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OtherBRAIN

MR Spectroscopy-Aided Differentiation: “Giant” Extra-Axial Tuberculoma Masquerading as Meningioma

P.C. Khanna, S. Godinho, D.P. Patkar, S.A. Pungavkar and M.A. Lawande
American Journal of Neuroradiology August 2006, 27 (7) 1438-1440;
P.C. Khanna
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S. Godinho
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D.P. Patkar
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S.A. Pungavkar
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M.A. Lawande
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    Fig 1.

    Axial T1WI (A; fast spin echo; TR/TE = 2015ms/9.7ms) and T2WI (B; fast spin echo; TR/TE = 4360ms/83ms) depicting a lobulated, dura-based lesion in the left frontal convexity that is predominantly hypointense on T1WI with a thick, iso-hypointense rim. On T2WI, it is of mixed intensity but predominantly hypointense with a hyperintense center. Displacement of the underlying parenchyma and a CSF cleft are identified (arrows). A large component of vasogenic edema is visualized.

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    Fig 2.

    Axial DWI (A; TR/TE = 3000ms/11ms) depicts a dark-appearing lesion, with a hyperintense rim (arrows). Axial contrast-enhanced T1WI (B; Gd-DTPA enhanced fast spin echo; TR/TE = 2015ms/9.7ms) depicts prominent central enhancement, a thick peripheral nonenhancing component and rim-enhancement beyond this. There is thick enhancement of adjoining meninges (“dural-tail” sign, arrow) with mild enhancement of meninges in the anterior interhemispheric region and the right cerebral convexity (not shown).

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    Fig 3.

    Single-voxel PRESS MR spectroscopy (A; TR/TE = 1500ms/35ms). Adequate water suppression has been achieved. Reading from right to left, peaks A and B (tall and broad) at 0.9 and 1.33 ppm, respectively, represent typical long-chain lipids (lipid/lactate). NAA and Cr are barely detectable. A small Cho peak, C, is seen to resonate at 3.2 ppm. Long TE MR spectroscopy (B; TR/TE = 1500ms/144ms) depicts persistence of predominant lipid peak at 1.33 ppm.

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American Journal of Neuroradiology: 27 (7)
American Journal of Neuroradiology
Vol. 27, Issue 7
August 2006
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MR Spectroscopy-Aided Differentiation: “Giant” Extra-Axial Tuberculoma Masquerading as Meningioma
P.C. Khanna, S. Godinho, D.P. Patkar, S.A. Pungavkar, M.A. Lawande
American Journal of Neuroradiology Aug 2006, 27 (7) 1438-1440;

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MR Spectroscopy-Aided Differentiation: “Giant” Extra-Axial Tuberculoma Masquerading as Meningioma
P.C. Khanna, S. Godinho, D.P. Patkar, S.A. Pungavkar, M.A. Lawande
American Journal of Neuroradiology Aug 2006, 27 (7) 1438-1440;
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