Female, 39 years old, with history of multiple sclerosis, new bladder urgency and gas incontinence. Evaluate for progression. Brain:Scattered small T2 hyperintense lesions are demonstrated within the periventricular and juxtacortical white matter of the cerebral hemispheres. One small lesion in the left superior parietal lobule appears to be new. The other lesions are not convincingly changed accounting for differences in technique.A previously prominent lesion along the right lateral wall of the fourth ventricle has decreased in size. There appear to be two small new lesions along the left lateral pons.No enhancing lesions are detected. Cerebral morphology is otherwise unremarkable. Parenchymal volume is preserved. The ventricles remain normal in size and morphology.Spine:Scattered T2 hyperintense lesions are seen throughout the spinal cord, primarily involving the cervical region. A lesion in the left lateral cord at C3-4 is new and lesions in the lateral aspect of the cord bilaterally at C4-5 are slightly more conspicuous. The remaining lesions are unchanged. No enhancing lesions are identified. Cord volume is preserved.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. Scattered marrow space lesions are seen with signal characteristics compatible with benign hemangiomas, most notably in the T5 vertebral body. These have not significantly changed. Minimal degenerative findings are noted. At no level is there any significant spinal canal or foraminal stenosis.
Multiple lesions are demonstrated in the brain and spinal cord compatible with demyelinating disease. On comparison with the prior examination, some lesions are smaller, a few are new, and many are unchanged. No enhancing lesions are seen to suggest active inflammation.