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Multiple Sclerosis Message Board

Multiple Sclerosis Board Index

I am an MRI tech and not a radiologist or neurologist so I am not an expert in diagnosis or even the billing. In the brain, contrast does not help distinguish MS lesions. Usually it is pretty obvious. It is suppose to tell if the lesions are active MS or not. Out of the many brain sequences (set of pictures) we run, something called the FLAIR will show MS best and it doesn't matter if you use contrast or not. The lesions are bright and easy to see. We will run another sequence called T1 and normally you cannot see these lesion or they are very difficult to see. Contrast will enhance these lesions if they are active otherwise they remain darker and difficult to see. Years ago, we never used contrast on brains as we could tell if it was MS or not without it. Now it is part of our routine but that will vary from hospital to hospital. I'm not sure about how treatment changes if the lesions are active or not. For spinal MRI's, the FLAIR sequence doesn't work well. I'm not why. I read in a book that doctors are not sure why. In these cases, contrast can really help in seeing MS lesions in the cord which are much harder to see than in the brain. Usually lesions are in the cervical or upper thoracic spine. I hate doing lumbar cases on MS patients because the spinal cord ends at about the the L1 level so it seems like a lot scanning for nothing. Contrast is given approx 1 ml per 10 lbs up to a max of 20 ml's. We charge per ml but I am not sure exactly how much. I am sure it is pretty expensive. The cost of a exam with and without contrast vs without will be several hundred dollars more. If you get a brain and entire spinal cord with and without contrast, I am guessing that it cost about $6000, not that the hospital would be reimbursed nearly that much. Also, if you are claustrophobic, tell your doctor. He/she should be able to give you a prescription for Xanax which will help. No sense torturing yourself. Sorry this is so long, just wanted to give as much info as I could.
I guess the question I was trying to ask was: [I]Wouldn't the MRI with contrast be enough to see everything?[/I] Miknan you seemed to answer exactly what I was trying to ask, and-some. I had it all wrong thinking that the contrast would/could show everything. I did have the brain and cervical done with and without contrast, so if there's something there, they're going to see it. For the claustrophobia, I covered my eyes with an eye mask, and they put a headset with music which helped tremendously. Next time [I]I will[/I] dope up with some Xanax. I would have taken something, but the center I went to rescheduled my MRIs 2x, and by that time, I no longer had a ride. I had to drive myself there. Thanks so much for the lengthy explanation. It was quite informative. I am so new to this MS thing, and every bit of information helps. MSNik, I wish I had your insurance. What bargains on your MRIs. We didn't have a choice of insurance companies. We just had to take what the job offered. I still need to send in my payment of $110.00 for a Lumbar MRI done w/and w/out contrast performed back in March. Thanks a bunch and take care.:wave:

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