Clinical question: Optic neuritis, please perform multiple sclerosis protocol. Compared to prior exam. Signs and symptoms: Optic neuritis. Pre and post enhanced brain MRI:Examination demonstrates a punctate new foci of T2 hyperintensity in the corpus callosum (sagittal 3-D FLAIR series 801 image 179) which demonstrate enhancement (axial post enhanced series 901 image 43 and 44) concerning for new enhancing demyelinating plaque.Compared to prior exam there is interval resolution of previously noted enhancing demyelinating plaque.Additionally there is subtle interval decreased size of few of the previously known demyelinating plaques. This observation is particularly noticeable in plaques in the bilateral posterior temporal periventricular white matter and the left parietal subcortical enhancing lesion.There is no convincing evidence of signal abnormality or enhancement of the suprasellar visual complex or the intracranial optic nerves.Subtle increased T2 signal intensity of right optic nerve in the retro-orbital space (axial FLAIR series 601 image 25) could represent a demyelinating plaque or possibly artifactual signal. Post contrast images are not fat saturated and assessment of enhancement in the retro-orbital space is not possible.
1.New tiny focus of T2 hyperintensity and enhancement in the anterior body of corpus callosum since prior exam.2.Artifact or a true demyelinating plaque of the right retro-orbital optic nerve as detailed. Postcontrast images are not fat saturated and assessment of enhancement in the retrorectal space is not possible.3.Interval resolution of enhancement of a left parietal demyelinating plaques since prior exam.4.Intervertebral decreased size of a few of the previously present lesions as detailed.