 Redemonstration of multifocal variable sized periventricular and deep white matter FLAIR high signal intensity lesions consistent with multiple sclerosis. There are couple new lesions seen including right posterior superior basal ganglia (series 701, image 45) and right upper pons (series 701, image 30) which appears to be extension of right cerebral peduncle lesion. However, current scans were obtained with a different technical parameters than prior (previously the scan was obtained with 5 mm thickness and 6 mm gap, but current scan is 2 mm thickness and 2 mm gap), thus these findings could be related to technical factors. On Gad enhanced scans, there is no evidence of abnormal enhancement. Focal tissue loss at the C1-2 junction area spinal cord with subtle increased signal intensity is again seen, unchanged.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The paranasal sinuses and mastoid air cells are clear.
1. A couple of new lesions seen including the left basal ganglia posterior superior aspect and right upper pons lesion. However, these lesions could be related to technical factors as described above.2. No evidence of abnormal enhancement.