Clinical question: Multiple sclerosis. Please perform multiple sclerosis protocol. Signs and symptoms: Multiple sclerosis progression. Pre and post enhanced brain MRI:Examination is performed utilizing dedicated Dr. Javed's multiple sclerosis protocol.Precise comparison difficult due to significant technique difference between the 2 exam. Current exam is performed utilizing dedicated multiple sclerosis protocol and prior study is a routine brain MRI examination.Within this limitation there is no detectable demyelinating disease in the posterior fossa.Images through the supratentorial space demonstrate findings consistent with mild chronic demyelinating disease. No detectable abnormal enhancement.Examination demonstrates mild interval progression of disease since prior exam. Several tiny new lesions are identified however none without evidence of enhancement. Note should be made that 2 mm slices on current exam could conceivably demonstrate larger number of lesion compared to prior study.Cortical sulci and ventricular system are within normal and with maintained midline.The signal void of major intracranial arterial branches are identified.
1.Negative diffusion weighted series.2.Mild chronic changes of demyelinating disease only in the supratentorial space with subtle interval progression since 2013 as detailed above.