Multiple sclerosis. Worsening gait. Evaluate for progression. Numerous juxtacortical and periventricular T2 hyperintense lesions are seen in both cerebral hemispheres becoming nearly confluent in the periatrial regions and along the temporal horns. Lesions are also evident within the pons, along the margins of the fourth ventricle, and in the cerebellum. There is questionable elevated T2 signal within the dorsal spinal cord at the C2 level, but this is equivocal and not adequately assessed on the present examination.The immediate prior examination was obtained with significantly different imaging technique which complicates precise comparison. However, given this caveat, no definite or significant interval changes are seen. When comparison is made to the older examination from 2013, most of the lesions show no significant interval change, but at least one lesion in the left centrum semiovale has become less conspicuous.No evidence of significant parenchymal edema or mass effect is seen. No abnormal extra-axial fluid collections are detected. The ventricular system remains within normal limits for size and morphology. Multiple nonspecific subcentimeter right parotid nodules are evident.
A substantial burden of supratentorial and infratentorial white matter lesions is again demonstrated compatible with the history of multiple sclerosis. Although the immediate prior examination was obtained with different imaging technique which complicates precise comparison, no definite or significant interval changes are appreciated.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.