Fig 4.
A 61-year-old woman with PCNSL (patient 12 in Table 1). Change of T2 signal intensity abnormality that was not associated with enhancing tumor at baseline. Baseline Z score −.46; end of treatment Z score −.26.
A, Baseline axial T2-weighted image demonstrates linear as well as tiny ovoid areas of T2 signal intensity abnormality bilaterally in the parietal periventricular white matter (arrows). This may represent small areas of chronic small vessel ischemic changes and probably enlarged Virchow-Robin spaces. Also note a large left frontal zone II abnormality (arrowhead).
B, End-of-treatment axial T2-weighted image shows enlarged and more intensive T2 signal intensity abnormality bilaterally in the parietal periventricular white matter (arrows). This may either represent aging with advanced ischemic changes but more likely represents changes secondary to chemotherapy, which is supported by the fact that multiple, new, partially confluent T2 foci appeared bilaterally in the periventricular white matter (curved arrows). Note the much smaller left frontal residual zone II abnormality (arrowhead).
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