Female, 47 years old, with multiple sclerosis and paresthesias. Evaluate for progression. Brain:Redemonstrated are numerous T2 hyperintense lesions involving the corpus callosum, periventricular and juxtacortical white matter, and to a lesser extent the brainstem and cerebellum. Lesion number and size have not significantly changed. As before, most lesions demonstrate moderate T1 hypointensity with a few showing marked T1 hypointensity, unchanged from prior.No evidence of edema or mass effect is seen. No abnormal extra-axial collections are detected. Mild thinning of the corpus callosum and periventricular volume loss are unchanged.C-spine:A segment of T2 hyperintensity is seen involving the right dorsal spinal cord spanning the C2 and C3 vertebral body levels. When compared to the prior cervical MRI from 2009, this lesion has increased in size. However, it is also visualized on sagittal views of the brain MRI from 05/17/16, on comparison to which, it does not appear to have changed significantly.Straightening of the cervical lordosis is seen. Vertebral body height and morphology are within normal limits. No pathologic marrow replacement or edema is demonstrated.C2-3: No spinal canal stenosis or neuroforaminal narrowing. C3-4: No spinal canal stenosis or neuroforaminal narrowing. C4-5: Left greater than right facet arthropathy. Minimal posterior disc-osteophyte complex formation. No spinal canal stenosis. Moderate left foraminal narrowing. No changes. C5-6: Left facet arthropathy. No significant spinal canal or foraminal stenosis. No changes. C6-7: Facet arthropathy. Posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Moderate left foraminal narrowing, slightly progressed. C7-T1: Facet arthropathy. Very small left paracentral protrusion. No spinal canal or foraminal stenosis. No interval changes.
1.Stable size and number of demyelinating lesions in the brain.2.A spinal cord lesion spanning the C2 and C3 levels is unchanged relative to the prior examination from 2016, but has progressed relative to the older examination from 2009.3.Additional smaller spinal cord lesions have decreased in conspicuity relative to the 2009 examination.4.Mild degenerative changes of the cervical spine as above.