Female, 14 years old, with history of glioma and growing lesion on a recent prior MRI scan. Assess for disease progression. Single voxel spectroscopy was performed on a region of progressive thickening and T2 signal abnormality within the right frontal periventricular white matter. The lesion spectrum is compared to a control spectrum obtained more posteriorly within the right frontal lobe from tissue which appears radiographically normal.The lesion spectrum demonstrates a reversal of the choline and NAA peaks, and when comparison is made to the control spectrum, the choline peak obtained from the lesion is indeed seen to be elevated relative to normal tissue.
MR spectroscopic findings concerning for progressive tumor.