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Cortical and subcortical T2 hyperintensity and expansion is again identified in the left paramedian frontal lobe, with no enhancement but containing a small region of diffusion restriction. Spectroscopy trace in the left frontal lesion demonstrates increased choline and reduced NAA but no lactate peak. No convincing CBV increase.
A smaller focal region of cortical and subcortical T2 hyperintensity in the paramedian right parietal lobe demonstrates more pronounced diffusion restriction. There is no pathological contrast enhancement.
6 mm focus of T2 hyperintensity in right temporoparietal white matter is non-specific. No further abnormality identified. No hydrocephalus.
Appearance is most consistent multifocal low-grade glioma.