Radiology Report (5/5/2005 – Routine checkup)
PATIENT: SMITH, ERIK
MRI OF THE BRAIN WITHOUT AND WITH CONTRAST
TECHNIQUE: Image sequences obtained include: Sagittal T1. Sagittal T2. Axial T1. Axial T2. Axial FLAIR. Postcontrast axial and coronal T 1.
FINDINGS: Numerous small foci of demyelination are present bilaterally as previously described.
In the interval sine the prior study, a new focus of demyelination has appeared in the right cerebral peduncle (please see axial T2 image 35 and 34). This extends somewhat inferiorly into the pontomesencephalic junction (image 37). A second new focus of demyelination is seen in the high right frontal white matter (please see FLAIR image 45). This was not present previously. A third new focus of demyelination is seen in the subcortical white matter in the left middle frontal gyrus (image 46 of the FLAIR sequence). This was not present previously (an adjacent area of demyelination was, indeed, previously present (image 49, sequence 4). No other new foci of demyelination are demonstrated. There is no pathologic enhancement within these foci to suggest current activity. However, these foci did appear at some point between the prior study and the current one. There is no recent infarct. There is no hemorrhage. There is no mass. There is no midline shift or hydrocephalus. The internal auditory canals and cerebellopontine angles appear normal. The mastoids and middle ear cavities appear normal. Mucosal thickening is present in the maxillary sinuses bilaterally. The remaining paranasal sinuses and the temporal bones appear normal.
- Three small plaques of demyelination have appeared in the interval since the prior study of 8-11-04.
- A small focus is present in the right cerebral peduncle, extending inferiorly into the right pontomesencephalic region. This measures approximately 5 mm in diameter. A second small focus of new demyelination is seen in the high right frontal region and measures approximately 7 mm in diameter. A third small new focus of demyelination is present in the left middle frontal gyrus and measures approximately 4 mm in diameter. This is seen in the subcortical white matter here.
- The remaining plaques were present previously and appear unchanged on the current examination.
- There is no pathologic enhancement within any of these plaques to suggest current activity.
- There is no recent infarct or hemorrhage.
- There is no mass.
- There is no midline shift or hydrocephalus.