Role of Diffusion–Weight MRI in Differential Diagnosis of Cerebral Cystic Lesions: A Prospective Study

Abstract

This study aimed to determine whether diffusion–weight MRI images and ADC (Apparent Diffusion Coefficient) could help accurately in distinguishing cystic cerebral lesions. The study included 65 patients with clinically suspected cerebral masses. They underwent surgery and diagnosed histologically. A conventional MRI was carried out on a 1.5T system using T1, T2 and fat-suppressed T1-weighted sequences before and after intravenous injection of gadolinium and echo-planar spin-echo sequence diffusion weight and ADC is carried for all patients. All MR imaging features were categorized cerebral cystic lesions without knowledge of clinical details, according to the imaging features which were compared with the surgical and pathological findings. The diagnosis was confirmed with surgery and histological evaluation which included 30(48%) patients with primary cystic brain tumors, 19 (35%) with metastatic tumors and 11 (17%) with abscess. All abscess cavities showed hyper intense DWI signal intensity and low signal ADC so the sensitivity for diagnosis abscess in DWI are 100%, while in primary brain tumor only 1 from 10 cystic glioma show hyper intense on DWI and hypo intense on ADC while the remain cystic glioma 9 show hypo intense on DWI and hyper intense on ADC make the sensitivity of DWI foe diagnosis primary malignant cystic tumor 90%. The study concluded that diffusion –weight MRI and ADC is sensitive for characterizing cystic cerebral lesions.