No easy answer...best to just ask.
                Disabled RN with MS for 14 years
                SPMS EDSS 7.5 Wheelchair (but a racing one)
                Tysabri

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                  #9
                  I called the lab and asked

                  and yes, mine was a 1.5 and I had one brain lesion in the right frontal lobe. May not mean a whole lot, but I look at lesions like some look at roaches... for every one you see, there are a lot you don't see!

                  In the meantime, eating better, taking my supplements, and trying to get in at least some exercise every day, which has been really difficult lately.

                  Best of luck,
                  Hugs,
                  Minnie

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