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Aggressive brain tumor

Case Study
Kovanlikaya, Ilhami Istanbul, Yeditepe University Hospital Turkey

Patient history:

A 32-year-old female presented with loss of sensation in her left lower extremity together with increased difficulty in walking over the period of one year.

MR examination:

An MR examination was performed on the Achieva 3.0T system with Quasar Dual gradients. 

A 3.5 cm hyperintense mass is found in the right frontal lobe which extends to the precentral and superior frontal gyri.

MR images and interpretation:

T2-weighted TSE axial Post-contrast T1-weighted SE axial
T2-weighted TSE axial
Post-contrast T1-weighted SE axial


The T2-weighted TSE axial image demonstrates the mass as being hyperintense, while in the post-contrast T1-weighted SE axial image the mass is shown to have minimal enhancement.


Postprocessing of the perfusion images
Postprocessing of the perfusion images


Postprocessing of the gradient echo perfusion images reveals significant increase of perfusion within the tumour.


Proton MR Spectroscopy
Proton MR Spectroscopy


A multivoxel, multislice PRESS proton MRS is also performed. The spectrum, obtained from a voxel defining the same region of interest as that used for the postprocessing of the perfusion MRI, reveals a marked increase in the choline/creatine ratio.



Postprocessed fMRI images of left lower extremity
Postprocessed fMRI images of left lower extremity
Postprocessed fMRI images of right and left motor tasks
Postprocessed fMRI images of right and left motor tasks
DTI fiber tractography Fractional anisotropy map
DTI fiber tractography
Fractional anisotropy map


BOLD fMRI is performed and on the postprocessed images the brain activity for the left lower extremity as well as the right and left hand motor tasks are indicated. From the DTI (diffussion tensor imaging) a fiber tractography is created to indicate the white matter fiber tracks. The postprocessing of both the BOLD fMRI and DTI series gives valuable information needed for the pre-surgical planning.The Fractional anisotropy color map is used to measure FA values from the tumour and the contra-lateral normal white matter which are 0.15 and 0.47 respectively.

Working diagnosis:

An aggressive brain tumour in the right frontal lobe.

Impact of system imaging:

The Achieva 3.0T system offers MR Spectroscopy, BOLD fMRI, DTI, perfusion-weighted images as well as conventional sequences providing a complete and sophisticated neuro package.


The Ambient experience offers soothing, thematic audio-visual surroundings in the examination room which may help to reduce patient anxiety and stress. This increases patient co-operation which in turn helps to produce optimal examination results as well as keeping the examination time as short as possible.



For background information, see:

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Nov 22, 2006

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Case Study
Achieva 3.0T
Release 1
Quasar Dual
Brain, Neuro

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