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On neuroimaging, the most common abnormality is the multiple ring enhancing lesions of the brain. This study was intended to characterize imaging findings in various ring enhancing lesions of brain. Material and Methods: 40 patients (Males=28; Females=12) were evaluated in this study conducted at Osmania General Hospital and MNJIO and RCC over a period of 2 years. MRI along with MRS was performed in patients ranging from ages of 7-66 years. Results: Out of the 40 patients evaluated 18 cases were tuberculomas, 10 were NCC, 4 abscesses, 4 metastases, 2 cases of primary brain tumors and 2 cases of toxoplasmosis. The highest incidence of REL’s were found in 21-30 years age group accounting for 10 cases and least was seen in age group of >60 years constituting 5%. 28(70%) were males and 12 (30%) were females. 14(35%) were noted on the right side, 10 (25%) were noted on the left side, Seizures are the most common presenting complaint in 50% of cases. 14 (35%) of them presented with a single lesion. Majority 28 (70%) of them showed RELs < 2cm. Choline peak was observed in 15 cases, Lipid in 18 cases, Lactate in 22 cases, reduced NAA peak in 7 cases and amino acids in 3 cases. Conclusion: The most sensitive modality which can characterize the intracranial ring enhancing lesions RELs is MRI’s. Based on characteristic imaging findings, MRI plays a pivotal role in patient management by suggesting the correct diagnosis.

Role of MRI in Evaluation of Ring Enhancing Lesions of Brain in Correlation with Mr Spectroscopy