Bilateral cerebral, cerebellar, and pontine multiple scattered small space-occupying lesions. The largest lesion is seen on the left occipital lobe. The lesions appear isointense on T1 WI and high signal on T2 WI with ring enhancement with some of them show blooming effect on SWI, except for the large left occipital lesion which shows heterogeneous signal and enhancement and is seen surrounded by vasogenic edema signal. MRS criteria are impressive of neoplastic process demonstrating high Choline peak and Cho/cr ratio, low NAA peak, and elevated lipid lactate peak.
MRI and MRS criteria were suggestive of a neoplastic (most likely metastatic) process.