22 years, Female, bilateral blurry vision, right face droop. Evaluate for MS worsening versus PML.. Again seen are multiple T2/FLAIR hyperintense lesions in the periventricular and subcortical white matter with morphology and distribution consistent with known demyelinating disease. Compared to 4/1/2016, there has been interval development of multiple, at least 5, new T2/FLAIR hyperintense lesions involving the bilateral frontal and parietal lobes. There is associated peripheral enhancement including some with incomplete rim of peripheral enhancement, characteristic of demyelinating lesions. Restricted diffusion is also evident, particularly of a left frontal lesion. No intracranial mass effect. No midline shift or herniation. Ventricles are normal in size. Brain parenchymal volume is preserved. Calvarium and extracranial soft tissue structures are unremarkable.
Evidence of progression of demyelinating disease since prior MRI. There are multiple new lesions with enhancement which are compatible with active demyelination. 