A large cystic mass is seen predominately involving the right frontal white matter causing
mass effect (axial T2, left). A more inferior cut (axial T2, right) reveals additional
signal abnormality in the right thalamus and splenium.
Pre –gad (top left coronal) and post gad (coronal bottom left, axial right) reveal mild
Spectrum 1 taken from the periphery of lesion reveals markedly elevated choline peak and
decreased NAA. The lactate peak is markedly elevated as well. Spectrum 2 reveals similar
abnormality. Spectra 3 is normal.
On multi-voxel MR spectroscopy, the spectra L and R1 are normal. Spectrum R2 in the area of
signal abnormality involving the right thalamus demonstrates elevated choline and decreased NAA.
Key words: mri tumor neoplasia mrs