Female, 50 years old, with history of multiple sclerosis on Rebif. Follow-up examination. Brain:Multiple scattered T2 hyperintense lesions are demonstrated within the periventricular and subcortical white matter, the corpus callosum, and minimally in the cerebellum. The number and size of these lesions have not significantly changed from the prior examination. No convincing lesional enhancement is seen. Most, however, are associated with moderate to marked T1 hypointensity. There is no evidence of significant parenchymal edema or mass effect. Overall brain volume is relatively preserved. No evidence of acute intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The ventricles are normal in size and morphology. C-spine:Slight reversal of the cervical lordosis is unchanged. Vertebral body heights are preserved. No worrisome marrow signal replacement or edema is detected. No pathologic marrow enhancement is seen. Signal characteristics compatible with benign hemangiomas are seen within the C5 and T1 vertebral bodies.A focus of T2 hyperintensity is seen within the right posterolateral cord at C5, unchanged from prior. There may be a few additional scattered foci of cord T2 hyperintensity, but imaging artifact prevents definitive visualization. No pathologic cord enhancement is seen.C2-3: Unremarkable. C3-4: Unremarkable. C4-5: Mild posterior disc-osteophyte complex formation and right uncovertebral hypertrophy. No significant spinal canal stenosis. Mild right foraminal narrowing. No interval changes. C5-6: Posterior disc-osteophyte complex formation with a right paracentral extrusion extending predominantly below the disc space, progressed from prior. There is effacement of the right ventral sac and perhaps very slight impingement of the right ventral cord. No significant foraminal narrowing. C6-7: Unremarkable. C7-T1: Unremarkable.
1.White matter lesions are identified in the brain compatible with multiple sclerosis. The size and number of these lesions have not significantly changed.2.At least one, but possibly several small lesions are seen within the visualized spinal cord. No significant interval change is suspected.3.A right paracentral disc extrusion at C5-6 has increased in size since the prior examination with resultant progressive effacement of the thecal sac.