A Deeper Dive Into MRIs
By: Nurse Kim
In my experience, people have a lot of questions about getting MRIs. The most common question is, “Do I really have to do this?” When you are living with MS, the answer is YES. This article is meant to help you understand a little bit more about what an MRI is and why it’s important.
What is an MRI and how does it identify lesions?
Let’s start with what MRI stands for: Magnetic Resonance Imaging. An MRI is really the definitive way your neurologist can see if there are lesions in your brain or spinal cord.
Simply put, a lesion is an area of inflammation (and possible scarring) found in the brain or spinal cord. It’s an area where the myelin—the outer nerve layer that protects the nerve cells as they send signals throughout the body—has been damaged.1
The myelin is fatty, and because of that, it repels water. When the myelin is damaged by MS, the fat is stripped away, leaving room for water to flow into those empty areas. The water spots then show up on an MRI scan.2
Depending on the type of MRI scan you get, the spots can show up as bright, white spots, or a darkened area of spots, and both of these are indicators of new or growing lesions.2
Why is it important to get regular MRIs?
Your healthcare provider will compare your new MRI to previous MRIs to see if you have new lesions or if your existing lesions have gotten larger—in other words, whether or not MS is active. If that’s happening, it may be time to switch treatments.
You may be wondering when it’s appropriate to get an MRI. Before switching treatments, your neurologist will usually recommend an MRI. After you’ve been on your new treatment for about 6 months, he or she will likely recommend another one to evaluate how well your body is responding to treatment. After that, you should get an MRI annually. Don’t be tempted to skip a scheduled MRI because you’re not having any new symptoms, because lesions and symptoms don’t always match up. Even if you haven’t had a relapse and your symptoms are mild, you may still have new or growing lesions. The only way to know is to get regular MRIs.
Sometimes my patients have told me that their neurologists are not as proactive about requesting MRIs, and I tell my patients to be proactive and ask for one themselves. You and your neurologist know what’s going on with your body in terms of symptoms, but knowing what’s going on inside your body is just as important for you to make informed treatment decisions.
There are some things I recommend to my patients to set themselves up for success when they’re going for MRIs. Bringing relaxing music, wearing comfortable clothes, and leaving all metal items, including jewelry, at home can be helpful.
Getting MRIs and discussing the results with your healthcare provider is an important part of your bigger goal—to better manage the progression of MS.
Do you have any tips you would recommend to someone going for an MRI? Please share them in the comments section below.
- Magnetic Resonance Imaging (MRI) is the most common way a healthcare provider can see if you have any lesions.2
- Lesions and symptoms don’t always match up—MRIs can show new lesions even if you have only mild symptoms or no symptoms at all.2
- You should get MRIs annually, as well as before and after switching treatments.2,3
References: 1. Multiple Sclerosis Coalition. What is myelin? https://www.nationalmssociety.org/What-is-MS/Definition-of-MS/Myelin. Accessed May 21, 2018. 2. Multiple Sclerosis Coalition. Magnetic Resonance Imaging (MRI). https://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-Tools/MRI. Accessed May 21, 2018. 3. Rae-Grant A, Day GS, Marrie RA, et al. American Academy of Neurology. Practice guideline: Disease-modifying therapies for adults with multiple sclerosis. March 6, 2018. https://download.lww.com/wolterskluwer_vitalstream_com/PermaLink/WNL/A/WNL_2018_04_19_RAEGRANT_NEUROLOGY201
7835181R1_SDC3.pdf. Accessed May 21, 2018.