Fig. 1.

Standard plus advanced MRI in a large bifrontal meningioma. MR images of a 67-year-old man with a 4-month history of progressive frontal headaches associated with decreased motivation and personality changes. (A) T1-weighted contrast-enhanced MR image shows a large meningioma bifrontally with intense, relatively inhomogeneous enhancement. (B) Axial T2-weighted sequence shows high signal intensity of the tumor with very little peritumoral edema. (C) MR spectroscopy shows a prominent resonance from choline (black arrow) and creatine (blue arrow) and an inverted doublet peak at 1.45 ppm, corresponding to alanin as a typical marker for meningiomas (red arrow). (D) In MR perfusion there is increased blood volume at the periphery of the lesion due to pial blood supply and heterogeneous blood volume in the tumor center.