MRI IN EVALUATION OF RING ENHANCING LESIONS OF THE BRAIN AND CORRELATION WITH MR SPECTROSCOPY.

Dr. Nikhil Parvatkar, Dr. Pradip Jhala, Dr. Chandra Raychaudhuri

Abstract


Ring-enhancing lesions are considered as routine imaging abnormality detected in neuroimaging . MRI and CT scans are used for diagnosing
these pathologies. There can be various etiologies of such lesions in the brain. MR spectroscopy is a potential tool for creating a differential
diagnosis between infectious conditions of the brain which present as ring enhancing lesions like tuberculomas, neurocysticercosis and pyogenic
or fungal abscesses among eachother and from the other mimicking conditions. This study was carried out on 38 patients referred to the
radiodiagnosis department of dhiraj hospital with clinical suspicion of an infective CNS lesions. These patients underwent MRI brain (Plain and
Contrast) and MR spectroscopy was carried out. Out of 38 patiens, the commonest pathlology encountered was tuberculoma (57%),
neurocysticercosis (28.9%) and brain abscesses (13 %). On spectroscopy examination 17 out of 22 tuberculoma patients showed Lipid peak as the
major metabolite. Raised choline and reduced NAA was found in Neurocysticercosis patients. Amino acid peak was seen characteristically in 2
cases of abscesses. All the 5 cases showed lactate peak. The present study concludes that MRI with contrast is the modality of choice for diagnosing
ring enhancing lesions of the brain. MR spectroscopy is a recent development which aides MRI is differentiating various pathologies presenting as
ring enhancing lesions. It is of great value in differentiating infective lesions like tuberculoma , NCC and brain abscesses from brain tumours and
metastases.


Keywords


Magnetic Resonance Imaging , Mr Spectroscopy, Ring Enhancing Lesions.

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