Legend T1 sagittal (left) along with T2 axial images reveal a well-circumscribed mass overlying the left cerebral convexity with a prominent CSF cleft. Pronounced mass effect on the brain and a left-to-right midline shift are noted.

Legend Pre gad (left) alongside post gad coronal and axial (right) images reveal homogenous enhancement of the mass with subtle dural tails noted as well, best seen on coronal (top) post gad image.

Legend Pre and post-contrast axial CT images (left) reveal enhancement, along with peripheral calcification of the mass, best seen on pre-contrast image (top left). Sagittal Gd-enhanced T1WI shows the mass extending to the superior sagittal sinus. An MR venogram MIP image (bottom right) reveals slight compression of the superior sagittal sinus, but the sinus remains patent.

Legend A single voxel short-TE spectrum (left) shows normal metabolites in the right brain. A single voxel spectrum from within the mass reveals abnormal elevation of glutamates (Glx), particularly α glutamate. Alanine (1.48 ppm) is elevated, as well as lipid (0.9 ppm), lactate (1.3 ppm) and choline (3.2 ppm). Creatine (3.0 ppm) is reduced. Key words: mri ct mrv mrs tumor neoplasia

Brain Diagnosis: Meningioma