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Magnetic Resonance Imaging Features of Solitary Inflammatory Brain Masses
Author(s) -
Bakshi Rohit,
Glass Jon,
Louis David N.,
Hochberg Fred H.
Publication year - 1998
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon1998818
Subject(s) - medicine , magnetic resonance imaging , neuroimaging , differential diagnosis , white matter , calcification , radiology , multiple sclerosis , pathology , lesion , hyperintensity , stereotactic biopsy , psychiatry
Abstract Brain lesions in inflammatory diseases may present as solitary masses, prompting a biopsy. We present neuroimaging and histologic findings in five patients with solitary, inflammatory, demyelinating mass lesions located in the supratentorial white matter and gray–white junction. The patients presented with seizures, focal neurologic signs, and neuroimaging findings that indicated the possibility of a neoplasm. Computed tomography (CT) revealed enhancing, sing le hypodense lesions associated with mild or no mass effect. On MRI, the lesions were hypointense on T3–weighted images and hyperintense on T2–weighted images. Variable patterns of enhancement were noted on CT and MRI, including homogeneous/patchy (n = 3) and ring/nodular (n = 1) enhancement. There was no evidence of calcification or hemorrhage. Biopsies revea led a leukoencephalitis and demyelination, with varying degrees of demyelination among the cases. The syndrome, re lating to a solitary lesion, was corticosteroid–sensitive, and it ultimately stabilized. Extensive longitudinal evaluations fai led to reveal multiple sclerosis, infection, or neoplasm. Solitary inflammatory lesions add to the differential diagnosis of large, supratentorial, solitary spaceoccupying lesions noted on CT and MRI scans.