Thursday, 30 April 2015

Research Day

Today we have Amy and DrK talking about MRI
This was the last of the Research Talks. 
We hope you enjoyed them. 

9 comments:

  1. I would really appreciate it if an MRI expert could tell me whether avastin (Bevacizumab) treatment could artifially make an MRI scan of the cervical neck look normal when in fact there is lesion/atrophy there.

    Thankyou I am really keen to get an answer to this question.

    ReplyDelete
    Replies
    1. I don't use Bevacizumab in my practice, however here's a paper suggesting efficacy in spinal cord cancer with corresponding reduction of the lesion visible on MRI (http://link.springer.com/article/10.1007%2Fs11060-012-0905-5). Improvement in this circumstance is obviously in the opposite direction from MS: In MS volume reduction is - generally speaking - an indication of deterioration whilst in malignancy it rather suggests remission.

      Delete
    2. thankyou very much. there is a query of whether I have MS or delayed radiation myelopathy (from treatment in 1990). I had treatment of Bevacizumab for the DRM. The scan showed resolution of lesion. Then after Fampridine (3 months later the lesion was back. I dont know if the drug made the scan look normal, or effects of drug wore off or if it was the fampridine putting stress on newly resolved lesion. My doctors dont know answer either. My LP is clear aling with brain scan.

      Delete
    3. Several things to look at it seems; difficult to advise without clinical review.

      Delete
  2. What about diagnosis with normal mri?
    Or even normal brain but lesions on spine?
    What is your stance on this

    ReplyDelete
  3. As a clinician a diagnosis of MS with completely normal MRI always leaves one with a trace of uncertainty. Having said that, any neurologist knows there are MSers who seem to have hardly any (or indeed: no) MRI detectable lesions in the white matter. These MSers may have demyelination and other MS-related changes in the grey matter, which we know from pathology play a significant role in MS. For several reasons, grey matter lesions in the brain (not necessarily the spinal cord) are more difficult to spot on standard MRI. Further tests including spinal fluid and neurophysiological studies can then help establish the diagnosis. The situation of "no detectable lesion" has some resemblance with the one where only "a single lesion" can be detected (http://www.sciencedirect.com/science/article/pii/S2211034813000102#).

    ReplyDelete
    Replies
    1. Also Dr K if this is a grey matter loss disease and testosterone has been proven albeit in a small study to help grey matter
      Is it worth having test levels Checked

      Delete
    2. Too early to call really. Testosterone supplementation is not without risks, and there is no sufficient data to support this.

      Delete
  4. Thanks Dr K
    it is early on in disease course but so many symptoms already and yet clear mri is causing a clouding of the water with regards to diagnosis
    I wonder if the testosterone treatment would be beneficial In this case, although not proven in a large study it could be worth a shot as ther is nothing else to prescribe I believe?

    ReplyDelete

Please note that all comments are moderated and any personal or marketing-related submissions will not be shown.