65 years, Female, multiple sclerosis, evaluate for progression. Brain: There are multiple T2/FLAIR hyperintense lesions in the periventricular and subcortical white matter with distribution and morphology compatible with known demyelinating disease. Differences in technique limit comparison; there are few small lesions involving the bilateral frontal and parietal subcortical white matter which are present on current high-resolution study and not evident on prior MRI from 4/14/2012 and 11/8/2010. The relatively largest lesions involving the right periatrial white matter as well as the right posterior pericallosal lesions are again seen and demonstrate T1 hypointensity. No new large lesions are demonstrated. No infratentorial lesions are definitively appreciated. No lesions with enhancement to suggest active demyelination. A right frontal developmental venous anomaly is incidentally noted. Brain parenchymal volume is within normal limits for age. No intracranial mass effect. No hydrocephalus or extra-axial collections. Calvarium and extracranial soft tissues are unremarkable. Cervical: Again seen are multiple T2 hyperintense lesions in the cervical cord including the right lateral C2 level, dorsal C2-C3 level, and left dorsal lesion extending from the C5-C6 to the C7 level, which is also associated with focal volume loss. No associated enhancement is seen. No new lesion is seen. The previously seen lesion in the cord at T3 is again seen and partially imaged on the sagittal sequence.Vertebral body heights and alignment are maintained. Mild degenerative changes are again seen with small disc disc protrusions at the C3-C4 to C5-C6 levels without significant spinal canal or neural foraminal stenosis. Foci of T1 hyperintensity compatible with small hemangiomas or focal fat. No suspicious osseous lesions are evident. Paraspinous soft tissues are unremarkable.
1. Multiple T2/FLAIR hyperintense lesions are compatible with known chronic demyelinating disease. Differences in technique with prior study from 4/14/2012 limited precise comparison; however, there are small lesions which are present on the current high-resolution study and not seen on prior. Comparison is technically better with MRI from 11/8/2010 with more definitive evidence of a few small lesions which are new since then. Overall there is minimal interval progression of disease in the brain. No new large lesions are evident.2. Unchanged multiple T2 hyperintense lesions in the cervical cord and upper thoracic cord compatible with chronic demyelinating disease. No new lesions.