Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Intra cerebral ring enhancing lesions are frequently encountered lesions with various etiologies. Conventional Magnetic Resonance Imaging (MRI) together with Magnetic Resonance Spectroscopy (MRS) narrows the differential diagnosis, thus aiding in better clinical management. To evaluate the role of conventional MRI together with MRS in assessing and differentiating various intra cerebral ring enhancing lesions. Present study is a retrospective, observational, cross sectional study of 100 patients diagnosed with cerebral ring enhancing lesions on contrast MRI study with MRS as an adjunct. Conventional MRI features on various sequences like T1W, T2W, Fluid attenuated inversion recovery (FLAIR), Diffusion weighted imaging (DWI) and post contrast (Injection Gadolinium) were recorded together with MRS spectra of various metabolite peaks like N‐Acetyl Aspartate (NAA), Choline (Cho), Creatine (Cr), amino acids, lipid, lactate peaks with special emphasis on Cho/Cr ratio to differentiate various pathologies. The most prevalent etiology amongst the 100 patients studied was NCC (28%), closely followed by tuberculoma(27%), and Glioblastoma multiformae(09%). Majority of NCC lesions were T2W hyperintense and tuberculoma were T2W hypointense with prominent aminoacid peaks in NCC, lipid lactate peaks in tuberculoma. Cho/Cr ratio was <1 in majority of NCC and >1 in most of tuberculoma cases. Glioblastoma multiformae (GBM) patients showed Cho/Cr ratio <2 with shaggy ring enhancement, Primary CNS Lymphoma patients having Cho/Cr ratio >2 with cases of Pyogenic abscess showing smooth rim enhancement and central diffusion restriction. Cysts with mural nodule tumours (CMNT) including Hemangioblstoma and Pilocytic Astrocytoma were primarily located in cerebellum showing avid ring enhancement of nodule with demyelinating tumours showing open ring enhancement Intracerebral ring enhancing lesions were accurately diagnosed by conventional MRI together with MRS thus paving the way for a better clinical management of the patient.
How to cite this article:
Pragya Ghosh, Sunny Gupta and Arnab Chaudhuri. Role of Magnetic Resonance Imaging in evaluation of Intracerebral Ring enhancing lesions and correlation with MR Spectroscopy.
DOI: https://doi.org/10.36478/10.59218/makrjms.2024.1.1.10
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2024.1.1.10