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Cerebral peripheral/ring enhancing lesions and how to differentiate
Infection: cerebral abscess , tuberculosis, neurocysticercosis
Malignancy: Mets, glioblastima, Leukaemia, lymphoma(in immunocompromised),
Vascular: subacute infarct/hemorrhage/contusion; thrombosed aneurysm,
Post -operative
Degenerative: demyelination, tumefactive demyelinating lesion
Necrosis: radiation necrosis, necrotising leukoencephalopathy after methotrexate
Rules of thumb:
a.Enhancing wall traits: thick+nodular (neo), thin+regular (abscess), incomplete ring open towards cortex(demyelination); intermediate to low T2 signal(abscess), restricted diffusion(GBM/demyelination)
b. Surrounding edema: extensive edema relative to lesion size (abscess), increased perfusion(neo)
c. Central fluid content: restricted diffusion(abscess), absence of diffusion restriction (tumor)
d. Number of lesions: similar sized at GW junction (meta/abscess), small<1-2am,thin wall (neurocyst), irregular mass with adjacent secondary lesions in the same region of edema (GBM)
Ddx of multiple hypoattenuating irregular liver lesions
Mets, abscesses(bacterial if many, amoebic if solitary, fungal usually due to biliary obstruction, diverticulitis, appendicitis )haemangiomas, simple liver cysts
(Differentiate based on clinical and HU)
Complications of pancreatitis
Pseudocysts, abscesses, necrosis, thrombosis of splenic /portal veins, pseudo aneurysms+/- haemorrhage
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