Vol. 4, Issue 12, Part C (2018)

Rings with Eccentric Dots showing scolex however was found in 73.3% case of our NCC cases. Dense Rings with Irregular Margin are found mostly due to malignant causes. Target sign (ring enhancement with central calcification) pathogomic of tuberculomata of brain was present in 2.5% of cases in our series,

We observed that infective pathologies (71.8%) were the most common etiology in patients with ring enhancing lesions of the CNS. Neoplastic etiology (26.9%) was the next common etiology causing ring enhancing lesions of the CNS. NCC and TB were the most common infections causing ring enhancing lesions of the CNS. Among Neoplastic causes, Primary Brain tumor (predominantly GBM) most common infections causing ring enhancing lesions of the CNS.

In our study Surrounding edema (84.61%), is the most common perilesional parenchymal changes followed by midline shift in 51.2%, Meningeal enhancement in 34.61% and Hydrocephalus in 26.9%. Mean ADC Value from the cavity and wall of the lesions can easily distinguish from neoplastic and non-neoplastic ring lesions. Proton MR spectroscopy is useful for the differentiation of neoplastic and non-neoplastic brain lesions. Among infective etiologies 86.49% shows clinical improvement and 83.79% radiologically. Among infective etiologies 13.51% shows non improvement clinically and 16.21% shows non improvement radiologically. Among NCC at 6-7 months follow up on treatment, 17/21(80.95%) cases showed both clinical and radiological improvement.2 cases required earlier MRI due to clinical worsening.2 cases showed radiological worsening at 6-7 months follow up on treatment despite of clinical improvement.

Among Tuberculomas at 6-7 months follow up on treatment, 13/16(81.25%) cases showed both clinical and radiological improvement.3 cases required earlier MRI due to clinical worsening. 3 cases showed non resolution at 6-7 months follow up on treatment despite of clinical improvement. Overall among NCC and Tuberculomas at 6-7 months follow up on treatment 30/37 showed both clinical and radiological concordant improvement. There was a concordance between clinical worsening and lesion persistence in 2/37 caeses both of were in the Tuberculoma category. At 6-7 months follow up 5/37 fell in to the group of non-concodance between clinical and imaging data, the patients being improved clinically but imaging showing persistence of lesions.