Is it possible to have a first thoracic spine lesion with stable brain MRI over 10+ years?

Here is My Question:
Is it possible to have a first thoracic spine lesion with stable brain MRI over 10+ years? Or is it more likely that the lesion (called focal signal abnormality on MRI) is caused by something else? Thank you for your time.

Answer:
There are several possible explanations for the apparent emergence of a new lesion on a thoracic cord MRI. For the sake of my reply I will assume that you have undergone MRIs of the thoracic spine in the past and they did not report any 'focal signal abnormalities'

1. The abnormality noted on the most recent scan may have been present on earlier scans but not visualized because of technical reasons such as artifacts obscuring the area of involvement, or the type of scanner or imaging sequences utilized in the scanning procedure. This is fairly common with imaging of the thoracic spine
2. The focal signal abnormality could represent another process. This is less likely in a person with definite MS with no compression of the spinal cord in the area of the new lesion and no prior abnormalities on MR imaging of this area.
3. The focal signal abnormality is indeed related to MS and appeared since the last MRI. Depending on the abnormality and its relationship to other known lesions in the spine, it may represent Wallerian degeneration not new inflammatory demyelination. Wallerian degeneration occurs over 6 to 12 months because of degeneration of fiber tracts by an MS inflammatory lesion above or below the area of the new 'focal signal abnormality'. 

Hope this helps.

Revere P (Rip) Kinkel, MDProfessor of Neurosciences
Director of the Multiple Sclerosis Program
University of California San Diego
#multiplesclerosis #MS #spinalcord