A ring-enhancing lesion is an abnormal
radiologic sign
A radiologic sign is an objective indication of some medical fact (that is, a medical sign) that is detected by a physician during radiologic examination with medical imaging (for example, via an X-ray, CT scan, MRI scan, or sonographic scan). ...
on
MRI
Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...
or
CT scans obtained using
radiocontrast
Radiocontrast agents are substances used to enhance the visibility of internal structures in X-ray-based imaging techniques such as computed tomography ( contrast CT), projectional radiography, and fluoroscopy. Radiocontrast agents are typically i ...
. On the image, there is an area of decreased density (see
radiodensity
Radiodensity (or radiopacity) is opacity to the radio wave and X-ray portion of the electromagnetic spectrum: that is, the relative inability of those kinds of electromagnetic radiation to pass through a particular material. Radiolucency or hypod ...
) surrounded by a bright rim from concentration of the enhancing contrast dye. This enhancement may represent breakdown of the blood-brain barrier and the development of an inflammatory capsule. This can be a finding in numerous disease states. In the brain, it can occur with an early
brain abscess
Brain abscess (or cerebral abscess) is an abscess caused by inflammation and collection of infected material, coming from local (ear infection, dental abscess, infection of paranasal sinuses, infection of the mastoid air cells of the temporal bone ...
as well as in ''
Nocardia'' infections associated with lung cavitary lesions. In patients with HIV, the major differential is between
CNS lymphoma and CNS
toxoplasmosis
Toxoplasmosis is a parasitic disease caused by '' Toxoplasma gondii'', an apicomplexan. Infections with toxoplasmosis are associated with a variety of neuropsychiatric and behavioral conditions. Occasionally, people may have a few weeks or mont ...
, with CT imaging being the appropriate next step to differentiate between the two conditions.
[Fauci A. Harrison's Principles of Internal Medicine, New York, McGraw Hill Medical, 2008]
References
External links
Ring Enhancement: The Free Medical Dictionary
Neuroimaging
Radiologic signs
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