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. 2022 Jul 22;10:2050313X221113261. doi: 10.1177/2050313X221113261

Table 2.

Most common differential diagnosis along with their characteristic features as an exclusion criteria.

Characteristic features
T1 T2/T2 FLAIR (Fluid attenuated inversion recovery) DWI Post contrast
Epidermoid cyst Isointense to CSF Heterogeneous signal from isointense to intensity higher than CSF Restriction on DWI: hyperintense, similar ADC (Apparent diffusion coefficient) values compared to adjacent brain parenchyma Peripheral enhancement
Lymphangioma Isointense to brain parenchyma Hyper intense with occasional multiple fluid: fluid levels and internal septations Focal areas of restricted diffusion Marginal and septal enhancement and a variable solid component enhancement
Meningioma Isointense to hypointense compared to the optic nerve Mildly hyperintense compared to the optic nerve Restriction and ADC value vary according to the histological form Homogeneous enhancement
Glioma Hypointense heterogeneous with cystic and solid components. hyperintense centrally with a thin low-signal at the periphery representing the dura. Variable intensity and ADC values Variable enhancement
Tuberculoma Isointense to grey matter ± central hyperintensity representing caseation. Isointense to grey matter ± a central hypointensity representing gliosis and abundant monocytes infiltration, surrounded by hyperintense T2/T2 FLAIR vasogenic edema. Central low signal but if liquid necrosis is present centrally, may be high signal. Usually appears as ring-enhancement.
Hematoma Intermediate signal at hyperacute period. Hyperintense at hyperacute period. Hypointense at chronic period. Might be bright at hyperacute period. Peripheral enhancement around the non-enhancing clot may be visible.
Orbital varix Hypointense Hypointense None Matches other veinous structures.

DWI: diffusion-weighted imaging; CSF: cerebro-spinal fluid.