Can I get a Noncontrast MRI if I have GDD? A response to a sufferer, which is generalizable.
Jun 12, 2024
1 min read
The is a short blog, a response to a question I often get:
these symptoms are almost certainly GDD. About 1/3- 1/2 of people with GDD who get noncontrast MRI will experience Flare from that - at this point the only way to find out if you are in that 1/3- 1/2 is to get a noncontrast MRI and see how you do. Since I don't think a syrinx is the problem and I am not sure finding one is the cause. I do not recommend a noncontrast MRI at this time. Generally how I approach these situations is: if it is likely to be GDD-related, then undergo 5 chelations (maybe 10) if the symptoms have not improved at all then look at other things. At that point a noncontrast MR would much less likely result in Flare, because there simply is less Gd in your body to cause Flare.
If the investigation/treatment carries a much greater risk of harm: such as ablation of electrical conduction foci in the heart or resection of bowel, then I would wait for at least 10 chelations (or more) before agreeing to undergo these procedures.
Richard Semelka, MD
The risk/benefit calculus here reminds me of something I saw at https://casinisicuri.com about knowing when to fold: with a third to half of GDD patients reacting to a noncontrast MRI, waiting for chelation before imaging seems like the only sensible play. I'd never thought about the connection between total gadolinium load and the likelihood of a flare, but it makes perfect sense once you state it. Thanks for being willing to say "not yet" instead of just ordering a test.