MRI - MRI and MR spectroscopy
Sagittal T2
Axial T2
Axial FLAIR
Axial DWI
Axial ADC
Axial SWI
Axial T1
Axial T1 C+
Coronal T1 C+
Sagittal T1 C+
MRS
MRS
MRS
MRS
MRS
Multiple leptomeningeal and parenchymal enhancing nodules are seen at the suprasellar/hypothalamic region, right temporal lobe, and left frontal regions. They elicit isointense signal at T1 WI, a low signal at T2 WI with homogenous post-contrast enhancement. No diffusion restriction. They are surrounded by vasogenic edema and exert a positive mass effect. Thickening and enhancement of the pituitary infundibulum. Left frontal subcortical white matter focus of abnormal signal with no contrast enhancement.
MRS criteria were non-specific, with no significant elevation of the Choline peak. No significant reduction of the NAA peak.