Female, 31 years old, with multiple sclerosis, follow-up exam. Extensive patchy, nearly confluent T2 hyperintense lesions are evident within the periventricular white matter with scattered additional lesions in the subcortical regions, brainstem and cerebellum. Many of these lesions demonstrate profound T1 hypointensity indicating chronicity and tissue loss. Since the prior examination, no evidence of any obviously new or progressing lesion is seen. One lesion previously noted in the right middle frontal subcortical white matter has evolved to a more chronic appearance.No evidence of significant parenchymal edema or mass effect is detected. The corpus callosum is severely thinned and there is mild generalized parenchymal volume loss compatible with long-standing disease. No abnormal fluid collections are detected. The ventricular system is stable in size and morphology.
Findings compatible with severe long-standing demyelinating disease. No evidence of any new or progressing lesion is seen.