Male, 37 years old, with multiple sclerosis and worsening left leg weakness and ataxia. Brain:Image quality is degraded by motion artifact. Within this limitation, the following observations are made.A mixture of discrete and patchy confluent T2 hyperintense lesions are evident in the periventricular regions and, to a lesser extent, subcortical white matter of the bilateral cerebral hemispheres. Many of these lesions are oriented radially with respect ventricles. Most demonstrate T1 hypointensity relative to the surrounding white matter. Lesions are also evident within the basal ganglia, brainstem and the posterior fossa.At least 8 of the above-mentioned lesions demonstrate either complete or partial rim enhancement including lesions in the bilateral frontal lobes, the bilateral occipital lobes, and the right temporal lobe.No evidence of mass effect is seen. No parenchymal edema is detected. Ventricles and sulci are mildly prominent for age indicating a degree of parenchymal volume loss. The corpus callosum is mildly thinned.C-spine:A T2 hyperintense nonenhancing lesion is evident within the central cord at the C2-3 level extending approximately 20 mm in the craniocaudal dimension. A smaller T2 hyperintense nonenhancing lesion is evident in the dorsal cord at the C4 level.Spinal alignment is anatomic. Vertebral body morphology and signal characteristics are within normal limits. No evidence of significant degenerative disc disease, spinal canal or neuroforaminal stenosis is seen.
1.Numerous supratentorial and infratentorial lesions compatible with multiple sclerosis. A number of these lesions demonstrate evidence of rim enhancement compatible with active demyelination.2.Two nonenhancing lesions are evident within the cervical spinal cord, also compatible with demyelination.