My doc ordered an MRi WITHOUT contrast

[JodieK]

 
I'm ready to lose my mind. I went to my PCP again yesterday for a "checkup" to see if the steroids he gave me were working. Uh, no doc, but thanks. Anyways, he said that I have trigimenial neuralgia (i'd agree, my face hurts like he*&) and gave me neurontonin that I haven't touched yet ( scared to try stuff, Im a wimp, I know). But anyways, he gave me a number to a neurologist to have my ear and neck and head and jaw problem looked into further. When I called to make the appt with the neuro,  they told me to bring my films. I said I did not have any, so I had to call my PCP back and tell him that the neurologist wants a brain MRI.

His nurse called me today and said your doctor wants you to have a brain MRI and a right ( my problems are on the right side, except the balance... alot of pain).... but a RIGHT IAC MRI. I was absolutely exstatic that she said that, but when I said please tell me he said with contrast, she said let me recheck and said "newp, he said he wants it done without contrast".

So when I scheduled with the Diagnostic Imagining place, I had evil lady on the phone and asked her if IAC exams will pick up small things in the ear without having contrast. She said rudely "the test is getting done the way your doctor ordered it. He ordered it w/out contrast. Thats what you get) Twice after that though, she said come in at such and such time for your MRI of the brian and sinuses to which I said NO, NO SINUSES- IAC MRI, and then at the end of the convo, she said "ok, actually, come in earlier, since this is an MRI of the brain AND sinuses". I freaked out on her and was like lady...

type this in real nice and neat IAC MRI RIGHT EAR.

So now that I am going to be stuffed in a tube for almost two hours getting two types of MRI's done, without contrast,

does anyone know if.... since he is doing an MRi of the Ear ITSELF as WELL as the brain, if I have a better chance of getting some results that way? My only other option is to talk to the radiologist when I get there and say "you know... most lesions of the inner ear cannot be seen without contrast and see if she/he agrees and can call the doctor and have the order changed. My doc is a sweetheart, but hes NOT a radiologist.

Anyways, I go next Tuesday. My doc will have the results by the end of the day as he gets ALL results from them within an hour, but I probably wont know anything until next wednesday.

Anyone have an IAC MRI of their affected ear?
Thanks for the time to read this and reply.
Jodie

[Denisex2boys]

Hi Jodi .... I hope you have some answers soon.  I live up here in Canada where there  is typically a 200+ wait time for MRI's - but I had sudden hearing loss in my left ear last Christmas - I was just told it was in infection by my family doctor - I had already had an appointment scheduled with an ENT for some ongoing sinus issues - anyway - to make a long story short - along with the sinus issues I mentioned the loss of hearing and some of the fullness/congestion/numbness I was experiencing on the left side - he booked me for an MRI immediately - he must have suspected sometjhing was amiss to get me in.

 I do truly feel that if Dr.'s up here in Canada suspect something they do 'bump' you up the list ...... He ordered the MRI WITH contrast but when I went to the hospital to have it done they did NOT do it with contrast - I mentioned what I had heard about an AN not necessarily showing up without contrast and she explained to me that they were taking such 'thin slices' that it would be hard to miss if I did have an AN or some other entity - and by gosh it DID show up without the contrast.

I am sure that maybe small one's would not - but in my case they did find it without the contrast.

Good luck - - oh yes, I did not nor do I have pain ....... just the hearing loss and the annoyance of the full 'ready to pop' kind of feeling.  I also have tintinitus - but not the typical 'riniging' - it's like a balloon hissing when it loses air ?

[JodieK]

Denise,

Thank you so much for your reply. Hopefully, it will detect something, and if it doesnt- its cause its NOT THERE.  I can only hope and pray. Being a single mom and going through this is really rough.

I dont have the regular tinnitus either. I can hear my heart beat in my ear  and when I can, you can G U A R A N T E E I will be in pain.

Heres to hoping SOMETHING gets figured out, right? 

[macintosh]

My first MRI was without contrast. It picked up a small (7mm) AN very clearly. It was necessary to do another MRI with contrast the day before treatment in order to get a more precise reading of location.

Good luck,

Mac

[sgerrard]

Hi Jodie,

I don't know if this will help or not. For my MRI, they did Brain and IAC, with and without contrast. The whole thing took about 45 minutes. I got a CD of the MRI and have looked at the pictures. On some of them, especially the close ups of the IAC, you can see  the AN without contrast, and it is only 8mm long.

I think the main reason they do contrast is that the AN looks pretty much like the other blobs of tissue, and there are quite a few blobs of tissue visible in the pictures - bits of nerve, cochlea, bone, etc. The anatomy of the head in that area is amazing. The contrast makes the AN "enhance", or show up bright white, so it stands out from all the other blobs.

I'm not sure why your doc doesn't want contrast, unless he is worried about a reaction to gadolinium. There are cases of that, but they are not very common, and doing contrast is pretty routine at the MRI places.

One way or another, getting a detailed picture of what is going on around your right ear is sure to help them arrive at a diagnosis. It took a week for me to get the results reported, since a radiologist had to review the MRI, then send a report to the ENT, who reviewed it and then called me. You just have to sit on pins and needles and wait it out until you get the results. Hang on, you will know soon enough.

Steve

[vibursd]

i am having same problem accept i had dizzyness in 2014 after ct and mri and many other wierd test nothing was figured out then last year i got bells palsy again nothing figured out now i have dizzyness and fullness in right ear but no hearing loss get mri of inner ear no contrast hope they figure this out and praying its not a an but very scared??

[Blw]

I would just call your doctor and ask why. If he is a good doctor he will explain it. More often than not, doctors have a good reason for doing things a certain way. You could make something up like you are terrified of an MRI because you are claustrophobic, so you would really rather not have it done twice. On the other hand, there are a couple of threads around here on contrast and I think the feeling is that if they know to look for an AN, they can see it without contrast.

[PaulW]

I believe with the latest MRI techniques they have no problems identifying a very small tumour.
So contrast is not needed to find a tumour where AN's normally live.
If they do find something they will then give the contrast.
The contrast will help determine what sort of tumour it is by the way it lights up.
So the contrast agent is used to determine if it is say a meningioma or an Acoustic Neuroma.
It's no longer needed to find AN's
There is a very small risk, of serious side effects from the contrast agent, especially if you in very poor health and have poor kidney function. Healthy people are normally fine.
That's why increasingly they won't order MRI's with contrast unless it is necessary.

The newer machines with bigger magnets, more sensitive detectors, more computing power and techniques to enhance the images, thinner slices, higher resolution, are good enough to see AN's without lighting it up like a light bulb with contrast

[ANSydney]

For those with yearly (or similar) MRI's, the thought of gadolinium each time can be concerning. It's a heavy metal and although it is chelated, not all of it is excreted by the kidneys. Personally I would go for the first MRI with gadolinium contract agent and the one at treatment for radiotherapy, however I would go for a non-contrast MRI otherwise. Not sure if T1-weighted MRI or T2-weighted MRI gives the best non-contrast definition of the tumor.

[ANSydney]

To quote http://www.xrayrisk.com/faq.php, "MRI uses strong magnetic fields and radio waves to obtain images, which have not been associated with an increased risk of cancer. Ultrasound uses sound waves to produce images. There is no exposure to ionizing radiation with MRI or Ultrasound."

MRI and ultrasound I don't think are any concern. CT scans (CAT scans) use x-rays which is a concern. However, the gadolinium contrast agent sometimes used ...