41 years, Female, multiple sclerosis, evaluate for progression of demounting disease. Again seen are multiple T2/FLAIR hyperintense lesions involving the subcortical and periventricular white matter with distribution and morphology consistent with known demyelinating disease. Multiple infratentorial lesions in the brainstem, cerebellar peduncles, and bilateral cerebellar hemispheres are also noted. Compared to 9/26/2006, no new lesion is identified allowing for slight differences in technique. There is no intracranial mass or mass effect. There is mild global parenchymal volume loss including thinning of the corpus callosum, similar to prior. Multiple T1 hypointense lesions are also seen similar to prior. No diffusion abnormality. No evidence of intracranial hemorrhage. No extra-axial collections. No hydrocephalus. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits.
Multiple T2/FLAIR hyperintense supra- and infratentorial lesions consistent with known chronic demyelinating disease. Compared to 9/26/2006, no new lesions are appreciated. No abnormal enhancement to suggest active demyelination. Mild global parenchymal volume loss including thinning of the corpus callosum again seen.