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Multiplanar multisequence MRI shows the pons is swollen with intrinsic pontine glioma (fibrillary astrocytoma). T1 C+ MR shows pontine expansion by predominantly low T1WI signal mass. Minimal focal enhancement is present. Note absence of hydrocephalus despite size of mass.
DWI and spectroscopy confirms the malignant nature of the disease.
MR spectroscopy demonstrates typical malignant trace, with increased Cho and decreased NAA.