57-year-old male patient with history of multiple sclerosis presents with limb weakness. Evaluate for progression. BRAIN: Allowing for slight differences in technique including imaging plane and slice thickness, there is no definite change in numerous areas of increased T2/flair signal in the periventricular, cingulate-callosal junction, and to a lesser degree subcortical white matter. Stable lesions are seen in the cerebral peduncles, pons and left cerebellum. There is stable atrophy of the corpus callosum. These findings are compatible with the patient's history of multiple sclerosis and are not significantly changed compared to prior exam. There is no evidence of mass effect or midline shift.There is minimal mucosal thickening in the left maxillary and ethmoid sinuses, decreased compared to prior exam. CERVICAL SPINE:No new cord lesions. There is redemonstration of small foci of T2 hyperintensity in the cord at right C3-4 to C4-5 with atrophy. There is a small lesion at the C7 level on the right anteriorly, also similar to prior. There is near-anatomic alignment of the cervical spine. Bone marrow signal is benign. Level specific findings:C2-3: There is no significant spinal canal stenosis or neural foraminal narrowing at this level.C3-4: Left paracentral disc osteophyte complex and ligamentum flavum thickening causing mild spinal canal stenosis and mild to moderate bilateral neural foramina narrowing.C4-5: No significant neural foraminal narrowing or spinal canal stenosis. C5-6: No significant spinal canal stenosis or neural foramina narrowing. C6-7: Left uncovertebral hypertrophy with mild left neural foramina narrowing. No significant spinal canal or right neural foraminal narrowing. C7-T1: No significant spinal canal or neural foraminal narrowing.The right vertebral artery is small as before.
1.Numerous lesions in the supratentorial and to a lesser degree infratentorial white matter are compatible with the patient's history of known demyelinating disease and are not significantly changed allowing for differences in technique. No new lesions are seen.2.Small lesions in the cervical cord with associated atrophy are also not significantly changed. No new lesions in the cervical cord.3.Multilevel degenerative disk disease of the cervical spine as described above with mild spinal canal stenosis at C3-4 remains unchanged.