I have a lesion from scan in October 2015. Now in December 2016, I have had 3 more scans and I still have active flaring. It is the same lesion. My MS doctor is ordering more blood testing and more scans of my body to see what is going on. He says it is abnormal for a lesion to be active for over a year and has continued to be active for over a year. Can you help me to understand what may be going on here?!!!
The majority of enhancing (“active”) lesions in MS patients cease to enhance within a month. Persistent enhancing lesions for more than 6 months occurs rarely (< 5 %) and should prompt further investigation before assuming this is a chronically enhancing MS lesion. Possible causes of persistent enhancement for over a year (other than MS) include benign vascular malformations, such as capillary telangiectasia or cavernomas, a granulomatous process and some tumors. It is unlikely that an infectious process would cause asymptomatic enhancement for over a year.
Further investigations to help sort out the cause could include gradient echo imaging (GRE) if not already done, MR spectroscopy, FDG PET scan and spinal fluid analysis
Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
Professor of Clinical Neurosciences
University of California San Diego