Multiple sclerosis (MS).

PROTOCOL:

T1W – Sagittal & axial scans
T2W – Axial & coronal scans
FLAIR – Axial scans 

FINDINGS:

-Follow up scan of MS case with previous examination done in 17/02/2014 revealed:
• Infra tentorial lesions with the same intensity and number (affection of the right ventro-lateral aspect of pons characteristic sign of MS).
• Same numbers and intensities of the lesions in the peri ventricular and centrum semi ovale bilaterally with confluent and Dowson’ finger sign appearance (with central liquefaction of one of the plaques in the high right frontal lobe giving impression of Tumefactive MS).
• No evident U-fibers affection in both studies till the time of this study.
• Abnormal diffuse signal intensities in body and genu of corpus callosum (seen in both studies with the same intensities and numbers).
• Diffuse patchy appearance in the cervical spinal cord (posterior to C2& C4-5 seen also in both studies).
• No abnormal enhancement is observed after contrast injection.

-No focal mass lesion is seen.
- Septum is in midline.  There is no midline shift.
-Basal cisterns are prominent in appearance.
-Corpus callosum shows normal MR morphology.
-Fourth ventricle is normal in size and is midline in position.


OPINION:

• In light of MR signs given by this study and previous one done in 17/02/2014; picture is suggestive of multiple sclerosis with stationary course for clinical correlation.


Reported By : DR.MOHAMMED MOHYELDIN
 Consultant-Radiologist