52-year-old inmunocompromised female:
* Presenting with right hemiparesis
What do you see?
Brain bacterial abscesses
DUAL T2 RIM SIGN; often also visible on SWI and FLAIR sequences.
Other tips
* Restricted diffusion
* Thin ring-like enhancement
* High amount of vasogenic edema.
Left and right frontal lobe (grey-white junction) expanding T2-bright lesions with well-defined T2 hypointense margin. Maybe there is an other little coponent on the anterior margin of the left lesion. There is surrounding vasogenic oedema and moderate mass-effect.
I need DWI to verify if the contenent or the margins present retricted diffusion. CE images could be useful to define eventual margin CE. Also spectroscopy could be useful to define the nature of the lesions.
The most consistent hypothesis is cerebral abscesses (bacterial or fungal).