When to get an MRI

Should I get another MRI?

1/15/2016

Question:
When you test for MS and then first MRI is normal and then a year later it is still normal, when should you do another MRI? I'm continuing to have symptoms such as stiffness, fatigue, eye pain, numbness and tingling.

Answer:
The answer to your question really depends on the likelihood that you have MS. For instance, if you experienced a clinically isolated syndrome (optic neuritis is an example) and your MRI is normal at onset your chance of developing MS over the next 10 years is less than 20 %. Repeating an MRI scan one year later is reasonable but if the repeat scan is normal, I would wait another 2 years before scanning again. Of course, if definite new symptoms consistent with MS occur during this follow-up interval, I would repeat the MRI earlier.

People with signs and symptoms that are less specific for MS (examples include fatigue, stiffness, tingling without exam findings) do not require multiple repeated MRI scans; repeating an MRI one year later is probably sufficient unless definite symptoms and signs of MS appear.

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

Jennifer

1/17/2016 07:07:10 am

Does the severity of the CIS matter in predicting 10 year risk? Ie. If optic neuritis is mild?

Dr Kinkel

1/18/2016 06:29:21 pm

The severity of the clinically isolated syndrome (CIS), especially with optic neuritis, has no effect on the either the risk of developing clinically definite MS or future disability as long as the syndrome is monofocal (e.g. only affects the optic nerve) and the individual recovers. Both multifocal onset (example would include optic neuritis and numbness and weakness of both legs) and residual disability after recovery are risk factors for early recurrences and early disability.

Kate link

7/23/2016 05:42:42 pm

Hello Dr.kinkel
Will you please help me to understand my MRI result.

I just had an MRI done two weeks ago. It was 1.5T open MRI without contrast. When my GP got the result he told me he doesn't think that it's big deal. He was not agreeing with radiologist. But I insist to see a neurologist.so I saw one last week. He checked on my reflexes then made me walk back and forth and told me no he also don't think that I have MS. Beacuse the images and symptoms should match.
He also told me that he'll take a look on my MRI and call me. After a day he called me to tell me to do another MRI with contrast this time. It's gonna be 1.5T open MRI again. The neroli told me people with headache can have white spots.
Here is my MRI result.

Findings:
Normal Configuration of the intracranial compartment and posterior fossa. There is no hydrocephalus, intracranial mass, hemorrhage, diffusion restriction or significant abnormality demonstrated extracranially. Several nonspecific punctuate FLAIR in distribution. In pationet of this age, these are atypical, and could be

inflammatory-infections, demyelinating, chronic migraine, vascular, and not completely excluding Vasculitis. Intracranial dominant flow-voids are identified in usual fashion.

Impression:

Tiny scattered frontoparieatal FLAIR hyperintensities are distributed largely peripheral. In a pationet of this age, with this MRI appearance, it could be due to variety of etiologies. Further work up is therefore recommended clinically. Further work up is therefore recommended clinically. Further radiographic work up may include MRI using Gadavist, cervical MRI if indicate, and follow up MRI for stability advised

The thing is that I had headache but I don't remember I had migraines.
So how and why i got third spots I don't understand and how they can be normal.
If they are nonspecific then why he asked for second MRI?
I am 37 years old and based on my age both my dr and the nerou dismissed other possibilities that radiyologyst suggested.
My dr ran many tests for inflammation and ANA test. ESR, C-receptive and many others all came back negative.

Thank you

Christine Granfield

7/25/2016 04:29:19 am

Hi Kate, we can't evaluate your MRI without permission from your primary physician or your neurologist. If you would like one of our specialists to provide a second opinion, the first step is to have your physician request a second opinion from us, then you can send your MRI and any other important info to us through our image storage capabilities (see the "store Images" icon on our homepage, then the cost would be $50.

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