Case of the Week

Postcontrast axial T1 sequence (A) shows linear radial periventricular enhancement (perivascular enhancement pattern, white arrows). Axial FLAIR sequence (B) shows mild hyperintensities in the basal ganglia and the thalami (orange arrows). Medullary sagittal T2 sequence (C) shows a longitudinally extensive myelitis (diffuse “hazy” appearing intramedullary hyperintensities, yellow arrows). Postcontrast sagittal T1 sequence shows diffuse “speckle” intramedullary enhancement (D). Postcontrast axial T1 sequence (E) shows leptomeningeal (green arrows) and periependymal (blue arrow) enhancement. Precontrast sagittal T1 (F) shows a cystic parauterine lesion with a fluid-fluid level and heterogeneous content at the bottom edge of the field of view, consistent with a mature ovarian teratoma (pink arrow).