Clinical question: Prior MRI with questionable demyelinating disease. Please assess for new lesions. Signs and symptoms: Cognitive decline/depression. Pre-and post-enhanced MRI:No diffusion weighted abnormalities. Examination redemonstrates stable few subcortical and periventricular foci of flair hyperintensity in bilateral cerebral hemispheres. There is no evidence of any new lesions or any detectable abnormal enhancement.Previously noted lesions within bilateral middle cerebellar peduncles are significantly less conspicuous on current the study and there is no evidence of any new or enhancing lesions in the posterior fossa.Unremarkable cerebral cortex, cortical sulci, ventricular system and the CSF spaces for patient's stated age. No detectable abnormal parenchymal or leptomeningeal enhancement.Unremarkable images through the orbits and including axial fat sat post enhanced series.Unremarkable calvarium, soft tissues of the scalp, paranasal sinuses and mastoid air cells.
1.No evidence of an acute or new lesions or any detectable abnormal enhancement.2.Revisualization of stable few subcortical and periventricular flair hyperintensity without enhancement since prior exam.3.Previously reported flair hyperintensity in bilateral middle cerebellar peduncles are significantly less conspicuous and demonstrate no enhancement.