Ax T2W: left temporal resection cavity with surrounding signal hyperintensity in the occipital,
temporal, and subinsular white matter and posterior limb of internal capsule.
FLAIR T2W: irregularity and heterogeneity of signal at the margins of the resection cavity.
Cor/Ax T1W: Heterogeneous signal just inferior to the resection cavity. Post gadolinium, thin,
smooth enhancement is seen around the superior cavity, with thick, irregular, enhancement
around the heterogeneous signal inferior to the cavity.
Proton Spectroscopy: Anterior voxel shows high lipid/lactate peak, with uniformly decreased
NAA, creatine, and choline. Posterior voxel shows increased lipid/lactate, but also high
choline relative to creatine and NAA.
Ax/Cor T1W: The resection cavity has decreased in size; nodular enhancement is seen
posterior and superior to the resection cavity.
Single and Multivoxel Proton Spectroscopy: Voxel over the nodular enhancement shows
marked increase of choline relative to creatine and NAA; multivoxel analysis shows that the
abnormal choline levels extend medially beyond the margins of the enhancing abnormality.
Key words: mri mrs tumor neoplasia