MS and MRI: What to expect

Last updated Jan. 27, 2025, by Susie Strachan
Fact-checked by Inês Martins, PhD

Magnetic resonance imaging (MRI) is an essential imaging tool for establishing a diagnosis of multiple sclerosis (MS), tracking its progression, and guiding MS treatments.

Your doctor relies on MRI scans to detect regions of damage in the brain and spinal cord, which appear as lesions, to help assess disease progression and determine if your current treatment is working or whether you might need to switch to a new one.

It’s normal to be nervous or anxious about an MRI, especially if you haven’t had one before.

But knowing how to prepare for an MRI, what to expect, and trying some stress management techniques can make the MRI process less daunting and help you feel calmer.

Preparing for your MRI

To feel better prepared for your MRI, you may want to learn as much as you can about the procedure by speaking with your MS healthcare team and the MRI technicians before your appointment.

An MRI is a machine that uses powerful magnetic fields and radio waves to create detailed images of your internal organs and tissues, allowing doctors to visualize areas in the brain and spinal cord that may be affected by MS. It is a noninvasive technique, which means it does not require surgery or other invasive procedures.

The one exception is if your healthcare team wants to do an MRI with a contrast agent, which is injected into a vein just before the scan to help highlight lesions with active inflammation.

An MRI can identify areas where the myelin, a sheath that wraps around nerve fibers, is damaged, and if there is active inflammation in those lesions that may result in further damage.

When new or active lesions develop, or when old lesions get bigger, you may experience MS relapses, new or worsening symptoms. MRI scans can also detect if your brain is shrinking at a faster rate than expected for someone your age, which is a sign of nerve cell degeneration.

For many people living with MS, it’s typically recommended to have a routine MRI scan every six months to two years, depending on factors such as disease activity, symptoms, and type of treatment.

You will generally have MRIs more frequently during the early years when MS is usually more active and fewer scans in the later stages.

Your doctor may order different types of MRI scans to evaluate your MS.

• T1-weighted scans can help find areas of permanent damage to nerve cells, called black holes, and are also used to detect lesions with active inflammation when a contrast agent is injected.
• T2-weighted scans can visualize overall numbers and sizes of lesions, both active and inactive.
• FLAIR scans make it easier to see lesions near spinal fluid.

If you have metal implants, a pacemaker, or other medical devices or if you’re pregnant, make sure to tell your doctor before your appointment.

What to wear

Because MRIs use strong magnetic fields, metals inside the body may move or shift positions during a scan and be harmful. External metal objects may also heat up and cause burns, or they can interfere with the magnetic fields and cause distortions in the images.

Ideally, do not come to the appointment wearing anything made from metal. This includes clothing that has metal, such as zippers or snaps, jewelry, piercings, eyeglasses, and bras with underwire. If you do, you will need to remove them before your MRI.

While you may be asked to change into a medical gown, if you are wearing loose, comfortable clothing, such as pull-on athletic pants and a T-shirt, you might not have to change.

You may also be asked to remove dentures, hearing aids, or a wig, if applicable, as they can interfere with the scan.

Eating and drinking

When preparing for an MRI, follow all the directions you have been given about eating, drinking, and taking your medications.

You may be able to eat and drink as usual, but, in most cases, you will be asked to fast for four to six hours before an MRI. If your MRI involves a contrast agent, the fasting period may be longer.

Emotional preparation

MRIs can seem intimidating and make you anxious because of the enclosed space, loud noises, and how long you spend inside of it.

It may be helpful to remind yourself the MRI is a safe, noninvasive tool for helping to manage your condition and guiding your MS care.

If you have a fear of enclosed spaces, known as claustrophobia, or are worried you will be triggered by being in the machine, discuss with your healthcare provider the possibility of taking a mild sedative to help you feel calmer.

You may also want to ask a friend or family member to accompany you to the MRI appointment for emotional reassurance.

The MRI process

An MRI is done at a hospital or imaging center.

Most traditional MRI machines are tunnel-shaped and open at both ends. There are also open MRIs, which have a wider opening and may not be as enclosed, and, while less common, MRIs where you stand or sit upright instead of lying down.

Usually, you’ll lie on a table that moves into the center of the machine. The MRI technician will guide and talk to you throughout the procedure.

Because the machine makes repetitive tapping, thumping, and other loud noises, you may be given earplugs or headphones for listening to music to help distract you.

Most scans take 15 minutes to an hour. You’ll need to stay still for the images to be clear and detailed.

Throughout the MRI process, the MRI staff will be nearby in a separate room. But they will be in constant communication with you and available to help you at any time.

Tips for staying relaxed during an MRI

Stress management can help you stay calm during an MRI.

These MRI tips can help you feel more comfortable during a scan:

• Take slow, steady breaths by inhaling through your nose, holding for a moment, and exhaling through your mouth.
• Try a visualization technique by imagining yourself in a calm place, like by an ocean with gentle waves or listening to leaves rustling gently in a breeze.
• Practice mindfulness by focusing on the present moment, paying attention to the sensations in your body and the rhythm of your breathing.
• Close your eyes or wear a blindfold to be less aware of the enclosed space, especially if you’re feeling claustrophobic or very anxious.
• Ask if you can listen to your own music, audiobook, or podcast.
• Request the technician talk to you throughout the procedure.

If you have difficulty staying relaxed during the scan, ask if you can take a break.

What happens after your MRI?

After your MRI, you should be able to do your regular activities right away.

The images are sent to a radiologist, who will look for any indications of changes in your brain or spinal cord including new or growing lesions.

If a contrast agent was used during the MRI, the radiologist will also assess highlighted areas for active inflammation.

The radiologist will send the MRI results to your healthcare provider.

Getting your results

When you get your MRI results can vary, but typically it may take anywhere from a few days to a couple of weeks.

Your healthcare provider should explain your MRI results and answer any questions.

The specific MS MRI findings will help your healthcare provider decide next steps, including if adjusting your MS treatment plan or other changes are needed.

In some cases, you may have symptoms consistent with MS but have a clear MRI, meaning there are no signs of MS-related damage in your brain or spinal cord. It’s possible some lesions are too small to be clearly seen on MRI scans, but other potential causes for your symptoms should be explored.

There will also be instances where your new scans show no new or growing lesions or signs of active inflammation; this can be a sign the disease is stable and well controlled with your current treatment.

Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.