MRI
Axial T1
Sagittal T1
Axial T2
Axial FLAIR
Axial Gradient Echo
Axial DWI
Axial ADC
Axial T1 C+
Coronal T1 C+
Axial MR Perfusion
MRS
There is a mass in the left precentral gyrus with thick and nodular peripheral enhancement with adjacent white matter high FLAIR signal with no mass-effect on the lateral ventricles and no midline shift. There is a small amount of diffusion restriction which appears related to the anteromedial wall. Spectroscopy demonstrated slight reduction in NAA and slight elevation of choline with no significant lactate rise. The peripheral enhancing component has increased cerebral blood volume.
No further contrast enhancing lesion.
Prominent periventricular white matter high FLAIR signal. Prior posterior fossa craniotomy. A large focus of calcification is seen in the left cerebellar hemisphere. Further focal calcification or cavernoma is seen in the right temporal parietal region as well as further scattered tiny areas of susceptibility artefact. These are stable when compared to previous examinations. Ex-vacuo dilatation of the left lateral ventricle again demonstrated.
IMPRESSION: Overall, findings favour tumour with increased cerebral blood flow and peripheral diffusion restriction concerning for high-grade glioma. Metastasis is a less likely differential diagnosis.