Axial images demonstrating T2 hyperintense infiltrating mass with involvement
of both white matter and gray matter, with enlargement of involved structures.
This mass involves the right frontal and temporal lobes with extension to the insular cortex.
Coronal T2WI confirms involvement of the same areas. DWI image does not demonstrate
restricted diffusion. Post contrast image shows no enhancement. Initial MR spectroscopy
demonstrates normal brain metabolites with a normal Hunterís angle.
Followup images reveal extension superiorly in the frontal lobe with focal enhancement.
Long and short echo MRS spectra demonstrate elevated choline, elevated myo-inositol and
decreased NAA, consistent with dedifferentiation in an untreated lesion with change in
Key words: mri tumor neoplasia dwi mrs