Female, 49 years old, with multiple sclerosis. Evaluate interval change. Numerous T2 hyperintense lesions are seen within the periventricular and juxtacortical white matter of the cerebral hemispheres, some oriented radially with respect to the ventricles and extending to the corpus callosum. Several lesions are noted in the pons and cerebellar peduncles, and at least one lesion is evident in the medulla. Marked T1 hypointensity is seen associated with lesions in the periatrial regions. The other lesions demonstrate mild to moderate T1 hypointensity. Punctate enhancement is evident in association with one small right corona radiata lesion. Incomplete ring enhancement is seen in association with a lesion along the right occipital horn. No evidence of significant mass effect or edema is noted. The corpus callosum is thin and the ventricles and sulci are prominent suggesting volume loss. No abnormal extra-axial fluid collections are detected.
Numerous white matter lesions are seen compatible with long-standing multiple sclerosis. At least two lesions demonstrate enhancement suggesting active inflammation.