Findings: <1>. Multidetector row CT scan of brain with multiplanar
reconstruction, and without intravenous contrast:
<2>. 1.5 Tesla MRI of brain with T1 weighted echo train spin echo,
T2 weighted echo train spin echo, T2 weighted fluid-attenuated
inversion recovery echo train spin echo, diffusion-weighted
echo-planar MR imaging, single voxel proton MR spectroscopy,
chemical shift MR imaging with metabolite map, diffusion-weighted
echo-planar MR imaging with fractional anisotropy maps,
colored-fractional anisotropy maps, and 3D diffusion tensor
tractography, and with intravenous gadolinium-enhanced images:
1. A high attenuation lobulated big mass (figure 1) with iso-T1
and T2 signals and contrast enhancement (figure 3), about
7.6cm in greatest dimension, in left parietal lobe, with
extension into left thalamus but minimal perifocal low density,
long T2 edema, in favor of brain tumor.
2. Presence of faint calcifications of the lesion (arrow in figure),
some degree scalloped erosion of adjacent parietal skull (arrow
in figure 2), and extensive cystic change of the lesion.
3. Besides, marked restricted water diffusibility of the solid
part (figure 3) with marked reduced the ratio of
N-acetylaspartate(NAA)/total Creatine (Cr) (figure 4,5),
elevated the ratio of choline (Cho)/total Creatine (Cr)
(figure 4,6), and presence of abnormal peak of lactate
(arrow in figure 7).
4. Presence of mass effect of the lesion with dilatation of left
lateral ventricle frontal horn, may due to compression of
foramen of Monro by the tumor.
5. Besides, uncal herniation with mild obliteration of left
suprasellar cistern and medial deviation of cerebral white matter
tract (figure 9,10), due to tumor mass effect alos.