Multiple sclerosis [G35], Reason for Study: ^Reason: please do dr javed MS protocol, compare to prior. History: progression MS Brain MRIThere are multiple FLAIR high signal intensities on bilateral periventricular white matter, including bilateral trigone area. These findings are nonspecific, however, considering the patient clinical history, these findings also are compatible with demyelinating disease such as multiple sclerosis.Comparing to prior scan performed outside institution, although the signal intensity of those lesions are slightly different, the number and distribution of FLAIR high signal intensity lesions appear to be unchanged.There is an no evidence of abnormal enhancement.The ventricles, sulci and cisterns are unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Lumbar MRIFor the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. There is normal lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing. The conus medullaris terminates at the T12 level. There is no evidence of abnormal enhancement, cord compression or mass. Degenerative changes are specified by the intervertebral level as follows: T12-L1: no neuroforaminal narrowing or spinal stenosis. L1-L2: no neuroforaminal narrowing or spinal stenosis. L2-L3: no neuroforaminal narrowing or spinal stenosis. L3-L4: no neuroforaminal narrowing or spinal stenosis. L4-L5: Disc desiccation. Focal annular tear with minimal bulging of disc which abuts thecal sac. No neuroforaminal narrowing or spinal stenosis. L5-S1: no neuroforaminal narrowing or spinal stenosis.
1. Multifocal white matter FLAIR high signal intensity lesions which are consistent with demyelinating disease such as multiple sclerosis, unchanged since prior scan.2. Focal annular tear with disc desiccation at the level of L4-5 otherwise unremarkable lumbar spine MRI.