I’m at the hospital waiting on the radiologist. I thought having the MRI with the due was a more conclusive way to determine whether or not there is any build up of spinal fluid. The tech keeps repeating “we normally don’t do mri with the dye for Chiari because we can see the fluid without it”. Now everything I’ve read says to get the dye because the neurosurgeon needs it to properly diagnosed if surgery is necessary. Any help here would be appreciated.
The cine MRIs are done WITH die! This allows the doc to see the flow of CSF in conjunction with the flow of blood.
Okay so when I told my doctor that I wanted the MRI done with the die he knew which one he was requesting correct? The radiologist was adamant that it didn’t make a difference whether I had the dye are not that they could still see if there was any fluid flow. I made him give me the injection with the die for the MRI. But it still leaves me bothered as to why he’s telling me that they don’t normally do this for a Chiari malformations. He made me feel so stupid. Is anyone else encountered this will getting an MRI done with the dye?
The intravenous MRI contrast dye(Gadolinium is the most common brand) stays within the blood vessels. Therefore, you will see areas of increased blood flow better(tumors, arteriovenous malformations). The cine MRI looks at CSF flow and therefore has nothing to do with intravenous contrast. It is the unusual MRI performed for a Chiari that requires contrast.
There are more esoteric issues(have intrathecal dye injected for a myelogram that can look at alterations/blockage of flow within the thecal sac) but those are radio-opaque dyes(meaning you see them on CT or plain films, not MRIs).
The MD ordering the MRI is required to state either with or without(or both) contrast. If in doubt, check with the ordering MD. The radiologist will only know what is on the 1-2 sentence history they get. The ordering MD may have other thoughts.
Thank you for clarifying that!! Well now that means that I got the wrong MRI done. Grr I don’t know if my insurance will cover a third one. Goodness.
Dr. Trumble said:
The intravenous MRI contrast dye(Gadolinium is the most common brand) stays within the blood vessels. Therefore, you will see areas of increased blood flow better(tumors, arteriovenous malformations). The cine MRI looks at CSF flow and therefore has nothing to do with intravenous contrast. It is the unusual MRI performed for a Chiari that requires contrast.
There are more esoteric issues(have intrathecal dye injected for a myelogram that can look at alterations/blockage of flow within the thecal sac) but those are radio-opaque dyes(meaning you see them on CT or plain films, not MRIs).
The MD ordering the MRI is required to state either with or without(or both) contrast. If in doubt, check with the ordering MD. The radiologist will only know what is on the 1-2 sentence history they get. The ordering MD may have other thoughts.
No, the "with contrast MRI" is fine(as long as they did cine studies if ordered). You just got another sequence. It added a little time but, in the case of a Chiari, gives similar information. You should be fine whether it was with or without contrast in the case of a Chiari(so we usually just do without so there is no exposure to the dye...like any medication, you can have an allergic reaction).
Jut have the ordering MD check the images. Even if it is not exactly what he ordered, it sounds like it would probably be fine.