- bilateral fronto-parietal predominantly peri-ventricular and subependymal multi-focal mass lesion is seen infiltrating the forceps major and the corpus callosum. The mass measures 4.9 X 4.3 X 2.5 cm in its main axial and CC dimensions. The mass shows hypointense T1 and iso- to mildly hypointense T2 signal with evident restricted diffusion. The lesion shows predominantly marginal post-contrast enhancement with solid enhancing lesion at the left high posterior frontal subependymal region.
- the mass is associated with mild perifocal vasogenic brain oedema with compression of the posterior portions of the lateral ventricles’ bodies.
- multi-voxel MR spectroscopy (intermediate TE) shows moderate elevation of the Choline (Cho) with mild to moderate depression of the N-acetyl aspartate (N-AA) and creatine (Cr) with increased Cho / Cr and Cho/NAA ratios. Single voxel MR spectroscopy (short TE) of the enhancing component of the lesion at the left high posterior frontal para-sagittal region shows elevation of the lipid/lactate. The spectroscopic findings are indicative of a malignant lesion.
- no hydrocephalic changes.
- normal cortical sulci.
- normal sellar region and posterior foss as well as the petromastoid system.