MRI - MRI Brain
Axial T1
Axial T2
Axial FLAIR
Axial T1 C+
T1 C+
T1 C+
MRS
How to differentiate lymphoma from GBM?
By contrast study GBM usually shows heterogeneous enhancement while lymphoma rather homogenous except in immunocompromised patient. By diffusion weighted images, lymphoma shows typically restricted diffusion while GBM shows mild diffusion restriction at the periphery of the lesion corresponds to tumorous oedema.
Right parietooccipital irregular intra-axial heterogeneous lesion surrounded by perifocal oedema and exerting a positive mass effect on the ipsilateral lateral ventricle. It displays heterogeneous enhancement with a haemorrhagic component at the posterior aspect of this lesion.
Magnetic resonance spectroscopy reveals:
- reduced NAA reflecting neuronal damage
- elevated choline denoting rapid membrane turnover
- marked lipid and lactate rise indicating intralesional necrosis