Patterns of Contrast Enhancement in Brain CT/MRI

7 Patterns of Contrast Enhancement seen in CT / MRI of the Brain:

  • Dural-based enhancement (meningioma)
  • Dura-arachnoid enhancement / pachymeningeal enhancement.
  • Pia-arachnoid or subarachnoid enhancement (bacterial meningitis or carcinomatous meningitis)
  • Gyral gray matter enhancement
  • Ring lesions – A. smooth ring (abscess)  B.  irregular ring, shaggy inner margin (necrosis, high-grade neoplasm)
  • Fluid-secreting neoplasms and demyelination
    • cerebellar “cyst with nodule” (pilocytic astrocytoma)
    • classic “open-ring” sign (tumefactive demyelinating lesions)
    • fluid secreting “cyst with nodule”
  • Periventricular enhancement
    • thin linear rim of enhancement – ependymitis (CMV infection)
    • mass / thick irregular rind surrounding ventricle (periventricular lymphoma, primary B cell lymphoma)

 

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  1.  Dura-arachnoid enhancement / pachymeningeal enhancement.

2. Dural-based enhancement   (typical for meningioma)

3. pia-arachnoid or subarachnoid enhancement (bacterial meningitis or carcinomatous meningitis)
4.  gyral gray matter enhancement
5.  ring lesions – A. smooth ring (abscess)  B.  irregular ring, shaggy inner margin (necrosis, high-grade neoplasm)
6.  Fluid-secreting neoplasms and demyelination
a. cerebellar “cyst with nodule” (pilocytic astrocytoma)
b. classic “open-ring” sign (tumefactive demyelinating lesions)
c.  fluid secreting “cyst with nodule”
7.  periventricular enhancement
a.  thin linear rim of enhancement – ependymitis (CMV infection)
b.  mass / thick irregular rind surrounding ventricle (periventricular lymphoma, primary B cell lymphoma)

 

 

<click here to access powerpoint file>

Reference:

Naidich, Thomas P et al. Imaging Of The Brain. Ch 5 Patterns of Contrast Enhancement.  1st ed. Print. pp. 79-95.

 

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