Value of MRI in Brain Ring enhancing lesions

K. Hussein, Hayder; Shukri, Mahmmood; Raekan, Bassem

	Value of MRI in Brain Ring enhancing lesions
kufa Journal for Nursing sciences
Article 1, Volume 3, Issue 2, 2013, Pages 47-56
Authors
Hayder K. Hussein; Mahmmood Shukri; Bassem Raekan
Abstract
The aim of this study : to evaluate the role of contrast enhanced MRI to distinguish the ring enhancing brain lesions with histological findings and clinical diagnosis as reference standard Patients and methods : This prospective study was done from may 2011 to may 2012. 20 patients with various ring enhancing lesions in the brain detected by MRI with different clinical conditions , fifteen males and 5 females between 13-63years age MR imaging was performed with MRI of (Philips - achiva 1.5 Tesla 16 channels). Routine sequences of T1, T2 and FLAIR spin echo sequences with IV contrast , gadolinium were carried out .Statical analysis include sensitivity , specificity and accuracy accounting in this study Results : Contrast enhanced MRI revealed 4 cases of non neoplastic and 13 cases as neoplastic brain ring lesions compared with histopathology which revealed 5 cases of non neoplastic and 15 cases of neoplastic brain ring enhancing lesions. Sensitivity of MRI for non neoplastic lesions was 80% and specificity is 86.6% .Sensitivity of MRI for neoplastic lesions was 86.6% and specificity was 80% .Accuracy of MRI in differentiation of ring enhancing brain lesion either neoplastic or non neoplastic was 85%. MRI of neoplastic ring lesions revealed 4 cases as metastasis and 9 cases as primary tumor of high grade astrocytoma(globlastoma multiforme ) while histopathology reveal 5 cases metastasis and 10 cases glioblastoma multiforme .Sensitivity of MRI for metastatic ring lesion was 80% and specificity was 81.8% .Sensitivity of MRI for primary neoplastic tumor is 81.8% and specificity was 66.6% . MRI for non neoplastic ring lesions included 3 cases as abscess , on case resolving hematoma while histopathology revealed 5 cases of non neoplastic ring lesions , 3 cases pyogenic abscess , one case resolving hematoma and one case radiation necrosis Conclusion and recommendation : The accuracy of differentiation of the neoplastic from non neoplastic ring enhancing lesions by MRI is 85%. In doubtful cases diagnosis improved by use of further sequences like diffusion – perfusion studies and nuclear studies .
Keywords
neoplastic; non neoplastic; ring enhancing brain lesion; magnetic resonance imaging

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