MRI
Axial T1
Axial T1 C+
Axial T2
Axial FLAIR
Axial DWI
Axial ADC
Axial Gradient Echo
Sagittal T1
Coronal T1 C+
MRS
Axial MR Perfusion (CBV)
An area of high signal on FLAIR within the left mesial temporal structures and extending along the body of the left hippocampus has positive mass effect. No contrast enhancement or elevated cerebral blood volume (CBV) is identified. Spectroscopy suggests decreased NAA and increased myoinositol. Right-sided mesial temporal structures are normal. Minor periventricular and subcortical white matter disease. No acute diffusion changes.
Conclusion: Infiltrative lesion with mass effect involving left mesial temporal structures and extending along the body of the left hippocampus, most likely representing a low-grade glioma. DDx paraneoplastic encephalitis.