Clinical question: Please perform Dr.Javed's multiple sclerosis protocol on 3T. signs and symptoms: MS progression, please compared with prior. Pre-and post-enhanced cervical MRI:Examination redemonstrates multiple foci of T2 hyperintensity throughout the cervical cord without convincing evidence of interval change since prior study. Limited view of the posterior fossa also demonstrate multiple lesions in the pons and medulla which also appear to have remained stable since prior exam. None of the lesions demonstrate abnormal enhancement. Findings consistent with patient's known emanating disease and medulla suggestion of progression.Multilevel degenerative changes cervical spine worst at C5 -- C6 and resultant central spinal stenosis and with moderate left and mild right neural foraminal compromise remain similar to prior exam. No evidence of spinal or neural foraminal compromise/stenosis at any other level.Pre-and post-enhanced thoracic MRI:Examination demonstrate multiple small foci of T2 hyperintensity in the ,mid to lower thoracic cord which considering slight difference in technique between the exam demonstrate no definitive evidence of interval change or progression. None of the lesions demonstrate enhancement. The lesions span from T5 inferiorly and with a cluster of lesions at T10 through the conus similar to prior exam. Some of the lesions demonstrate subtle associated decreased cord caliber suggestive of volume loss. The signal intensity in the alignment of the tubercle remains within normal and without evidence of spinal canal or neuroforaminal compromise at any level. There is no detectable abnormal enhancement of the vertebral column.
1.Mild to moderate findings of chronic demyelinating disease of the cervical cord without convincing evidence of interval progression. Degenerative changes of cervical spine with resultant central spinal stenosis and bilateral neural foraminal compromise only at C5 -- C6 remains similar to prior exam. No spinal stenosis or neural foraminal compromise at other levels.2.Findings of chronic demyelinating disease of thoracic cord from T5 through the conus without enhancement or progression since prior exam.