MRI - Brain
Left frontoparietal para-falcine ill-defined cortical based space-occupying lesion with gyral swelling showing the following :
- size: averaging 2.5x1.5x1.8 cm, in maximum AP, SS and CC dimensions
- signal pattern: T1 hypo, T2 hyperintensity with no detected appreciable post-contrast enhancement
- vasogenic edema: surrounded by grade I perifocal edema
- mass effect: mild effacement of the related cortical sulci
- enhancement pattern: heterogeneous enhancement with small central none enhancing spot
- SWI: no blooming
- diffusion-weighted imaging: the lesion shows no diffusion restriction. The mean ADC value of the lesion = 1.382 x 10-3 mm2/sec
Spectroscopy (TE 135 msec)
- Cho/Cr ratio =0.81
- Cho/NAA ratio=1.56
- NAA/Cho ratio = 0.64
- NAA/Cr ratio = 0.52
- Lactate peak is detected
The short echo time TE 30 msec spectroscopy showed reduction in the choline levels with high MI levels.