Female, 28 years old, with weakness. Evaluate for progression of MS. Brain:Numerous scattered T2 hyperintense lesions are redemonstrated within the cerebral hemispheres, brainstem and cerebellum showing morphology and distribution compatible with multiple sclerosis. While the majority of these lesions are unchanged, multiple new or larger lesions are identified, particularly on the left (see key images for examples). Many of these new lesions demonstrate enhancement. T1 signal characteristics range from mildly to moderately hypointense. No evidence of significant parenchymal edema or mass effect is seen. Brain parenchymal volume is generally preserved. The ventricles are normal in size and morphology. A mucous retention cyst is evident in the left maxillary sinus.Cervical:Ill-defined T2 signal abnormality affects the spinal cord somewhat diffusely at the C2 and C3 levels, and to a lesser degree at lower cervical levels. It is difficult to appreciate individual lesions, but overall it does appear that the extent of signal abnormality has progressed from the prior examination. One clear focus of pathologic enhancement is evident within the right aspect of the spinal cord at the C7-T1 level, though there may be additional smaller foci of enhancement as well.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No concerning marrow signal abnormality is seen. No significant compromise of the spinal canal or neural foramina is detected.Thoracic:Scattered ill-defined areas of T2 signal abnormality are seen within the thoracic spinal cord without significant or convincing interval change. No definite enhancing lesions are seen. As on the prior examination, the spinal cord in the thoracic region is somewhat generally thinned.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No concerning marrow signal abnormality is seen. No significant compromise of the spinal canal and neural foramina is detected.
1.Progression of demyelinating disease intracranially with new and/or enhancing lesions on a background of numerous chronic lesions.2.Progression of demyelinating disease in the cervical region.3.Stable demyelinating disease in the thoracic region.