Brain Abscess MRI

A 50 yo male with headache and recent onset left sided weakness. 

This MRI study of Brain shows:
A right parietal space occupying lesion.
Lesion has a thick walls, peripheral enhancement along its wall of uniform thickness, central non enhancing necrotic core showing restricted diffusion on Dw images.
Marked T2 hyper intense perilesional vasogenic odema and mass effect.

Imaging wise DDs given were Abscess and Glioma.
Steriotactic biospy of lesion performed.
Histopathological diagnosis : Abscess.

Organised Brain Abscess

Chronic Abscess with well organised wall fails show enhancement on post contrast study. 

A known case right frontal lobe abscess, steriotectic biospy and histopathology proven pyogenic abscess.

Serial CT studies of brain at approximately 6months interval shows no significant change in size of lesion. The lesion is round has uniform thickness hyper dense wall with no enhancement on post contrast study, an adjacent perilesional Gliosis.

The typical appearance of abscess is a hypodense necrotic center with a peripheral uniform enhancement along its wall. Rarely in chronic cases a well organized abscess wall fail to generate such ring enhancement as in this case.