72 years, Female, progressive left-sided weakness. Evaluate for CNS demyelinating disease.. Brain: There are multiple foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter which have slightly increased in number since prior study from 6/11/2009. For example, T2 hyperintense lesion in the right parietal periventricular white matter, coronal T2 image 22, is not definitively seen previously. Patchy left posterior frontal deep white matter hyperintensity, axial FLAIR image 20, also not definitively seen previously. No restricted diffusion to suggest acute ischemia. No evidence of hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration for age. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Bone marrow signal and extracranial soft tissues are grossly within normal limits. Thoracic spine: There is subtle T2 hyperintensity involving the left ventral aspect of the cord at the T12 level (axial T2 image 7, sagittal T2 image 8 and sagittal STIR image 8) which has decreased in prominence when compared retrospectively to prior lumbar spine MRI dated 6/21/2013. There is also a subtle T2 hyperintensity involving the left dorsal aspect of the cord at the T9 level (axial T2 image 22, sagittal T2 image 8 and sagittal STIR image 8). There is otherwise no large lesion in the thoracic cord or evidence of cord edema. Cord parenchymal volume also appears grossly maintained.Thoracic vertebral body heights are maintained. Alignment is maintained. Bone marrow signal is benign with no suspicious lesions. Scattered foci of T1 hyperintensity in the vertebral bodies are compatible with foci of fat or hemangiomas. There is tubular soft tissue in the midline extending inferiorly from the T12-L1 to the mid L1 levels which likely represent a central disc extrusion with inferior migration, and slightly decreased in size since prior lumbar spine MRI from 6/21/2013. There is no significant spinal canal or foraminal stenosis.
1. No recent prior brain MRIs available for comparison. There are multiple T2/FLAIR hyperintense lesions in the periventricular and subcortical white matter which have slightly increased in number since brain MRI from 6/11/2009. No abnormal enhancement. These lesions are nonspecific with differentials including prior inflammation, demyelination, as well as ischemia. 2. Subtle, nonenhancing T2 hyperintense lesions in the thoracic cord at the left T9 and T12 levels which may represent chronic demyelinating plaques. The T12 lesion is decreased in prominence since prior lumbar spine MRI dated 6/21/2013 compatible with evolution. No significant spinal canal stenosis at any level.