Demyelinating disease of central nervous system, unspecified [G37.9], Reason for Study: ^Reason: Demyelinating disease; eval for progression History: paresthesias Brain MRI:There is no evidence of acute ischemic or hemorrhagic lesion.There are suspicious enhancing area which most likely represent a venous channel (series 2101, image 34). Otherwise there is no evidence of abnormal enhancement.Comparing to prior scan which showed a couple of enhancing lesions on the right posterior frontal lobe and right mid-pons lesion do not show any evidence of enhancement on today's scan.Multifocal scattered white matter T2/FLAIR high signal lesions were again seen and do not show any significant interval changes in terms of size and distribution since prior scan. The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. 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.Cervical Spine MRIRedemonstration of subtle T2 high signal intensity lesions throughout the cervical spine, unchanged since prior scan.On Gad enhanced scan, there is no evidence of definitive, discrete enhancing lesion within the spinal cord.Spinal alignment is anatomic. Vertebral body height and morphology are normal. No concerning marrow signal abnormality or enhancement is seen. No significant spinal canal or neural foraminal stenosis. Paraspinous soft tissues are unremarkable.
1. Unchanged bihemispheric scattered FLAIR high signal intensity lesions since prior scan.2. No definitive evidence of enhancing lesion on today's scan. Specifically, previously shown nodular enhancing lesions do not show any evidence of enhancement on today's scan.3. Subtle T2 high signal lesions throughout the cervical cord is again seen without definitive enhancing lesion, unchanged since prior scan. 