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5 Things to Know About MRIs and MS

By Matt Cavallo


Magnetic resonance imaging uses magnetic fields and radio wave energy pulses to develop images inside the body that can’t easily be detected by other imaging devices, such as X-Ray and CATScan. MRIs can reveal to doctors injuries in joints, cartilage, ligaments, muscles and tendons. If you are familiar with sport injuries, tears to the ACL or MCL are commonly reported sports injuries that are found by using MRI.
 
In addition to sports injuries, MRIs can be used to evaluate problems with the brain or spine. Whether you are in the process of being diagnosed or ruling out multiple sclerosis or have been living with MS for a while, an MRI is a useful tool for both you and your neurologist. The following are five things you should know about MRIs and MS.
 
  1. Diagnosing MS – MRI is used in the diagnosis of multiple sclerosis, but it is not the only diagnostic tool. Diagnosing MS includes blood tests to rule out other diseases, lumbar puncture, and MRI studies. The initial MRI can be useful in determining whether the patient has a clinically isolated syndrome or as a predictive indicator for MS. MRIs are not a 100 percent positive in the diagnosis of MS. In 5 percent of the people showing clinical MS disease activity, lesions were not visible on the MRI. However, if follow-up MRI studies continue to show no lesions, the MS diagnosis should be reconsidered.
  2. Monitoring MS progression – MRIs are also useful in monitoring the progression of MS. Once the diagnosis is confirmed, MRIs are no longer needed for diagnostic purposes but continue to help with a patient’s MS journey and decision making. An MRI may be ordered to track changes or locate new and enhancing lesions. MRI studies can also be used for treatment decisions like determining the efficacy of a treatment plan.
  3. MRI with gadolinium contrast agent – One way to measure disease activity with MS is to use gadolinium. Typically, a series of MRI images are taken without gadolinium. Then the patient is taken out of the MRI machine and gadolinium contrast agent is administered intravenously. The patient is then put back in the MRI and a new set of pictures are taken with the gadolinium contract agent. The gadolinium contrast agent highlights inflamed legions showing current disease activity.
  4. Is gadolinium safe? – In 2015, the FDA issued a statement announcing that they were researching the safety of Gadolinium. In the statement, the FDA identified that Gadolinium deposits remain in the brains of patients who undergo four or more MRI scans long after the last administration. The FDA was evaluating the risk or adverse health events that would be associated with these Gadolinium deposits. In 2017, the FDA concluded that there was no evidence that the gadolinium deposits were harmful and that they would not limit the use of gadolinium in any way. If you have concerns about gadolinium, please speak to your ordering physician.
  5. Open vs. closed MRI – A traditional closed MRI occurs in a small, confined tube. If you suffer from claustrophobia, or if you are a larger patient, then you may want to research open MRI options. The closed MRI option is typically faster and more accurate in achieving higher resolution which is important, especially for the tests needed for MS.