Demyelinating disease. Paresthesias. Cervical: Examination is significantly motion degraded despite repeating multiple sequences. There is a definite T2 hyperintense lesion in the cord at the right dorsal C2 level. T2 hyperintense lesion also suspected involving the dorsal mid C4 level in the midline as well as a ventral midline C4-C5 lesion seen only on the axial T2 sequence. There is also a questionable midline ventral lesion at the C7-T1 level seen only on the axial T2 sequence. There is also a questionable left ventral C7 lesion seen only on the axial proton density sequence. Cord volume is maintained.Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is grossly maintained aside from mild straightening. Bone marrow signal is benign.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: Small left paracentral and foraminal disc osteophyte complex. No significant spinal canal stenosis. Neural foramina are also patent. C4-5: No significant compromise to the spinal canal or neural foramina.C5-6: Small disc extrusion with partial effacement of the ventral thecal sac. Overall no significant spinal canal or neural foraminal stenosis.C6-7: No significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.Thoracic: Motion degradation on the thoracic sequences limits sensitivity for small lesions. No definite lesion in the thoracic cord is definitively appreciated. Cord volume is maintained. Vertebral body heights and alignment are maintained. Bone marrow signal is benign. There is no significant spinal canal or neural foraminal stenosis at any level.
1. There is a T2 hyperintense lesion involving the right dorsal C2 level consistent with known demyelinating disease. Multiple additional small lesions are also suspected in the cervical cord, particularly on the axial T2 sequence, as described above but are difficult to confirm due to motion degradation on multiple sequences.2. No lesions in the thoracic cord are definitively appreciated within the limits of motion degradation, which limits sensitivity to small lesions.