Clinical question: Multiple sclerosis, evaluate for progression. Signs and symptoms: Weakness. Nonenhanced brain MRI:Negative diffusion-weighted images.There is technique difference between the current exam (routine multiple sclerosis brain MRI with 4 mm slices) compared to prior Dr Javed's dedicated protocol with 2 mm slices. This examination is also performed without intravenous contrast as is requested by clinical service compared to prior post enhanced exam. The difference in technique precludes precise evaluation for detection of smaller lesions.Within this limitation however there is no convincing evidence of new demyelinating plaque or progression of demyelinating disease since prior study. Mild findings of demyelinating disease in the supratentorial brain parenchyma, midbrain, posterior pontine and bilateral cerebellum are again identified.Unremarkable cerebral cortex and cortical sulci and with normal size of the ventricular system with maintained midline. There is revisualization of cavum septum pellucidum and vergae.
Findings consistent with patient's known demyelinating disease without convincing evidence of interval progression. Please see above comments.