37 years, Male, multiple sclerosis, evaluate disease burden. Paresthesias. Brain: There are approximately 20 T2/FLAIR hyperintense lesions in the supra and infratentorial white matter with morphology and distribution consistent with known demyelinating disease. Several lesions involving the juxtacortical white matter in the bilateral frontal and parietal lobes are seen. Several periventricular lesions are seen along the bilateral temporal horns. There are also several pericallosal lesions as well as infratentorial lesions including along the nerve root entry zones of the trigeminal nerves and the right cerebellar hemisphere. Some of these lesions demonstrate low T1 hypointensity. Brain parenchymal volume is grossly preserved for age.No intracranial mass or mass effect. No hydrocephalus. No extra-axial collections. There is mild to moderate mucosal thickening involving the maxillary and frontal sinuses as well as patchy opacification of the bilateral ethmoid air cells. Extracranial soft tissues are otherwise unremarkable.Cervical spine: There are multiple T2 hyperintense lesions throughout the cervical cord. These lesions include the C2 level in the midline anteriorly, right dorsal C3, dorsal C4 right greater than left, left lateral C4-C5 and right ventral C4-C5, bilateral C5 where there is also focal volume loss, left C5-C6, and right ventral C7-T1 levels.Mild degenerative changes are seen throughout the cervical spine including disc protrusions at C3-C4 and C6-C7 and smaller bulges at C4-C5 and C5-C6 without significant spinal canal stenosis at any level. There is mild bilateral C4-C5 and right C5-C6 neural foraminal stenosis. There is mild multilevel facet arthropathy. Vertebral body heights and alignment are maintained. Bone marrow signal is benign. Paraspinous soft tissues are unremarkable.
There is moderate burden of chronic appearing demyelinating lesions in the brain and cervical cord as detailed above. Comparison with prior studies can be made if made available.