Clinical question: Multiple sclerosis; follow-up progression. Signs and symptoms: Anesthesia. Pre and post enhanced brain MRI:Examination is performed utilizing multiple sclerosis protocol. Precise comparison is hindered secondary to difference in technique between the 2 exams (multiple sclerosis protocol on current study and routine brain MRI on prior exam) and lack of sagittal FLAIR on prior study. Images through posterior fossa are also limited due to extensive pulsation artifact.There is a suspected lesion in the right aspect of pons and axial FLAIR series (series 601 image 16) which cannot be confirmed with certainty on sagittal FLAIR sequence and could be artifactual.Few tiny demyelinating plaques in supratentorial subcortical and periventricular white matter are present. There is subtle interval increase in the number of lesions since prior study however note should be made that this observation can be at least partially secondary to difference in technique.No detectable abnormal enhancement on post infused images. Cortical sulci and ventricular system as well as the CSF spaces remain within normal for patient of stated age of 24.
Minimal findings of chronic demyelinating disease in the supratentorial space with suggestion of subtle interval progression since prior exam from 2013 as detailed. Please see above comments.