MRI Scan in Evaluation of Intracranial Ring Enhancing Lesions

Maulik Jethva, Anjana Trivedi, Manthan Solanki, Chirag Solanki

Abstract: Introduction: Multiple ring-enhancing lesions are commonly encountered neuroimaging abnormalities. On neuroimaging, these lesions appear as hypodense or isodense space occupying lesions on non-contrast computed tomography studies. After contrast administration, there is a ring- or a homogeneous disk-like enhancement within the region of central hypodensity. Owing to MRIs high inherent soft tissue contrast and its ability to image in multiple planes, MRI has a clinical advantage in early detection of disease as it can differentiate various causes. MR spectroscopy employs the principle of chemical shift imaging to detect metabolites within a ring enhancing lesion and serves as a potential tool for differentiating between various RELs. Results: In present study most common lesion seen was tuberculoma (35%) followed by neurocysticercosis (20%), abscess (12%), metastasis (10%), glioblastoma multiforme (8 %) ,toxoplasmosis (6%),multiple sclerosis (5%), radiation necrosis (2%) and subacute infarct (2%). Irregular type of ring enhancement is the most common feature noted in most of the lesions. ears was the most common age group involved (40% of cases) and more than 60 years was the least common age group involved(3% of cases) . Seizure was the most common presenting complaint (70%) followed by headache (29%) and fever (15%). 80 % of cases were presented with multiple lesions and 20% cases were with single lesion. Conclusion: MRI is definitive, sensitive, accurate, though costly but very specific, non-invasive, radiation free modality for of intracranial ring enhancing lesions - RELs

Keywords: MRI, MRI Spine, intracranial ring enhancing lesions, RELs