Figure 2.
Case 13, male, 12 years old, with classic medulloblastoma in the cerebella vermis accompanied by cerebrospinal fluid spread in the supersella cistern.
The white squares represent regions of interest used to select voxels to determine ADC values.
(A) Transverse T2WI: slight hyperintensity, and sv-PRESS localized in the center of neoplasm (region of interest, 12 × 12 × 12 mm3).
(B) 1H MRS (repetition time/echo time = 1 500 ms/135 ms): NAA peak significantly decreased, Cr peak moderately decreased, Cho peak highly increased, low taurine peak at 3.4 ppm, and little myo-inositol peak.
(C) ADC map: Left square ADC value = 0.47, right square ADC value = 0.69.
(D) Tumor morphology (hematoxylin-eosin staining, × 200): classic medulloblastoma, showing sheets of small, round cells with a high nucleus-to-cytoplasm ratio and abundant mitoses.
ADC: Apparent diffusion coefficient; Cho: choline; Cr: creatine; CSF: cerebrospinal fluid spread; NAA: N-acetyl aspartate; sv-PRESS: single voxel point resolved spectroscopy technology.