CASE 57: MRI Brain

60 M, convulsions

Intra axial mass lesion, Hypo T1, hyper T2, and dense enhancement on contrast. Hemorrhage seen within in on SWI

MR spectroscopy of the lesion shows a raised choline peak with a depressed N-acetyl aspartate peak.

Diagnosis

Gliobastoma Multiforme (High Grade Glioma)

PEARLS

High Grade Glioma (Gliobastoma Multiforme) is the commonest CNS tumor of adulthood

Typically poorly-marginated, diffusely infiltrating necrotic masses localized to the cerebral hemispheres

MR Spectroscopy aids in diagnosis showing elevated choline peak and depressed NAA levels.