Non-enhanced cranial MRI reveals numerous lesions in the cerebellar and cerebral hemispheres which are hypointense on T1WI and hyperintense with a peripheral hypointense rim on T2WI. The lesions demonstrate restricted diffusion characterized by low apparent diffusion coefficient (ADC) and hyperintensity on the diffusion-weighted image (DWI), with surrounding edema.
Impression
These findings are consistent with caseating tuberculomas with liquefactive necrosis centrally or tuberculous abscess, both of which are indistinguishable on MRI.