39 year-old female with multiple sclerosis diagnosed in 2005. MRI BRAIN: There is a new left pontine lesion with low T1 signal and a newly apparent patchy T2 hyperintense lesion in the right middle cerebellar hemisphere. Otherwise, there has been no significant interval change of the T2 hyperintense cerebral white matter and small medial left cerebellar hemisphere lesions, which are predominantly distributed in the periventricular regions. Many of the lesions demonstrate T1 hypointensity, but there is no evidence of associated enhancement. The ventricles are unchanged in size and configuration. There is no midline shift. There are unchanged mildly low-lying cerebellar tonsils. There is mild persistent scattered paranasal sinus mucosal thickening. The skull and extracranial soft tissues are unchanged. MRI CERVICAL SPINE: There is redemonstration of scattered high T2 signal lesions in multiple portions of the cervical and thoracic spinal cord. No enhancing lesions are identified. The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body heights are well-maintained. There is mild disc desiccation signal throughout the cervical spine and mild disc height loss at C5-6. The vertebral bone marrow is unremarkable. A posterior disc osteophyte complex with central disc protrusion is demonstrated at C5-C6 with mild flattening of the ventral spinal cord. There is no significant neural foraminal stenosis is evident.
1. Newly apparent infratentorial demyelinating lesions. The supratentorial demyelinating lesions otherwise appear to be similar as on the prior exam, accounting for differences in technique. 2. The demyelinating lesions in the cervical and thoracic spinal cord do not appear significantly changed, given differences in technique.3. Interval central disc protrusion at C5-C6 that mildly indents the spinal cord.