Axial T2 and FLAIR images show focal signal hyperintensity involving the left thalamus,
periventricular white matter, and external capsule. Notice the lack of significant mass effect.
Axial FLAIR image (top left) shows involvement of the insular cortex and posterior
limb of the internal capsule. Axial and Coronal T1 Gadolinium enhanced images
(center and top right) show no abnormal enhancement.
Single Voxel MR Spectroscopy was obtained at the level of the lesion (voxel 1), and
contralateral white matter (voxel 2). The contralateral normal white matter shows a normal
spectrum. The spectrum obtained from the lesion shows slight elevation of the Choline
peak (relative to the adjacent Creatine peak), suggesting cell membrane turnover.
Myo-inositol at 3.56 is also mildly elevated, suggesting some gliosis.
Key words: mri mrs tumor neoplasia