Clinical question: please do dr Javed MS protocol and compare to prior MRI on 3 T. Signs and Symptoms: fatigue and headaches. Pre and post enhanced brain MRI:Mild to moderate supratentorial and minute infratentorial findings of chronic demyelinating disease are again identified and without convincing evidence of any appreciable interval change since prior exam. Lesions extensively involving the periventricular white matter and the corpus callosum and minimally of the subcortical white matter of cerebral hemispheres.There is mild prominence of cortical sulci for patient's stated age of 24 similar to prior exam and concerning for underlying parenchymal volume loss.Similar to prior exam there is a single small focus of FLAIR hyperintensity/demyelinating plaque in the dorsal aspect of cervical cord at C2-C3 disc level.There is no detectable abnormal enhancement of the above detailed lesions. There is revisualization of a tiny developmental venous anomaly in the paramedian left frontal lobe.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.
1.Stable chronic findings of demyelinating disease primarily in the supratentorial white matter and corpus callosum and minutely in the posterior fossa.2.Stable mild prominence of cerebral cortical sulci for patient's stated age.