frequency of mri

[sara1953]

i have been battling a very severe flare the past 3 weeks. I went through a 3 day solomedrol infusion early last week with little to no results. My question is how and when does the dr make a dermination as to when to order an mri? After each flare? Only the bad ones? Once a year? Can you have too many, like xrays? This has been so bad I'd love to know what if any changes are seen. Not that my symptoms would suddenly go away if I know how many and where the lesions are...... I just feel like we have to do something proactive. Sara

[Bob698]

It helps to learn about MS as a disease.
In many ways, we're dealing with two seperate issues. The MS itself and the secondary symtoms we feel as a result of MS.
For the post part, Drs. don't like over-doing MRIs. We tend to get our first MRI to determine IF we have MS. The follow-ons are to figure out stuff like the rate of progression (is the DMD working or not?) or locations of certain leasions or if we have leasions in our brain, spinal collumn, or both.
I don't think there is a huge risk to having too many MRIs done- except to our bank accounts. Otherwise, MRI machines tend to have long waiting lines and get a lot of use by patients with many other diseases.
I've been formally diagnosed for almost two years. I get occasional mild flares but have no plans for additional follow-up MRIs because my DMD is working really well (that's the difference between MS and the secondary symtoms again).
The only way I or my Dr. would want a new set of MRI images is if I start getting new symtoms I've never experienced before. That would be a sign of new progression and that maybe my DMD is no longer effective and its time to switch to something else.

[Scooter24]

I also thought it needed to be done more often, but a few months ago when the dr said it was time to get another one he only scheduled a brain to watch for PML as I am positive to antibody, I asked why he wasn't doing a cervical one, his response made alot of sense once I heard it, he said " what good would it really do, if you have more legions there is nothing that can be done, not like we can go in and remove them and that I only needed one once a year for watching for activity just to keep an eye on if the meds are working but he said my body will tell us that".

He also made sense as I am seen at the VA that it frees up the machine for others to be tested as they already schedule MRI's from 6 am to 10pm at the moment to try to keep from having too big of a backlog for getting them done.

[SNOOPY]

Hello Sara,

The MRI is a great diagnostic tool. Unfortunately, the MRI does not necessarily correlate to how we may feel. You can have a relapse and the MRI may not show any new activity or lesions, you may feel fine and the MRI shows new activity or more lesions and sometimes the MRI will correlate to how you feel.

It's always good to remember: treat the patient not the MRI.

[rocky282]

just some advice

If you have had steroids, don't let your Doctor do an MRI until at least 4 weeks from the last day of infusion. My doctor had to go home for several weeks right after one of my treatements (his mother died) and wasn't there for a consult. The PA who was seeing me in his place was very upset that my vision had not improved so at the end of week 3 she ordered another MRI, it showed more enhancement. We found out AFTER my doctor got back that the steroid needs a full 4 weeks to do it's job before you recheck. He also said if I new in that 3-4 week period that I was still having problems he could have ordered another 2 days of IV steroids to kick it up a little bit.

I hope it starts doing something for you soon. As a side note, my first year I was having MRI's about every 3 months, because none of the CRABS were working. This year I have had 2, and it appears that aside from the ON, my Beteserone is slowing it down.

[sara1953]

mri

Thanks everyone. I've been on a combo of Avonex and Cellcept for about a year with 3 flares so far, so I'm guessing that a change of meds is in my future. My case is complicated by the fact that the cellcept is what we are using to try and keep my intermediate uveitis under control-I've been on it for about 4 years. I think I will approach my neuro about an mri just to make sure that a new lesion is evident before we do anything radical. ( i was just getting used to the Avonex and have a "system" so that I can still live my life the day after my shot.) Does a new flare always indicate new lesions? Can an old lesion reactivate? Do new symptoms indicate a new lesion(s)? Does anyone know of a site that might list symptoms and the part of the brain or spine that might be affected?

[lchoppel]

no, a flare does not mean you have new lesions necessarily. Yes, new lesions can form with a flare but old ones can be "activated" again and cause you flare.

I think there exists a sight that shows parts of the brain and you can read your MRI report and correlate the location of the lesions on your MRI to the part of the brain. I just don't know the web site. But you should find something on the internet, just do a thorough search.

As part of your original question, my neuro orders an MRI when I've believed I've experienced a flare, as well as using one as a diagnostic tool to see how well my DMD is working, maintenance like every 6 months. I don't believe you can get over-radiated from MRI's like you can from regular xrays, but don't quote me!