 Direct comparison to the previous MRIs difficult given technical limitations on that study. Multiple periventricular white matter lesions appear more conspicuous and confluent than on the prior study, which may be due to technique and/or progression. For example, a posterior left frontal lobe lesion was not definitely apparent on the prior study and may represent a new lesion. Additionally, there are several punctate lesions in the bilateral cerebral hemispheres, which were not apparent previously and which may indicate new lesions. Furthermore, the T2 signal surrounding the right occipital horn of the lateral ventricle appears more pronounced than on the prior study. Many of these lesions demonstrate T1 hypointensity indicating chronicity. In particular, a right pons/midbrain lesion appears to have developed T1 hypointensity along with decreased T2 hyperintensity. The ventricles and sulci are unchanged. The basal cisterns remain patent. There is no midline shift or mass effect.
Numerous supratentorial and infratentorial demyelinating lesions. Comparison with the prior exam is limited due to differences in technique, although some lesions may have slightly progressed and some now exhibit more chronic features.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.