Author Topic: MRI follow up next month - what to do?  (Read 752 times)

judyl

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MRI follow up next month - what to do?
« on: April 29, 2018, 04:22:26 pm »
When I saw Dr. Wilcox (Jefferson) for my evaluation in December, I told him I wanted to do Watch and Wait and I will have a follow up MRI in May before my appointment with him in June.  I expressed my concerns about the contrast agent and he was somewhat dismissive but said I still have the MRI without if I wanted. However, he still ordered it "with and without."  My question is when I make my appointment, will the facility still do the MRI "without" and has anyone done this?

This is an update to a reply I posted on an earlier thread (below) started by one of the moderators (ANASydney)  - MRI With and Without Contrast."

Can anyone help?

Thanks,
Judy


My initial MRI without contrast was done with the following sequences: 1 Sagittal T1; 2 Axial T2 Flair, diffusion, 3. Coronal T2 and the findings were suspicious for a mass with recommendation for follow up with contrast induced images. A week later, the MRI with/without contrast was done, which found a 1.4 cm acoustic schwannoma with the sequences: 1 Axial T1, Flair. Thin section axial space and T1 of the bilateral internal auditory canals and thin section post contrast axial and coronal of the bilateral internal auditory canals with fat saturation. Post contrast axial T2 of the entire brain.  The first line in the comment refers to minimal increase in T2 signal abnormality.   

I have no idea what these sequences mean.  Even though T2 is mentioned in the report, should I assume this was done with T1.  Would a  prescription for a follow up study need to specify without contrast and using T2?  What are my options if the MRI center and/or the ordering doctor tell me I must have contrast? 2





11/2/17 MRI w/o contrast for positional vertigo-1.3 cm mass in left IAC
11/8/17 MRI with contrast - AN 1.4 cm by 0.5 cm by 0.4 cm
12/19/17 Watch and wait
5/23/18 MRI w/o contrast 1.4 cm by 0.6 cm by 0.5 cm.

ANSydney

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Re: MRI follow up next month - what to do?
« Reply #1 on: April 29, 2018, 05:18:09 pm »
I believe the diagnostic MRI should be done with contrast. From then on, I believe, there is no need for contrast. My last two MRIs were done without contrast and future ones will be done without contrast.

I do my own measurements (as well as the radiologist) and I have no trouble doing the measurement from the images. T2-weighted images are the way to go (with fast spin or turbo spin). The person doing the MRI should be able to select the right MRI sequences to give you the best image without contrast.

judyl

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Re: MRI follow up next month - what to do?
« Reply #2 on: April 29, 2018, 06:38:01 pm »
Thank you. How do you take your own measurements?
11/2/17 MRI w/o contrast for positional vertigo-1.3 cm mass in left IAC
11/8/17 MRI with contrast - AN 1.4 cm by 0.5 cm by 0.4 cm
12/19/17 Watch and wait
5/23/18 MRI w/o contrast 1.4 cm by 0.6 cm by 0.5 cm.

ANSydney

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Re: MRI follow up next month - what to do?
« Reply #3 on: April 29, 2018, 09:13:24 pm »
The MRI place will give you a CD with the images. (You may need the doctor to requests this.) The CD has measurement tools that allow you to draw a line and display it's length.

The axial view with give you two of the dimensions and the coronal (back to front) view will give you the height.

I get the CD at the same time as the MRI and I have the measurements done by myself on the same day. When I get the radiologist's report, it just a matter of checking things. (By the way, what's more important than size is growth. So even if your method is somewhat off, as long as you're consistent, that's what matters.)

Take a look at https://www.anausa.org/smf/index.php?topic=23670.msg979775078#msg979775078 for more information.