Female, 46 years old, with multiple sclerosis, assess for progression. Brain:Scattered, at least 10, T2 hyperintense lesions are evident within the periventricular and juxtacortical white matter as well as at the root entry zone of the left fifth cranial nerve. One lesion, along the body of the right lateral ventricle, appears to be new from prior (see image 53 series 701), while the remaining lesions show no significant interval change. Most demonstrate moderate T1 hypointensity which does not seem to have changed significantly. On postcontrast images, there is a vague vascular pattern of enhancement within the right corona radiata. Also noted is a developmental venous anomaly in the right parietal lobe. The new right periventricular lesion noted above demonstrates a central enhancing vein. Otherwise, no definite enhancing lesions are seen, and in particular, none of the discrete white matter lesions described above show inflammatory-type enhancement.C-spine:Small areas of cord T2 hyperintensity are seen centrally at the level of the odontoid process and right posterolaterally at the C2 level. There is no associated enhancement at these locations or elsewhere in the cervical spinal.The cervical lordosis is straightened but sagittal alignment is otherwise unremarkable. Vertebral body height and morphology are within normal limits. With the exception of degenerative endplate signal change at C6-7, no concerning or pathologic marrow replacement is observed.C2-3: No spinal canal stenosis or neuroforaminal narrowing. C3-4: No spinal canal stenosis or neuroforaminal narrowing. C4-5: Minimal posterior disc-osteophyte complex formation. No significant spinal canal stenosis or neuroforaminal narrowing. C5-6: Minimal posterior disc-osteophyte complex formation. No significant spinal canal stenosis or neuroforaminal narrowing. C6-7: Posterior disc-osteophyte complex formation with effacement of the ventral thecal sac but no significant spinal canal stenosis. Mild left foraminal narrowing. C7-T1: No spinal canal stenosis or neuroforaminal narrowing.
1.Multiple lesions are evident within the brain compatible with demyelinating disease. One lesion, along the body of the right lateral ventricle, is new from prior while the remaining lesions are unchanged. No enhancing lesions are seen to suggest active or ongoing demyelination.2.Two small areas of signal abnormality are evident within the spinal cord, but again, there are no enhancing lesions to suggest active or ongoing myelination.3.Multilevel cervical spondylosis is seen but without high-grade spinal canal or foraminal stenosis.