Ring Enhancing Lesions of Brain on MRI in Correlation with MR Spectroscopy

Abstract

Background and Purpose: This study is intended to study the characteristic imaging findings in various ring enhancing lesions which help in their characterization. A wide variety of aetiologies may present as multiple cerebral ring enhancing lesions. These can be caused by a variety of infectious, neoplastic, inflammatory, or vascular diseases. The aim of the study is differentiating neoplastic & non neoplastic brain lesions using conventional and advanced MR imaging techniques. Methods: We studied MRI brain scans of 60 patients who were being evaluated for specific neurological symptoms over a period of 3 months (15-09-2021 TO 15-12-2021) who presented to radiology department. Results: Most common lesion seen is Neurocysticercosis (50%) followed by tuberculoma (30%), abscess (10%) & metastasis (10%). 21-30 years is the most common age group involved (30% of cases) and seizures is the most common presenting complaint (60%). Pattern of signal intensity on T2 and FLAIR, Diffusion weighted imaging & MR spectroscopy helps us to differentiate benign from malignant lesions. Conclusion: The most sensitive modality useful in the characterization of intracranial ring enhancing lesions is MRI. Most common feature noted in most of the lesions is irregular type of ring enhancement.MRS plays an important role in characterizing various ring enhancing lesions. MR spectroscopy is a most potent tool for making differential diagnosis between brain abscesses and lesions which are non-infectious such as primary brain tumour, lymphoma, brain metastasis, and tuberculoma.