IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-9-2-24194 Original Research Paper THE ROLE OF DIFFUSION–WEIGHTED MAGNETIC RESONANCE IMAGING IN DIFFERENTIAL DIAGNOSIS OF INTRACRANIAL–CYSTIC LESIONS Akriti Gupta Dr. Dr. N.C. Sharma Dr. February 2020 9 2 01 02 ABSTRACT

Introduction: Currently there is widespread use of MRI to determine the tumour extent for surgical and radiotherapy planning, as well as for post–therapy monitoring of tumour recurrence or progression. However, biopsy is still generally considered the gold standard for determining the cancer type and degree of malignancy. Objective: To compare the features of intracranial cystic lesions on various MRI sequences (T1 WI, T2 WI, FLAIR, DWI, ADC map, T2*GRE, etc.). Materials And Methods: The MRI was done on SEIMENS – Magnatom AVANTO 1.5 Tesla. The head coil was used for the scan. After intravenous administration of 10 ml of Gadolinium contrast, 5 mm T1W axial, sagittal, coronal images as well as 5 mm T1WI were obtained as and when required. Additionally, 0.9 mm thin post gadolinium 3D T1 weighted SPGR (spoiled gradient recoil). Results: DWI in MRI is capable of differentiating brain abscess from primary intracranial malignancy, High grade (IV) glioma and intracranial metastasis with accuracy of 87.1%, 90% and 89.4% respectively. Conclusion: Contrast enhance MRI is an integral part in the initial evaluation of intracranial lesions. However, in some instances, contrast enhanced MRI alone without the use of DWI is not effective for the differentiation of intracranial cystic lesion type or for detection of tumour grade. DWI can increase both the sensitivity and specificity of MRI in the evaluation of these intracranial cystic lesions by providing information about cellularity and restricted movement of water molecules in the tissue, which may in turn improve the prediction of etiology of the lesion.