IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-6-12-13714 Original Research Paper ROLE OF DIFFUSION WEIGHTED MR IMAGING IN EVALUATION OF INTRACRANIAL RING ENHANCING LESIONS KURUBA RAMANJANEYULU Dr. JYOTSNA RANI YARLAGADDA Dr. December 2017 6 12 01 02 ABSTRACT

 Aims and objectives: 1.To study the imaging findings and establish a differential diagnosis of various ring enhancing lesions on MRI.2.To differentiate neoplastic and non–neoplastic ring enhancing lesions using Diffusion Weighted Imaging.3.To differentiate primary and secondary neoplastic lesions using Diffusion Weighted Imaging.4.To correlate imaging findings of ring enhancing lesions with histopathological findings wherever possible.Materials and methods: The study was done in Department of Radiology and Imageology, Nizam’s Institute of Medical Sciences, Hyderabad from May 2014 to May 2016. 40 cases referred to the radiology department for MRI brain with clinical diagnosis / suspicion of focal cerebral ring enhancing lesions, irrespective of age and sex, were studied during this period.  Both out–patients and in–patients were included in the study. Informed and written consent was taken from all the subjects participating in the study.The study was conducted using 1.5 Tesla MRI machine (Signa LX, GE).  Observations and results: In our study, 4 lesions showed diffusion restriction at the core (2 bacterial abscesses, 1 tuberculous abscess and 1 tuberculoma). All the other lesions (all but one tuberculomas, NCC granulomas, toxoplasma abscesses,primary glial neoplasms and metastasis) did not show diffusion restriction. We found significant difference in the ADC values at the core of tuberculomas and NCC granulomas (p<0.05). The mean ADC values at the core of the restricted bacterial abscesses was (67 +/– 3) x 10–5 mm2/s. The toxoplasma abscesses were evaluated with DWI showing absence of diffusion restriction and mean ADC values at the core as (139.33 +/– 3) x 10–5 mm2/s. There was significant difference noted in the ADC values at the core of the brain abscess and neoplastic lesions, neoplastic and non neoplastic lesions(p<0.05).There was also  significant difference in the ADC values in the peritumoral region of the primary and secondary neoplastic lesions(p<0.05). No significant difference was found in mean ADC values at the core of tuberculous and bacterial abscesses and between toxoplasma lesions and tuberculomas, primary and secondary neoplastic lesions.Conclusions: DWI has a complimentary role in differentiating the neoplastic and non neoplastic lesions and in differentiating the etiology among the ring enhancing lesions.