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Do MRIs do more harm than good for MS patients? Our neurologist explains.

A doctor and their patient look at an MRI scan together.

/ by Jay Avasarala, MD, PhD

Written by Dr. Jay Avasarala, director of Multiple Sclerosis and Neuroimmunology at the Kentucky Neuroscience Institute.

There is no definitive test that can identify multiple sclerosis (MS), which is why imaging of the brain/spinal cord or the use of MRIs is "mandatory." The role of MRI in the diagnosis of MS has become more important over the past few decades, and physicians use MRIs to sort out MS from MS-like diseases.

What MRIs are used for

However, doctors don't just use MRIs to diagnose MS.

They also use MRIs to examine patients' symptoms, assess complications from the use of disease-modifying drugs such as Tysabri (Natalizumab) or others, and evaluate treatment response.

The potential danger of MRIs

Unfortunately, there is a downside: Repeated MRI use in patients, specifically the use of contrast agents, has been show to lead to kidney problems: nephrogenic syndromes, such as nephrogenic systemic fibrosis, or acute or chronic renal failure. Some studies have specifically questioned the use of frequent MRIs as an assessment tool given that no benefit accrual was noted with frequent MRI use for guiding therapy or preventing disability.

Hence the use of repeat MRIs is a patient-to-patient consideration in most cases.

Recent reports suggest that providers should use MRIs without the use of contrast agent, or gadolinium, to follow disease progression. If MRIs are obtained using 3.0 T machines, one study notes that contrast does not need to be administered and disease interval progression can still be followed with the same degree of accuracy without contrast administration.

How patients can benefit from our doctors

At UK HealthCare, we separate ourselves by keeping up with current trends, research and optimization of patient care. That means we engage in research and publications, and we look beyond one patient and think about the "larger footprint" that comes with planning original work for patients across the globe.

A case in point is the exploration of techniques to identify optic nerve disease using a no-cost approach to the patient. Another example is the theory that use of medications for one disease could spur the onset of another disease. This is just the tip of the iceberg, but that is what we do: We aim for a better tomorrow.

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