History of multiple sclerosis presenting with lower extremity weakness. Extensive increased T2 white matter signal centered in the periventricular white matter with a radiating morphology compatible with the history of multiple sclerosis. Similar to prior, the lesions have variable mild to marked low T1 signal. Compared to prior this is more extensive and confluent compatible with mild disease progression. Discrete new lesions are identified in the left precentral gyrus, right superior frontal gyrus, and mesial left temporal lobe. No definite lesional enhancement is present on the postcontrast images.There is no evidence of intracranial hemorrhage or mass. Mild generalized cerebral volume loss similar to prior. The expected intracranial vascular flow voids are present. The paranasal sinuses are clear. The visualized mastoid air cells are clear. The orbits are unremarkable.
White matter signal abnormality primarily within the periventricular white matter compatible with the history of multiple sclerosis. Compared to 2011, there has been slight interval progression of disease burden with scattered small new lesions and increase in size of the prior lesions.