 There is redemonstration of extensive diffuse patchy increased T2/FLAIR signal within the periventricular and, to a lesser degree, subcortical white matter as well as the brainstem and cerebellar peduncles without significant interval change. Many of the foci of increased T2/FLAIR signal also demonstrate decreased T1 signal, not significantly changed. No abnormal intracranial enhancement is identified. There is moderate diffuse volume loss affecting the cerebrum and cerebellum appearing similar to prior. The corpus callosum is again thin. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and scalp soft tissues are unremarkable. There is mild mucosal thickening within the paranasal sinuses and a small mucous retention cyst within the right maxillary sinus.
1.Stable white matter signal abnormality without enhancement consistent with multiple sclerosis. Overall, moderate T1 and moderate-severe T2 burden of disease2.Moderate diffuse brain volume loss greater than expected for patient's stated age, consistent with history of MS.