Ring-enhancing lesion: Difference between revisions
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==Background== | ==Background== | ||
*[[head CT|CT]] or [[brain MRI|MRI]] with lesions having an enhancing ring of contrast around a less dense center can indicate certain neurological infections, injuries, and indolent disorders | |||
*Immune status of patients is key in helping to narrow potential causative agents | |||
[[File:Ring enhancing lesion on CT.png|thumb]] | |||
[[File:Ring enhancing lesion on MRI.png|thumb]] | |||
==Clinical Features== | ==Clinical Features== | ||
*Clinical presentation can vary from asymptomatic to focal neurodeficits to coma | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Ring-enhancing lesion DDX}} | {{Ring-enhancing lesion DDX}} | ||
== | ==Evaluation== | ||
*Ring-enhancing lesion is a radiologic diagnosis | |||
*Workup must be directed towards presentation, comorbidities, and risk factors | |||
==Management== | ==Management== | ||
*Focused treatment plan based on etiology | |||
==Disposition== | ==Disposition== | ||
*Typically require admission for further work up | |||
==See Also== | ==See Also== | ||
*[[Toxoplasmosis]] | |||
*[[Multiple sclerosis]] | |||
==External Links== | ==External Links== | ||
*[http://radiopaedia.org/articles/toxoplasmosis-vs-lymphoma Radiopaedia.org - Toxoplasmosis versus Lymphoma] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Radiology]] | |||
[[Category:Neurology]] | |||
Latest revision as of 01:21, 2 October 2019
Background
- CT or MRI with lesions having an enhancing ring of contrast around a less dense center can indicate certain neurological infections, injuries, and indolent disorders
- Immune status of patients is key in helping to narrow potential causative agents
Clinical Features
- Clinical presentation can vary from asymptomatic to focal neurodeficits to coma
Differential Diagnosis
Ring-Enhancing Lesion
Common Mnemonic: DR MAGIC
- Demyelination
- Radionecrosis/hematoma
- Metastasis
- Abscess (consider bacterial, fungal, parasitic)
- Glioma (and other primary neoplasms such as lymphoma)
- Infarction
- Contusion
HIV and ring-enhancing lesion(s)
- Toxoplasmosis v. lymphoma (see comparison of characteristics at Radiopaedia.org.)
Neoplasm
- Primary brain tumor
- Primary CNS lymphoma
- Metastatic disease
Infectious
- Pyogenic brain abscess
- Tuberculoma
- Toxoplasmosis
- Syphilis
- Neurocysticercosis
- Nocardiosis
- Cryptococcosis
- Aspergillosis
Neurologic
- Multiple Sclerosis
- Sarcoidosis
- Vasculitis
- Aneurysm
- Resolving hematoma
- Cerebral infarct
- Post-op changes
Evaluation
- Ring-enhancing lesion is a radiologic diagnosis
- Workup must be directed towards presentation, comorbidities, and risk factors
Management
- Focused treatment plan based on etiology
Disposition
- Typically require admission for further work up