Role of MRI in Evaluation of Cystic Lesions of Brain: A Prospective Observational Study

Abstract

Introduction: Cystic brain lesions represent a heterogeneous group of pathologies requiring accurate diagnosis for appropriate management. MRI provides superior contrast resolution and multiplanar capability for characterizing these lesions.

Aim: To differentiate various cystic brain lesions according to their pathological classification and to determine their exact location, size, extension, and multiplicity using MRI.

Materials and Methods: This prospective observational study was conducted at the Department of Radiodiagnosis, Dhiraj General Hospital, Vadodara, Gujarat, India from October 2022 to April 2024. A total of 109 patients with neurological symptoms who were found to have cystic brain lesions on MRI were included. MRI was performed using PHILIPS 1.5 Tesla machine with standard brain protocols including T1WI, T2WI, FLAIR, and post-contrast sequences. Data was analyzed using descriptive statistics.

Results: The mean age was 35.4±17.2 years with male predominance (60.55%). The most common presenting symptoms were headache and altered sensorium (42.20% each). Tumors were the most common etiology (32.7%), with glioblastoma multiforme being the most frequent (14.68%). Single lesions were observed in 73.39% of cases. Supratentorial location was predominant (77.06%). Ring enhancement was the most common pattern (65.06%), particularly in tuberculomas (24.07%) and neurocysticercosis (22.22%).

Conclusion: MRI effectively characterizes intracranial cystic lesions by providing crucial information about anatomic location, size, morphology, and enhancement patterns. Following a systematic algorithmic approach based on location, signal intensity, and enhancement characteristics facilitates accurate diagnosis and appropriate management planning.