MS protocol for MRIs - what is it?

[twopack]

There have been several references to using "MS protocol" when having MRIs done.  What is this exactly?  How would I know if it was used?

[twopack]

Wish I could edit after posting.  I always forget to sign off with my name.

twopack
~Mary

[twopack]

I'm good.  Thanks to you both.  

I went to the MS Care Consortium and looked around.  I did bookmark it for future reference as it seems there is plenty of reliable information there.  For the moment I just watched the slide presentation by Anthony Traboulsee, MD, titled, "Top 10 Things to Look for on an MRI in the Work-up of CIS".  It explained plenty.

I would think it would be most helpful if the radiologist has some little clue to what is being looked for, especially when the lesions can be so small.  It seems more an insurance industry rule to me or a way to keep MS out of your chart until there is a definite diagnosis (to protect patients from potential insurance and employment prejudices).

Then again, that presentation I just finished made it clear that you need to correlate history and symptoms with MRI findings to determine just what's causing the changes.  Apparently, the best even the experts can do is describe the light.  It takes teamwork and time to tell if it's a light bulb or sunbeam.

[sllowe]

If the Dr. suspects MS and is ordering standardized MRI, based on the 2006 MRI Protocol recommendations (mentioned above) it states for Dr. to indicate the following 1.) suspected MS;  2.) baseline evaluation of MS;  3.) follow-up of MS

It's important to know that the Dr. sending you to imaging may only write up a "symptom" you are having.   It happens a lot. Or, it may not be a symptom at all....

My MD ordered an MRI for me and it said "headache."  When I got to the facility, they asked me what was going on and I told them my symptoms. I highly recommend doing that....I was dx'd in 07 and 1.5T's were used.

All the referrals after the 1st headache order read MS, and though they may have added sequencing, nothing different was identified from the 1st sets.

Unfortunately the 2009 guidelines do not include language for the initial referral. Only the standards for the the reporting.  There is a health page and you'll find it in the list by MRI Protocol....

Momtogirls, I think you are headed in the right direction.

Twopack - hope didn't confuse you...

-shell

[Lulu54]

MT2G, the neuro does not want to unduly influence the radiologist by telling them that MS is the suspected diagnosis if you are still looking for answers.    The fact that the parasthesias was mentioned should be enough of a flag for the radiologist to look for demyelinating activity.  

Doing the MRI with contrast is also a sign to the radiologist.  

Please don't be angry about this ... you are in the right direction with your MRI.


Twopack-
For the most recent MRI protocol, you can read it at the MS Care consortium - a network of MS centers about the world.  

You might want to bookmark their homepage and go there often to read the latest MS news.  mscare.org

The MS protocol guidelines for 2009 is at  

mscare.org/cmsc/images/pdf/mriprotocol2009.pdf

[momto2grls]

So, if my neuro orders an mri w/ contrast it doesn't necessarily mean it was done under MS protocol? I didn't see any reference to MS on my orders when mine were done - just noted left side parasthesias.
This makes me so angry, why is it so hard for the docs to order the proper tests and do it right the first time? This is costing my ins. co. a fortune and I am getting absolutely nowhere.

[Meaganj]

The protocol for an MRI to check for MS is different than for other MRI studies. MS protocol should involve taking pictures with and without gadolinium contrast, as this contrast solution can highlight new or active lesions. Also, they should be done in 1 to 3mm "slices" or pictures, to catch the very tiny lesions that can hide easliy. And you should research your area to see ifyou have access to a 3T MRI machine. 1.5T and 2T machines are not quite as strong and therefore do not always take as clear images. And if you are going to be stuck in the tube, have them do your brain, cervical spine, and thoraci while they're at it. Many docs just do the brain first, but many MS patients have lesions ONLY in the spine (I cant remember the statistic, but I think around 20 or 25% have no brain lesions). I am one of those- They have found a thoracic lesion..so far. Make sure you know what you are talking about- the health pages here are really useful- and what you want and double check to make sure you are getting the best care for your money.

Meagan :)

[twopack]

Thank you.  I guess I missed that one.

~Mary

[doublevision1]

Click on Health Pages on the top right section of your screen, scroll down and about 10 entries up from the bottom of the list is "MRI Protocol for the Diagnosis and Follow-up of MS."  I'm not sure if this is current though; I seem to recall someone saying it has since been revised.

Your MRI report should give you a good sense of whether or not this was used.  Ask your neurologist or the radiologist to go through it with you.  Your neuro should be doing this anyway.