Reason: MS evaluate for progression History: paresthesias legs MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of patchy T2 and flair signal hyperintensity within the white matter of the supratentorial brain as well as the middle cerebellar peduncles and brainstem compared compared to the previous exam this does not appear to have changed substantially, however, the prior exam acquired using different technique compared with current exam and as a result a more subtle change would not be readily appreciated..Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:There is a redemonstration of ill-defined patchy signal hyperintensity within the cervical spinal cord at approximately C5.The cervical vertebral bodies are appropriate in overall alignment and height. At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots.
1.There are ill-defined the lesions present throughout the brain parenchyma which have been present since prior exams. They are located within the white matter of the supratentorial brain as well as brainstem and cerebellum. There is an additional lesion present within the cervical spinal cord. Compared to the prior exam there is no appreciable interval change. Etiology is uncertain. Please note that given the subtlety of these lesions in the brain and cervical spinal cord, any similar thoracic spinal cord lesions may be relatively less apparent due to lower sensitivity of thoracic spinal cord imaging and as a result not readily appreciated.