Multiple sclerosis Brain: There are least 6 T2/flair hyperintense lesions involving the bilateral periventricular and subcortical white matter including pericallosal/periventricular lesions with an ovoid morphology. Lesions include the bilateral pericallosal white matter, splenium of the left corpus callosum, left anterior temporal subcortical white matter and adjacent to the left occipital horn. Possible tiny juxtacortical lesions involving the superior frontal gyri. Few lesions with T1 hypointensity are noted. No lesions with enhancement are seen. There is a small lesion involving the right middle cerebellar peduncle. No other infratentorial lesion is appreciated. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Brain parenchymal volume is within normal limits. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Possible tiny cyst in the posterior aspect of the pituitary, not well evaluated. Bone marrow signal and extracranial soft tissues are within normal limits. Cervical Spine: There are T2 hyperintense lesions in the cervical cord, most prominent of which are seen at the left ventral C3 level and the left aspect of the cord at the C6-C7 level. There may be additional tiny lesions such as at the left dorsal C4 level. Small lesion involving the left T1 level is also noted. There is some intrinsic T1 hyperintensity associated with the left C6-C7 lesion. No significant enhancement is appreciated.Vertebral body heights in the cervical spine are normal. Alignment is normal. Mild degenerative changes are seen with disk osteophyte complexes at C4-C5 and C5-C6 including disk extrusion at the C5-C6 level with effacement of the left ventral thecal sac. There is mild left neural foraminal stenosis at the C5-C6 level. Otherwise, no significant spinal canal or neural foramina stenosis is appreciated. Bone marrow signal is benign.
1. At least 6 T2/FLAIR hyperintense lesions involving the supratentorial and one in the infratentorial white matter, several of which demonstrate a morphology and distribution consistent with demyelinating disease. No lesions with enhancement to suggest active demyelination. Brain parenchymal volume is maintained. Several T1 hypointense lesions are also noted. No prior study is available for comparison.2. Multiple T2 hyperintense lesions in the cervical cord such as the left ventral C3 and left C6-C7 levels compatible with chronic demyelinating plaques. Small upper thoracic lesion at left T1 level also noted. No lesions with enhancement to suggest active demyelination.3. Small disk extrusion at the left C5-C6 level with mild left neural foraminal stenosis. Otherwise no significant spinal canal or neural foramina stenosis in the cervical spine.