Multiple sclerosis [G35], Reason for Study: ^Reason: Multiple Sclerosis History: follow up progression Brain MRIFLAIR/T2 high signal intensity lesions are seen at the left frontal white mater, bilateral corpus callosum, bilateral parietal white mater, right posterior temporal white mater and right cerebellar white mater. These lesions are consistent with lesions of demyelinating disease such as multiple sclerosis. The ventricles, sulci and cisterns are symmetric and unremarkable.There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.There is a retention cyst on the right maxillary sinus.Cervical spine MRIThere are T2 high signal intensity spinal cord lesions involving C2, C4, C5, C6 and C7 level. Some of those lesions involving hemi spinal cord and some involves posterior aspect of the cord. Comparing to prior scan, especially lesions at the level of C6 and C7 appear to be slightly more prominent than prior. On the other hand, the lesions at the level of C2 to C5 lesions show less conspicuous especially on axial T2 images than prior. These finding can represent some improvement and some aggravation. However, considering the difference in scanning machine and imaging technique, these lesion signal intensity variation could be related to artifacts related to the difference in imaging machine and technique.There is normal cervical lordosis. The cranial-cervical junction is normal. There is no evidence of spinal canal stenosis.There is no evidence of neuroforaminal stenosis.Thoracic spine MRIAgain T2, T10, T11 and T12 spinal cord lesions are seen.Among them, the T11 lesion appears to be more prominent and slightly bulging posterior which was flat patchy lesion on prior indicating possible aggravation of this lesion. There is normal thoracic kyphosis. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The cord signal is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal stenosis, cord compression or myelopathy. The conus medullaris terminates at the level of T12-L1.There is T2 high signal intensity lesion within the T11 vertebral body indicating possible hemangioma, unchanged since prior scan.
1. Multifocal white mater FLAIR high signal intensity lesions are seen bilateral periventricular white mater, consistent with demyelinating disease such as multiple sclerosis.2. Multifocal cervical spinal cord lesions are again seen. Some of them appears to be slightly more conspicuous and some are less conspicuous. These could represent local aggravation and improvement. But could also be related to artifacts related to different scanner and imaging technique.3. Multifocal thoracic spinal cord lesions are seen which are consistent with demyelinating disease. Especially T10-T11 spinal cord lesion shows more prominent and conspicuous indicating possible aggravation. Other lesions appear to be grossly unchanged since prior scan. 