55 years, Female, multiple sclerosis, follow-up progression. Paresthesias. Leg weakness. Brain: There are greater than 20 T2/FLAIR hyperintense lesions involving the periventricular and subcortical white matter with a distribution and morphology consistent with known demyelinating disease. Compared to outside MRI from 8/6/2014, no new lesion is demonstrated. Multiple foci of T1 hyperintensity also noted, particularly associated with a periventricular/pericallosal lesions. Multiple infratentorial lesions are also seen including the right dorsal and left lateral pons as well as few foci in the bilateral cerebellar hemispheres. Motion artifact limits evaluation. There is new enhancing focus involving the right parietal lobe, series 4801, image 50, with surrounding confluent FLAIR hyperintensity in the right parietal white matter not significantly changed since prior. Apparent enhancement involving the suprasellar cistern is most likely artifactual. No intracranial mass or mass effect. No hydrocephalus. No midline shift or herniation. There is an enhancing focus involving the right parietal calvarium with intrinsic T1 hyperintensity, likely representing a hemangioma. Bone marrow signal is otherwise within normal limits.Cervical Spine: Multiple T2 hyperintense lesions are seen throughout the cervical cord consistent with demyelinating plaques. There is a relatively large lesion at the C2 level, a small right C2-C3, dorsal C3-C4, ventral C4, left C4-C5, and right C6-C7 lesions. No new lesions within the cervical spine or evidence of pathologic enhancement in the cervical spine is appreciated.Vertebral body heights and alignment are within normal limits. Bone marrow signal is benign. Mild degenerative changes are seen without significant spinal canal or neural foraminal stenosis.Thoracic Spine: There are multiple T2 hyperintense lesions throughout the thoracic cord as seen before. There are more prominent lesions at the right dorsal T2-T3 level with mild volume loss ventral T4-T5, right lateral T7-T8, right dorsal T8, left ventrolateral T8-T9, and right lateral T12. Some of these lesions appear more prominent on the current study which is favored to be related to differences in technique.There is mild loss of height involving the T9 vertebral body compatible with chronic compression fracture similar to prior. Vertebral body heights and alignment are otherwise maintained. No significant spinal canal or foraminal stenosis is appreciated.No significant change in appearance of subcentimeter enhancing lesion involving the T7 vertebral body favored to represent an atypical hemangioma but is nonspecific.
1. Numerous foci and confluent regions of T2/FLAIR hyperintensity in the supratentorial and infratentorial white matter are consistent with known demyelinating disease and not significant changed since prior. There is a new enhancing focus involving the right parietal lobe, series 4801, image 50, with surrounding confluent FLAIR hyperintensity in the right parietal white matter not significantly changed since prior. 2. Multiple T2 hyperintense lesions throughout the cervical and thoracic cord which allowing for differences in technique are not appreciably changed in the interval. No abnormal enhancement to suggest active demyelination in the spinal cord.