If lesions are inactive does that mean my wife doesn't have MS anymore?

Here is My Question:
My wife has lesions on her brain and spine but they are inactive. Does this mean she doesn't have MS anymore? That is an excellent question.

Answer:
We define "activity" on an MRI by the development of new or enlarging white spots (also called T2 hyperintensities) over an interval of a year or less or by the presence of typical gadolinium enhancing lesions on an MRI at any time. Scans with any of these features are said to be "active."

Active MRI scans are far more common in younger relapsing remitting people with MS (under age 45) and especially in those not on disease modifying therapies. Once individuals are over the age of 45, it becomes less and less common  with further aging for MRI scans to show short term activity (observed over an interval of a year or less)

The absence of activity on an MRI scan does NOT mean the person no longer has MS or the disease is in remission. There are many reasons for lack of activity on an MRI including but not limited to the following reasons:

1. Too short an interval from the last scan to detect activity
2. The disease is treated very well 
3. The person is no longer in the relapsing remitting phase of the disease, usually over the age of 45
4. The MRI scan was not technically adequate to detect activity
5. The radiologist read the images incorrectly

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(Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego