Clinical question: Evaluate for MS progression. Signs and symptoms: Multiple sclerosis. Pre and post enhanced brain MRI:Negative diffusion weighted images.Examination demonstrates interval increase in number of demyelinating plaques in bilateral cerebral hemispheres and without significant change of the finding in the posterior fossa. Few of the new lesions are best appreciated on axial FLAIR series 901 on images 21 and 22 on the left, images 17 and 18 on the right and image 15 on the left.Few of the new lesions demonstrate enhancement. There is also interval minimal decrease size of few of previously noted demyelinating plaques.The cortical sulci and ventricular systems remain within normal size and without deviation of midline. The signal voids of major intracranial arterial branches are identified. Signal intensity of intracranial venous sinuses are within normal and the normal pattern of enhancement.Unremarkable images through the orbits demonstrate enhancement along the dorsal aspect of the left optic nerve (axial fat sat post enhanced series 1101 image 10).
1.Interval progression of demyelinating disease in the supratentorial brain parenchyma and with enhancement of few of the new demyelinating lesions.2.Few of the previously seen demyelinating lesions demonstrate interval decreased size.