Axial FLAIR images show T2 hyperintensity involving the right occipital lobe, the mesial
temporal lobe and the splenium of corpus callosum, crossing the midline to involve the
left occipital white matter. Mass effect is demonstrated in the regions of signal
abnormality. Isointense region just lateral to the the occipital mass is either a cyst
or related to prior surgery.
Left: Axial FLAIR again shows T2 hyperintensity in the occipital lobe, the splenium of corpus
callosum, and crossing the midline. Abnormal T2 hyperintensity is also noted in the right
Right: Axial post contrast T1WI image shows mild heterogeneous enhancement within the
occipital lobe. The right atrium is displaced anteriorly and enhancement of the displaced
choroid plexus is seen.
Single voxel, long TE MRS over the enhancing zone shows decreased NAA and significantly
increased Choline peak.
Multi-voxel MRS over the enhancing zone shows abnormal spectra over most of the voxels
with normal spectrum in the lower right corner in the medial left occipital lobe.
Key words: mri tumor neoplasia glioma mrs
Anaplastic astrocytoma (Grade 3)