Clinical question: Demyelinating disease; follow progression. Signs and symptoms: Left hand weakness. Pre-and post-enhanced brain MRI:Negative diffusion weighted images.Examination demonstrates interval progression of demyelinating disease since prior study. There is a new demyelinating plaque in the subcortical white matter of the left anterior temporal lobe with evidence of enhancement. The findings measures approximately 8.5 mm in transaxial dimensions.A second enhancing demyelinating plaque is in the subcortical white matter of the left posterior parietal measuring at 7.5 times 5.5-mm in transaxial dimensions. Additionally there are two small subcortical foci of flair hyperintensity with enhancement in the left superior temporal gyrus anteriorly.The lateral ventricles are slightly prominent for patient's stated age of 30 however without interval change since prior exam. Mild prominence of cerebral cortical sulci is also noted without change. Multiple previously seen demyelinating plaques are again identified.Unremarkable calvarium and soft tissues of the scalp.Unremarkable images through the orbits and including axial fat sat post enhanced series. All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal pattern.
1.Negative diffusion weighted images.2.Interval progression of demyelinating disease with multiple new enhancing plaques in the left temporal and right posterior parietal as detailed/measures above.