Female, 37 years old, with multiple sclerosis and paresthesias. Assess for progression. Brain:Many round and oval T2 hyperintense lesions are seen within the periventricular white matter, some oriented radially with respect ventricles. A few additional scattered lesions are seen within the juxtacortical white matter bilaterally. Lesions are noted along the posterior limb of the left internal capsule, along the left anterior commissure and hypothalamus, within the pons and at the bilateral superior cerebellar peduncles. A lesion is also seen involving the left aspect of the spinal cord at the foramen magnum.A majority of the above mentioned lesions demonstrate conspicuous correlating T1 hypointensity. None of the lesions demonstrates significant mass effect. Brain volume is preserved. No abnormal extra-axial collections are seen and the ventricular system is normal in size and morphology.Cervical spine:Abnormal T2 hyperintensity is seen in the cervical spinal cord ventrally at the C2-3 level and left laterally at the C4 level. These lesions are associated with no significant mass effect. Morphology of the cord is otherwise unremarkable.Straightening of the cervical lordosis is likely positional. Sagittal alignment is otherwise unremarkable. Vertebral body morphology and signal characteristics are normal. No significant spinal canal or neuroforaminal stenosis is observed.Thoracic spine:Foci of abnormal T2 signal are seen within the thoracic spinal cord at the T5 level centrally and at the T11-12 level right laterally. No mass effect is seen and elsewhere the spinal cord morphology is unremarkable.Spinal alignment is anatomic. Vertebral body morphology and signal characteristics are within normal limits. No spinal canal or neuroforaminal stenosis is seen
1.Numerous T2 hyperintense lesions are seen within the brain showing morphology and distribution compatible with demyelinating disease. The majority of the lesions are associated with conspicuous T1 hypointensity compatible with chronicity and underlying cellular loss.2.At least four areas of abnormal T2 signal are identified within the spinal cord which are also compatible with demyelinating disease. Evaluation of the cervical and thoracic spine is otherwise unremarkable.