51-year-old with fatigue and numbness. MS protocol. Brain: There is a nonspecific focus of T2/FLAIR hyperintensity in the right inferior frontal lobe involving the subcortical white matter which appears to be present on prior MRI from 5/23/2007 but less well appreciated due to differences in technique. No new lesions are demonstrated. No lesions with enhancement to suggest active demyelination. No restricted diffusion to suggest acute ischemia. No intracranial mass or mass-effect. Incidentally noted is a cavum septum pellucidum and cavum vergae. No hydrocephalus. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Bone marrow signal and extracranial soft tissues are within normal limits. Cervical Spine: Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is straightening of the cervical spine; alignment is otherwise maintained. Bone marrow signal is benign. Incidentally seen is a T1 hyperintense lesion involving the left aspect of the T2 vertebral body which may represent hemangioma or focal fat.Moderate degenerative changes are seen with disc desiccation and height loss at C4-C5, C5-C6, and to a lesser degree at C6-C7. No abnormal cord signal is seen in the cervical spine. No abnormal enhancement.Degenerative changes in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: No significant compromise to the spinal canal or neural foramina.C4-5: There is a central and right paracentral disc osteophyte complex including disc extrusion. There is moderate spinal canal stenosis with mild flattening of the ventral cord in the midline and on the right. Mild left neural foraminal narrowing. No significant right foraminal narrowing.C5-6: Small disc osteophyte complex with minimal narrowing of the spinal canal at this level. Minimal bilateral neural foraminal narrowing.C6-7: Disc osteophyte complex including disc extrusion and mild to moderate spinal canal stenosis. There is mild impression on the ventral aspect of the cord bilaterally. There is no significant neural foraminal stenosis.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Nonspecific focus of T2/FLAIR hyperintensity in the right inferior frontal lobe which appears to be present since 2007. No new lesions or clear stigmata of chronic demyelinating disease in the brain.2. There are moderate degenerative changes in the cervical spine with moderate spinal canal stenosis at C4-C5 and to a slightly lesser degree at C6-C7. There is associated cord flattening, relatively worse at C4-C5 and C5-C6. No associated cord signal abnormality. 3. No findings to suggest demyelinating lesions in the cervical cord.