105         SA JOURNAL OF RADIOLOGY • June 2009

Presentation
A 50-year-old woman, known to have been recently diagnosed with advanced colonic carcinoma, and on palliative therapy, presented with an acute 
confusional state and associated seizures. The following MRI images were obtained.

Cranial MRI diagnosis

QUIZ CASE

105         SA JOURNAL OF RADIOLOGY • December 2009

S K Misser, MB ChB, FCRad (D)
Lake Smit and Partners, Durban

Fig. 2a. Uncontrasted axial T1-weighted 
image.

Fig. 2b. Axial post-gadolinium T1-weighted 
sequence.

Fig. 2c. Coronal post-gadolinium T1-weighted 
sequence.

Figs 1a and 1b. Axial T2-weighted sequence. Fig. 1c. Coronal FLAIR sequence.

a b

We invite readers to describe the MRI findings and provide the most appropriate clinical diagnosis. Please submit your response to shalendramisser@
hotmail.com. An award of R1 000 will be made for the best interpretation. A detailed diagnosis will be presented in the next SAJR.

Quiz Case.indd   105 11/18/09   9:06:20 AM