50 years, Female, worsening gait and depression, history of untreated multiple sclerosis. Examination is obtained per multiple sclerosis protocol. Comparison study from 2014 was obtained with thicker slices, limiting comparison of small lesions. Again seen are extensive patchy confluent areas and scattered foci of T2/FLAIR hyperintensity throughout the periventricular and subcortical white matter with morphology and distribution compatible with known demyelinating disease. Few infratentorial lesions are also evident involving the right cerebellar hemisphere and middle cerebellar peduncles. Allowing for the differences in technique, there is no clear evidence of progression. There is mild parenchymal volume loss as before. There is also a mild to moderate burden of T1 hypointense lesions. No abnormal enhancement. No intracranial mass or mass effect. No hydrocephalus. No midline shift or herniation. Calvarium and extracranial soft tissues are grossly unremarkable.
Allowing for differences in technique, there is no evidence of progression of chronic demyelinating disease when compared to prior MRI from 5/16/2014. No abnormal enhancement.