Computed Tomography Characteristics of Intracranial Ring-enhancing Lesions

Introduction: Ring-enhancing computed tomography (CT) lesions are those which consist of focal area of hypodensity on plain CT scan on which contrast administration shows ring-like enhancement. CT scan has largely replaced previous radiological procedures such as plain roentgenograms, pneumoencephalogram, cerebral angiography, and myelography. Purpose: The purpose of the study was to determine the various CT morphological characteristics of ring-enhancing lesions in various intracranial pathological entities. Materials and Methods: This is a cross-sectional study conducted in the department of radiology in a tertiary care center in Mangalore, Karnataka, from July 2015 to November 2016. A total of 30 patients were included in this study whose CT scan showed ring-enhancing lesion or lesions after contrast administration and with a final diagnosis following surgery or complete cure. The morphological features of the lesions observed were tabulated and analyzed using SPSS software version 16. Various morphological features are expressed as percentages. Conclusions: CT morphology characteristics of ring lesion are strongly suggestive of the diagnosis such as tuberculoma, brain abscess, glioma, metastases, and nerocysticercosis; however, they have to be corroborated by clinical history, laboratory investigation, and histopathological examination to arrive at a definite diagnosis.

A study of clinical profile and etiology ring enhancing lesion in CT scan brain at a tertiary care center

Background: Confusion lies over the diagnosis when the patients show ring enhancing lesions of the brain on CT scan. Some consider it as tuberculoma while some consider it as cysticercosis. More studies are required to give clear picture of ring enhancing lesions of the brain. The objective was to study clinical profile and etiology ring enhancing lesion in CT scan brain at a tertiary care center.Methods: This study was conducted in the Department of General Medicine, SVS Medical College, Mahabubnagar district which is a tertiary care referral hospital in the state of Telangana. This study was done during the period from July 2006 to October 2008. A total of 50 cases were taken up for this study. After selecting the patients for the study, already prepared protocol was followed strictly for each patient. The protocol contained identification data, detailed history and examination of central nervous system and peripheral signs for tuberculosis and cysticercosis.Results: The males were more than the females and 14-24 years age group was most affected. The most common presentation of ring enhancing lesions was seizures alone in 72% of the cases. Out of these cases the most common presentation was generalized tonic-clonic seizure in 40% of the cases. Majority i.e. 45 had single ring enhancing lesion on CT scan of the brain. The most common etiology of the ring enhancing lesion was found out to be neurocysticercosis in 54% of the cases of ring enhancing lesions.Conclusions: Ring enhancing lesions should be considered in differential diagnosis of those who present with seizures in endemic areas like India.

Acquired Toxoplasmosis Presenting with a Brainstem Granuloma in an Immunocompetent Adolescent.

Background: Toxoplasmosis is an uncommon disease in immunocompetent people. Case characteristics: We report an adolescent boy with central nervous system toxoplasmosis who presented with progressive lower cranial nerve palsies and a ring-enhancing lesion on neuroimaging. Intervention: Diagnosis of toxoplasmosis was confirmed on histopathology of the excised lesion. Message: Toxoplasmosis should be considered in the differential diagnosis of focal brain lesions irrespective of immune status.