Multiple sclerosis (MS) is a disease in which the body’s immune system attacks the protective covering surrounding the nerves of the central nervous system (CNS).
Magnetic resonance imaging (MRI) is an important tool in diagnosing MS. MRI is also used to monitor disease activity and progression. It can reveal tell-tale scars, also called lesions or plaques, in the brain or spinal cord. This is caused by inflammation that results from the immune system attacking the outside layers surrounding the nerves.
If you have symptoms of MS, your doctor may order an MRI of your brain and spine. Lesions show up as bright or dark spots, depending on the type of scan. MRI is a non-invasive test that does not involve radiation. It uses a powerful magnetic field and radio waves to transmit information, which translates into cross-sectional pictures. Although the procedure is painless, the MRI machine makes a lot of noise and the patient needs to lie very still for the images to be clear. The scan can take 30 minutes to an hour.
An MRI scan can differentiate between active and non-active lesions. Active lesions show up in the scan as bright patches when a contrast fluid or dye is injected into a vein in the arm. If the lesion does not show up as bright, then it is likely to be an older lesion, and more than 3 months old. Sometimes, lesions will repair themselves and not be seen on subsequent scans. Persistent lesions may eventually show up as ‘black holes’, where the underlying neuron has suffered irreparable damage.
Following a diagnosis of MS, some doctors will use MRI to monitor MS if troubling new symptoms appear, or after the person begins a new treatment. Watching for changes in the brain may help assess current treatment and future options. Some neurologists order a new MRI scan of the brain or spinal cord every year.
From the Radiographer:
“When a patient arrives at OSD Healthcare for an MRI of the brain/spine for suspected MS, or a progression check for MS, we prepare the scanner to make the experience as comfortable as possible for the patient. Not knowing the degree of pain or range of movement the patient has until they are with us in the Imaging Department, it is vital to make the environment very welcoming. An MRI scanner can seem overwhelming, at OSD Healthcare, however, our scanner is wider and shorter than most scanners in the UK, and we can change the surround light system to suit the individual.
The patient is asked to lie on the scanning table, support aids can be given if needed. A cannula (small plastic tube) is placed into a vein in their arm (like a blood test). The patient is given ear protection and headphones (because the MRI’s can be/is noisy), which are connected to our stereo system which has Digital Radio and Spotify, so the choice of music is theirs!
Equipment is placed across their face and neck (called a coil), this does not touch them and there is a large periscope mirror, so they can always see us during scanning. They are handed a buzzer to squeeze if they need our attention during scanning, as the noise can be quite dramatic, this is their communication device with us, and are encouraged to use it if needed. They are in control! They are then moved in to the scanner, where their head is in the middle of the scanner, they are in the scanner to about their waist.
We then go into the control room where we start the scans. We constantly monitor the patient throughout. The patient is asked to remain as still as possible throughout scanning, regular updates and time scales of how long the scans will take are given throughout.
If we are scanning their spine, the table will move to get the relevant area into the middle of the scanner.
About two thirds into the whole scanning process, we move the patient out if the scanner and give the injection of contrast through the cannula, this is painless. 5-10 minutes worth if more scans happen after the injection.
After the scan the cannula is removed, and the patient is offered tea/coffee/water.
The images are reported by our expert team of Radiologists and the report is sent to their referring doctor to be discussed at their follow up appointment.”