Multiple sclerosis. Brain: There is interval increase in size of left parietal and posterior frontal periventricular demyelinating lesions. Multiple other demyelinating lesions are otherwise not significantly changed. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is mild left maxillary sinus mucosal thickening.Cervical Spine: The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. There is a subcentimeter T2 hyperintense nodule in the right tracheoesophageal groove, which may represent a thyroid nodule.
1. Interval increase in size of left parietal and posterior frontal periventricular demyelinating lesions. Multiple other demyelinating lesions are otherwise not significantly changed, although characterization is limited without intravenous contrast. 2. No evidence of demyelinating lesions in the spinal cord. 3. Nonspecific subcentimeter T2 hyperintense nodule in the right tracheoesophageal groove, which may represent a thyroid nodule. A thyroid ultrasound may be useful for further evaluation.