 Again seen are greater than 20 foci of T2/FLAIR hyperintensity involving the periventricular and juxtacortical white matter with morphology and distribution consistent with known demyelinating disease. Few lesions within the posterior fossa are also evident such as in the left cerebellar hemisphere and the right pons. No new lesion is appreciated when compared to 6/2/2015. There is enhancement involving the lesions adjacent to the right temporal horn and the right pons which is slightly decreased in the interval. Apparent focus of enhancement in the left superior temporal gyrus is most likely artifact as there is no corresponding lesion on the FLAIR sequence. Multiple lesions with T1 hypointensity also again seen. Brain parenchymal volume is grossly preserved. No intracranial mass or mass effect. Ventricles are normal in size. Calvarium and extracranial soft tissues are grossly unremarkable.THORACIC SPINE
1. Multiple T2/FLAIR hyperintense lesions in the supratentorial and infratentorial white matter consistent with known demyelinating disease. No new lesion is demonstrated compared to 6/2/2015. There has been interval decrease in enhancement of the lesions adjacent to the right temporal horn and in the right pons compatible with recent active demyelination.2. No lesions within the thoracic cord are appreciated.3. Lumbar spine MRI appears within normal limits without evidence of significant spinal canal or neural foraminal stenosis at any level.