ROLE OF ADVANCED MAGNETIC RESONANCE IMAGING TECHNIQUES IN DISTINCTION BETWEEN CEREBRAL ABSCESSES AND HIGH-GRADE NEOPLASMS.

Abstract

• Distinguishing between cerebral abscess and rim-enhancing tumor is a problem that is encountered frequently by radiologists. Conventional contrast-enhanced MRI reveals ring enhancement of a brain abscess that is similar to the ring enhancement of a necrotic high-grade glioma or metastasis.• Advanced MRI techniques (DWI, MRS and DSC MR perfusion) may be used to differentiate between cerebral abscesses and high grade brain neoplasms.• DWI is an advanced MRI technique that provides the physiological nature of the disease based on motion of water molecules across cell membrane.• DWI allows assessment of the cellularity of the lesion non-invasively, as cellular and subcellular elements significantly impede the mobility of water molecules, thus densely cellular lesions show restricted diffusion and hence low ADC values. • Magnetic Resonance spectroscopy (MRS) is a non-invasive diagnostic test for measuring biochemical changes in the brain, it MRS is capable of differentiating normal from pathologic brain.• Dynamic susceptibility contrast (DSC) perfusion MRI is a technique that allows derivation of relative cerebral blood volume (rCBV) maps on the basis of the susceptibility effect related to passage of MRI contrast material through tissue.• It provides noninvasive physiologic measurements of tumor vascularity and relative cerebral blood volume (rCBV) maps, which can be used to identify and quantify areas of neovascularization.• We try to evaluate the role of advanced MRI techniques (DWI, MRS, DSC PERFUSION) to reach a final diagnosis in a case of brain abscess versus a cystic or necrotic tumor.