Aim and objective: To study the role of MR spectroscopy in the evaluation and differential diagnosis of various ring enhancing lesions in the brain with multi–voxel proton MR spectroscopy.

Materials and methods: It is the prospective observational study carried out on 42 patients from June 2016 to Aug 2018 at Department of Radiodiagnosis at AVBRH, DMIMS, Sawangi, Wardha. Appropriate MRI sequences with spectroscopy and multiplanar imaging has been performed on patients with intracranial ring enhancing lesions.

Result and Conclusion: Total 42 patients were taken. Most common lesions seen were tuberculoma (38%) followed by brain metastasis (34%), neurocysticercosis (16%) and pyogenic brain abscess (12%). On MRS, Tuberculoma was differentiated from NCC by high Cho: Cr ratio > 1.1 and high lipid lactate peak. Special peaks like amino acids, acetate, aspartate and succinate were seen in pyogenic brain abcess while alanine and succinate were present in NCC. High choline peak and high Cho: Cr ratio were seen in brain metastases.