Fig. 2

MRI of the brain was performed using a 1.5 T scanner with the following sequences: A Axial T2-weighted imaging (T2WI), B Axial T2 FLAIR-weighted imaging (FLAIR), C Axial ADC map, D Axial T1WI with gadolinium, E DSC-perfusion imaging, F Multi-voxel spectroscopy with TE 135 ms. Axial T2WI and FLAIR images showed a frontal dural-based mass with a signal intensity similar to the brain parenchyma with strong homogeneous enhancement on T1WI with gadolinium (white arrowheads). On T2WI and FLAIR sequences, there was also a heterogeneous and hyperintense area on the underlying frontal brain parenchyma (*) with cortex affection and without facilitated diffusion. The perfusion imaging showed high rCBV values and the spectroscopy an inversion of the choline/NAA ratio with elevation of choline and NAA reduction