Female, 35 years old, with subacute left-sided weakness and history of multiple sclerosis. Brain:Multiple new T2 hyperintense lesions are seen scattered through the cerebral hemispheres, the brainstem and cerebellum. A number of these lesions demonstrate either solid or rim enhancement. No evidence of significant parenchymal edema or mass effect is observed. Brain volume is within normal limits. No acute intracranial hemorrhage or any abnormal extra axial fluid collection is detected. Ventricular size and morphology are within normal limits.Cervical spine:Multiple scattered T2 hyperintense lesions are seen within the cervical spinal cord. The largest lesion is located dorsally and spans approximately 13 mm at the C4-5 level. This lesion does not enhance, but several of the smaller lesions at the cervico-medullary junction and at C3 do enhance.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No marrow replacement or marrow edema is seen. The spinal canal and neural foramina are patent. No disc degeneration is seen.Thoracic spine:Multiple T2 hyperintense lesions are demonstrated through the thoracic spinal cord including large lesions at T5-6 and T10 which measure up to 15 mm in length. Both of these lesions, and several smaller lesions, demonstrate enhancement on postcontrast images.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No marrow replacement or marrow edema is seen. The spinal canal and neural foramina are patent. The intervertebral discs are normal.
1.Multiple new and enhancing lesions are evident within the brain compatible with interval progression of demyelinating disease and with the presence of actively inflamed lesions.2.No prior examination is available for comparison in the spine. However, numerous enhancing and nonenhancing spinal cord lesions are also demonstrated.