47 years, Female, leg weakness. Multiple sclerosis, evaluate for progression. Brain: There is a T2/FLAIR hyperintense lesion involving the juxtacortical white matter of the right posterior frontal lobe as well as along the medial cortical surface. There is also a juxtacortical lesion along the left intraparietal sulcus. There is also a lesion along the undersurface of the corpus callosum adjacent to the right frontal horn as well as along the inferior aspect of the callosal splenium on the. Additional periventricular lesion is seen adjacent to the right temporal horn. Asymmetric FLAIR hyperintensity along the right medial aspect of the right middle cerebellar peduncle is also unchanged. Allowing for slight differences in technique, there is no definite evidence of a new lesion compared to prior MRI from 1/21/2014. Brain parenchymal volume is preserved. T1 hyperintensity is noted associated with the right frontal and right medial temporal lesions. No intracranial mass or mass effect is identified. Ventricles and sulci are within normal limits. Calvarium and extracranial soft tissues are grossly unremarkable.Thoracic spine: There are multiple T2/STIR hyperintense lesions in the thoracic cord. There is a lesion involving the left hemicord at the T5 level with mild associated volume loss and present previously. Small lesion is suspected at the left dorsal T1 level, not definitively seen on prior study. There is a small left T3-T4 lesion which appears to be present on prior. There is a lesion extending from T6 to T7 levels not definitively seen on prior.Vertebral body heights and alignment in the thoracic spine are normal. Minimal degenerative changes are seen without significant spinal canal or neural foraminal stenosis. Small left paracentral disc protrusion at the T5 level is noted.Partially imaged cervical spine demonstrates diminished changes with multiple disc bulges at C3-C4, C4-C5, C5-C6, and C6-C7. There is moderate associated associated canal stenosis.
1. Multiple T2/FLAIR hyperintense lesions including the juxtacortical and periventricular white matter as described above are not significantly changed allowing for slight differences in technique compared to 1/21/2014. The morphology and distribution of these lesions is consistent with known demyelinating disease. No new lesion is definitively appreciated in the brain.2. Multiple T2/STIR hyperintense lesions in the thoracic cord consistent with known demyelinating disease. Left T5 lesion was seen on prior studies and is associated with mild volume loss. There are additional smaller lesions, which are described above, not definitively seen on prior, and suspected to represent progression of disease since 1/21/2014.3. Degenerative changes in the cervical spine with multiple disc bulges including C3-C4, C4-C5, C5-C6, and C6-C7. There is at least moderate associated spinal canal stenosis, which can be better assessed with a dedicated cervical spine MRI study.