Neuromyelitis optica 24294 Brain: Again seen are few scattered nonspecific foci of white matter T2 hyperintensity in the bilateral frontal and parietal lobes, which are unchanged. No new lesions. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. Mild scattered paranasal sinus mucosal thickening. Calvarium and extracranial soft tissues are grossly unremarkable.Orbits: Again seen is volume loss of the left orbital segment of the left optic nerve with high T2 signal, similar to prior. No definite enhancement within the limits of motion degraded sequences. The right optic nerve appears to be unremarkable. No abnormal signal within the optic chiasm. The globes and extraocular muscles are otherwise unremarkable. There is no evidence of intraorbital mass lesions.Spine: Compared to 4/26/2015 and 12/2/2015, there is continued decrease in T2 signal in the cervical cord with mild residual patchy T2 signal extending primarily from the C2-3 to C4-5 levels. Again seen is enhancement associated with this lesion but not well assessed due to the motion degradation. Subtle T2 hyperintensity in the cervical cord at the C6 and C7-T1 levels may be artifactual. There is T2 hyperintensity involving the thoracic cord at the T1-T3 levels which was also present previously, and is not associated with enhancement. No new cord lesions. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. There is a hemangioma in the T5 vertebral body. The vertebral bone marrow signal is otherwise unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. Again seen are multiple thyroid nodules.
1. Few nonspecific scattered supratentorial white matter lesions, which are unchanged. No new lesions or lesions with enhancement.2. Left optic nerve atrophy with T2 hyperintensity appears unchanged and compatible with history of NMO. No new lesions along the optic nerves or chiasm.3. Slight further decrease in size of enhancing cervical cord lesion. Please note examination is motion degraded. No new lesions in the cervical or thoracic cord are appreciated on the sagittal sequences.