 Allowing for differences in technique, there is been no significant interval change in multiple scattered punctate and oval foci of T2/FLAIR hyperintensity within the periventricular and subcortical white matter, some of which are oriented perpendicular to the long axis of the lateral ventricles, consistent with known demyelinating disease. Pattern is overall similar to prior exam, with some lesions demonstrating corresponding T1 hypointensity. There is redemonstration of peripheral enhancement superimposed upon mild intrinsic T1 hyperintensity along the margins of the previously referenced right parietal subcortical lesion.The ventricles and sulci continue to be prominent, consistent with mild global volume loss slightly greater than expected for the patient's stated age. The cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Additional lesions are seen in the visualized upper cervical cord, most conspicuous at the mid C2 and C3-C4 levels. These appear grossly unchanged comparing to previous MRI of the cervical spine.
1.Redemonstration of multiple white matter lesions consistent with known demyelinating disease, without significant interval change when allowing for differences in technique. Overall, mild T1 and T2 burden of disease, with persistent peripheral enhancement of a right parietal subcortical lesion which may suggest more recent changes.2.Partial visualization of additional cervical cord demyelinating lesions, grossly similar to prior exam.