Vol. 6, Issue 2, Part A (2024)

Background: Ring-enhancing lesions are one of the most commonly encountered neuroimaging abnormalities. Some consider it as tuberculoma while some consider it as cysticercosis. More studies are required to give clear picture of ring enhancing lesions of the brain. The objective was to study clinical profile and etiology ring enhancing lesion in CT scan brain.
Methods: This was a prospective observational study, a total of 56 consecutive cases were selected who were admitted in the Neurosurgery Department of BSMMU with the clinical history of ring enhancing lesions of brain supported by CT scan during the period from January 2012 to December 2013. The CT findings were correlated with pathological findings.
Results: The mean age of the patients of study group were 40.8±10.4 years ranging from 16 to 64 years. It was found that among the ring enhancing lesions of brain patients, highest percentage were in the range of 31-40 years (35.7%). Out of 56 patients of present study group 35 were male and 21 were female. Here male and female ratio was found 1.7:1. Clinical features of different etiologies of the present study, in Glioma, headache was the most common presentation (80.9%), followed by neurological deficit (71.4%), vomiting (71.1%), convulsion (61.9%) and vertigo (47.6%). Analysis of number of lesions out of 21 diagnosed Glioma patients, 20 (95.2%) were single number of lesion and the rest 1 (4.8%) was multiple number of lesion. Finally, out of 14 diagnosed as abscess patients, 11 (78.6%) and 3 (21.4%) patients were in multiple and single number of lesion. Analysis of etiological diagnosis of ring-enhancing lesions of brain glioma found 37.5% cases, metastasis 19.6% cases, tuberculoma 17.9% cases and abscess25% cases. In the present study, CT evaluation of Ring-enhancing lesions of brain (Glioma) and its correlation with histopathological diagnosis, the overall accuracy of CT as a diagnostic modality is 96.4%, sensitivity 100% and specificity 94.6%. Analysis of metastasis patients CT evaluation of Ring-enhancing lesions of brain and its correlation with histopathological diagnosis, the overall accuracy of CT as a diagnostic modality is 98.2%, sensitivity 100% and specificity 97.8%. In tuberculoma, CT evaluation of Ring-enhancing lesions of brain and its correlation with histopathological diagnosis, the overall accuracy of CT as a diagnostic modality is 96.4%, sensitivity 100% and specificity 97.8%. In abscess, CT evaluation of Ring-enhancing lesions of brain and its correlation with histopathological diagnosis, the overall accuracy of CT as a diagnostic modality is 98.2%, sensitivity 100% and specificity 97.7%. 
Conclusions: CT findings of the present study correlated well in most of the cases with the pathological results. It can therefore be concluded that CT scan is accurate and sensitive modality in the evaluation of ring enhancing lesions of brain.