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Confluent T2 hyperintense lesions near CSF intensity are noted at the deep white matter showing suppression on FLAIR with partial involvement of the subcortical U-fibres. The distribution of the disease involves both anterior and posterior white matter with no either predominance. The posterior limbs of both internal capsules are affected with typical sparing of the anterior limbs. The external capsules are spared. The corpus callsoum is diffusely involved with typically sparing its outer rim. Minor peri-ventricular rim of enhancement seen. No blooming on SWI. Small foci of restriction on DWI with low ADC seen at the outer peri-ventricular white matter.
MR spectroscopy (centrum semiovale): Large inverted lactate peak with relative increased levels of Choline and diminished NAA.