 Brain: There are several, approximately 5, foci of T2 hyperintensity the periventricular white matter. The largest of these measures up to 5 mm in the subcortical white matter of the left superior frontal gyrus. In addition, a few of the lesions demonstrate mild enhancement. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no evidence of acute infarction or intracranial hemorrhage. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. Thoracic Spine: There are subcentimeter foci of high T2 signal in the lower thoracic spinal cord, at the level of the T2 vertebra, without convincing associated enhancement. There is also mild prominence of the central canal of the lower spinal cord, measuring up to 2 mm in width. The vertebral column alignment is within normal limits. There are Schmorl nodes in multiple vertebral bodies. The vertebral body and disc space heights are otherwise preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.
Several lesions within the cerebral white matter, some of which demonstrate associated enhancement, and lesions in the ower spinal cord may represent a demyelinating process. Infection and vasculitis are differential considerations.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.