 There is significant decrease in confluent T2 signal abnormality in the right superior and middle frontal gyri. Many of these lesions show low signal on T1 images, although more lesions are visible on T2 images. Numerous (greater than 15) remaining periventricular and subcortical white matter lesions in the supratentorial brain are without significant change, most of which remain rather confluent. There are white matter T2 hyperintense lesions in pons and left cerebral peduncle which are also unchanged. Stable lesion are also likely present in the right brachium pontis. There is a single area of enhancement along the right corona radiata on 901/54 although it has a minimally curvilinear figuration. It is not identified on the prior postcontrast images. There is no other definite pathologic intracranial enhancement. The ventricles and sulci are main unchanged.There is an unchanged 23 x 22 x 6 mm lipoma along the high left paramedian scalp. There is redemonstration of a lobulated area of T1 hypointensity and T2/FLAIR hyperintensity when correlating with prior exams along the paramedian anterior frontal calvarium. Previous sagittal T1 postcontrast images demonstrated mass effect upon the adjacent superior sagittal sinus which is narrowed at this location, possibly representing focal prominence of arachnoid attenuation.Artifact limits evaluation of the visualized upper cervical cord, although there is questioned focal FLAIR hyperintensity at the C4-C5 level within the cord, as well as dorsally at the C3 level.
1. Significant decrease in confluent T2 signal abnormality in the right superior and middle frontal gyri with numerous other stable white matter lesions both in the supratentorial and infratentorial brain. Overall, mild to moderate T1 and moderate T2 burden of disease.2. Single area of apparent enhancement along the right corona radiata which may indicate a small active plaque, given its absence on prior post contrast imaging. This is not favored to represent a vascular structure despite its minimally curvilinear appearance.3. Questioned focal FLAIR hyperintensity in the cord at the C3 and C4-C5 levels versus artifact. Dedicated MRI of the cervical spine may be obtained as clinically indicated.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.