Long TR sequences from inferior to superior demonstrate diffuse signal abnormality involving
both grey and white matter centered in the left parietal lobe and extending into the frontal
and occipital lobes. A focal cystic mass is identified in the left parietal lobe.
Pre-gad (upper left) along with post gad coronal and axial images reveal ring enhancement of
the left parietal lesion, as well as additional parietal parenchymal enhancement.
Single-voxel short and long TE spectra of the ring enhancing lesion reveal evidence for
elevated choline, more pronounced on long TE spectrum (right). The doublet at 1.3 ppm inverts
on the long TE spectrum, consistent with lactate.
Additional single voxel spectrum of the occipital lesion reveals additional abnormal choline
elevation and a small amount of lactate.
Key words: mri tumor neoplasia mrs