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Bilateral symmetrical butterfly-shaped T2 prolongation of the peri-ventricular and deep white matter with relative sparing of the subcortical U-fibers. The lesion shows hypointense T1 and hyperintense T2 / FLAIR signal with characteristic tigroid pattern. No evident post-contrast enhancement. The lesion shows evident restricted diffusion with high DWI and low ADC signal.
MR spectroscopy examination of the lesion shows elevation of the choline (Cho), myoinositol (MI) and lipid / lactate with depression of the N-acetyl aspartate (NAA).