Role of Magnetic Resonance Imaging in Evaluation of Ring Enhancing Lesions of Brain

Abstract

ABSTRACT

Background

Ring-enhancing lesions (RELs) in the brain represent a diagnostic challenge due to their diverse etiologies,

ranging from infections to neoplastic conditions. MRI offers superior imaging features to distinguish among

these conditions.

Purpose

To evaluate the spectrum of ring-enhancing brain lesions and assess the role of MRI in differentiating these

pathologies.

Methods

A retrospective study of 160 patients with RELs on contrast MRI was conducted from May 2022 to July 2025. MRI

findings were analyzed with respect to lesion morphology, signal characteristics, and diffusion restriction.

Results

Infective lesions such as tuberculoma (40%) and neurocysticercosis (33%) were most common, followed by

abscesses (10%), metastases (13%), and primary tumors (4%). Diffusion restriction was a key differentiator, with

all abscesses showing restricted diffusion.

Conclusion

MRI, with its multiparametric capabilities, plays a pivotal role in the non-invasive differentiation of RELs and aids

in formulating appropriate management strategies. Advances in MRI techniques—such as diffusion tensor

imaging, perfusion imaging, MR spectroscopy, and functional MRI—hold promise for improving diagnostic

accuracy and reducing the need for invasive procedures. Incorporating artificial intelligence and radiomics may

further enhance lesion characterization and enable more precise, non-invasive differentiation of pathologies in

the future.