Female, 42 years old, with multiple sclerosis. Assess for progression. Brain:Extensive nearly confluent T2 hyperintensity is present within the periventricular regions of the cerebral hemispheres with multiple additional scattered focal lesions seen elsewhere in the cerebral hemispheres, basal ganglia and cerebellum. No significant interval change in the size or number of these lesions is seen when compared to the prior exam.Ring enhancement of one of the right periventricular lesions has significantly subsided though it is still vaguely detectable. No additional clearly enhancing lesions are seen. There is a generalized pattern of microvascular enhancement in the periventricular regions.No evidence of significant parenchymal edema or mass effect is seen. Mild cerebral volume loss appears similar to prior. No abnormal extra-axial fluid collections are detected. Ventricles are stable in size and morphology. A hypoenhancing right intrasellar lesion is partially visualized on this exam.C-spine:Successful cord T2 signal abnormality is identified at several locations including the dorsal right aspect at C2, the lateral left aspect at C2-3, and the dorsal right aspect at C3. Accounting for differences in technique, no significant change in the size, number or distribution of these lesions is seen. These lesions show no definite pathologic enhancement. Spinal cord morphology and caliber are otherwise within normal limits.Straightening of the cervical lordosis is seen. Spinal alignment is otherwise unremarkable. The vertebral bodies demonstrate normal height and marrow signal characteristics. No significant disc degeneration, spinal canal or neuroforaminal stenosis is seen.
1.No significant interval change in the size, number or distribution of extensive white matter disease in the brain. Some interval subsidence of enhancement is seen pertaining to one of the right periventricular lesions when compared to the prior examination.2.Multiple scattered cervical spinal cord lesions are redemonstrated showing no significant interval change.