Axial FLAIR images centered at the third ventricle and thalamus (left) and lateral
ventricles (right) reveal a large area of encephalomalacia in the right frontal lobe likely
from prior resection, with some hyperintensity in the adjacent brain parenchyma.
Additionally, note the abnormal high signal in the medial right thalamus.
Additional FLAIR sequences (left and middle) reveal abnormal high signal in the right external
capsule, right thalamus and posterior right midbrain. A post-gadolinium sequence (right)
reveals no abnormal enhancement.
Single voxel spectroscopy (TE 30 msec) reveals mildly elevated choline in the right thalamus.
Multivoxel spectroscopy on the right reveals elevated choline peaks in all but the most
Multivoxel spectroscopy reveals abnormal choline elevation on the left as well in all but the
most lateral and posterior voxels.
Key words: mri mrs tumor neoplasia postoperative
Recurrent anaplastic astrocytoma
with conversion to a higher grade