Answers :
Describe the findings seen on the
non contrast scan ?
Low attenuation (density) is seen in the right cerebral hemisphere predominantly involving the white matter and giving rise to the appearance of 'digitations'. This is vasogenic oedema (not to be confused with cytotoxic oedema).
There is the suspicion of a mass in the centre of the oedema.
There is mass effect (the occipital horn of the right lateral ventricle can not be seen and is compressed).
What type of contrast has been given and how is it administered ?
Typically 50mls of an iodinated contrast is given intravenously.
Describe the findings on the post contrast scan?
There is 'ring enhancement' of a lesion in the right cerebral hemisphere i.e. the edge of the lesion has enhanced with intravenous contrast. The presence of enhancement reflects breakdown of the blood-brain barrier.
What is the differential diagnosis ?
There are a number of pathologies that can give rise to a ring enhancing mass. These include :
Primary brain tumour
Metastasis
Abscess
plus others
This lesion is a glioblastoma.
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