Reason: please do dr jave d ms protocol compare to prior History: progression MS MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. There is a moderate degree of periventricular and subcortical punctate and confluent hyperintense white matter lesions present identified on the FLAIR and T2 images. These are stable compared to last years exam.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. There is redemonstration of small foci of signal hyperintensity within the posterior aspect of the spinal cord along its midline at the C2, C3 -4 and C5-6 vertebral levels. These were also present on the prior exam from March of last year and is not display any interval change. No abnormal enhancing lesions are identified in the cervical spine.There is multilevel disk desiccation present cervical spine and mild reversal of the normal cervical curvature which is stable compared to the prior exam.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a mild disk bulge present at this level.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a mild disk bulge present at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.A single hyperintense lesion measuring 12 mm in diameter is present which is bright on T2 and isointense on T1. It was not included on imaging on the prior exam it is associated with some enhancement following gadolinium administration.
1.There are periventricular white matter lesions present which are stable since the prior exam and compatible with patient's clinical history of demyelinating disorder.2.There are several lesions present in the spinal cord which are compatible with a diagnosis of demyelination and stable since the prior exam. 3.There are mild degenerative changes present in the cervical spine without significant compromise of spinal canal or neural foramina.