Male, 44 years old, with paresthesias and history of MS. Evaluate for progression. Brain:Accurate comparison with the prior examination is compromised due to technical differences in the scans. Within this limitation, the following observations are made.Numerous scattered T2 hyperintense lesions are evident within the periventricular regions, the juxtacortical regions, brainstem and the posterior fossa. Most of these lesions are moderately to markedly T1 hypointense. Lesions are better visualized on the present examination. There are no obviously new or growing lesions, though subtle changes will likely not be appreciated.No evidence of significant generalized edema or mass effect is seen. Brain parenchymal volume is generally preserved. No abnormal extra-axial fluid collections are detected. The ventricular system is normal in size and morphology.Spine:Please note that there is no prior spine imaging available for comparison.A segment of abnormal T2 signal is evident affecting the left aspect of the spinal cord spanning the C3 and C4 vertebral bodies. The cord in this area demonstrates volume loss.There are numerous additional small foci of pathologic spinal cord signal in all areas of the visualized spinal cord. However, no additional areas of significant cord atrophy are demonstrated. No epidural abnormalities are suspected.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No pathologic marrow edema or replacement is seen. The intervertebral discs are preserved with no evidence of significant spinal canal or foraminal stenosis.
1.Innumerable lesions are evident within the brain compatible with demyelinating disease. Technical differences prevent accurate comparison with the prior examination. No obvious new or growing lesions are seen, though subtle changes would likely not be appreciated.2.Numerous foci of pathologic signal abnormality are evident within the visualized spinal cord. The most conspicuous lesion is at C3-4 where there is associated spinal cord thinning indicating chronicity. No prior examination is available for comparison of the spinal cord lesions.