A Grade II PXA involving the right frontal lobe, right temporal-parietal lobe, corpus callosum, and left insula in a 25-year-old female. (A–C) Contrast-enhanced axial, sagittal, and coronal T1WI showing marked enhancement of multiple lesions in the brain. (D) DWI showing restricted diffusion of multiple lesions. (E) The mean ADC of the right temporal-parietal lobe lesion was 0.80 × 10−3 mm2/s, and the mean ADC ratio was 1.01. (F) Sagittal T2WI depicting a hyper-intense spinal intramedullary lesion at the L2 level.