Axial T2 images demonstrate multiple lesions scattered throughout the thalami, deep white
matter and at the corticomedullary junction. Extensive vasogenic edema results.
The lesions are hypointense on pre gad T1 images on the left. A single post-gad coronal
image (right) reveals ring enhancement of one of these lesions.
Additional axial and coronal post gad images (top left and middle respectively) reveal an
additional ring enhancing mass in the right temporal lobe. No restricted diffusion is seen
Spectrum 1 in the area of signal abnormality reveals marked elevation of lactate/lipid with
decreased NAA. Spectrum 2 is normal.
Key words: mri mrs dwi infection inflammation AIDS