38 years, Female, multiple sclerosis, evaluate for progression. Brain: There are numerous foci of T2/FLAIR hyperintensity within the periventricular and subcortical white matter with appearance and distribution consistent with known demyelinating disease. Much of the signal abnormality demonstrates a confluent appearance. Multiple lesions with T1 hypointensity are also noted. Prior comparison study from 4/28/2015 was obtained with thicker slices; however, given differences in technique no new lesions are definitively appreciated. Few infratentorial lesions are also noted including the right midbrain, bilateral medulla, and adjacent to the right fourth ventricle which also appear to be present on prior. There is mild diffuse thinning of the corpus callosum reflective of global parenchymal volume loss. No intracranial mass or mass effect. No hydrocephalus. No extra-axial collections. Calvarium and extracranial soft tissues are unremarkable.Cervical spine: There are numerous T2 hyperintense lesions throughout the cervical cord involving all levels from C1 through C7. There appears to be interval increased T2 signal abnormality involving the cervical cord from the C3 to the C4 level suggestive of progressive disease (best seen on axial T2 image 18/36 and axial series 1502 mFFE image 69), although smaller lesions were present at these levels on prior study. There is more questionable subtle interval increase in T2 hyperintensity at the C1-C2 posteriorly in the midline compared to prior, although this area was incompletely imaged on prior study. Otherwise no significant change is seen in the remainder of the lesions. There is volume loss involving the cervical cord at the C6 and C7 level similar to prior. Lesions involving the upper thoracic cord are also noted based on the sagittal images and present previously.Vertebral body heights and alignment are normal. Bone marrow signal is benign. There is no significant spinal canal or neural foraminal stenosis at any level.
1. There are numerous lesions in the brain supra- and infratentorially as well as throughout the cervical cord compatible with advanced demyelinating disease. Differences in technique with outside study slightly limit comparison however no new lesion within the brain is definitively appreciated. There does appear to be a new lesion in the cervical cord at the C3-C4 level, which is not seen on prior, and suggestive of progression. Please see additional details above.2. Numerous T1 hypointense lesions in the brain similar to prior.3. Mild global parenchymal volume loss in the brain including mild diffuse thinning of the corpus callosum. There is also volume loss in the cervical cord at the C6 to C7 levels and similar to prior.