The differential diagnosis of supratentorial enhancing lesions on computed tomography

One hundred and fifty-one surgical, autopsy or clinically confirmed supratentorial lesions evaluated by Computed Tomography at Mount Sinai Medical Center were reviewed to determine if their etiology could be predicted by their pattern of enhancement after the intravenous bolus injection of an iodine containing contrast agent. Meningiomas, gliomas, metastases, primary lymphomas, cerebral infarcts, intracerebral hematomas, arteriovenous malformations, aneurysms and abscesses were evaluated. The different patterns of enhancement were defined as homogeneous, ring-like, vermiform and mixed. The differential diagnosis of each pattern of enhancement is presented. In addition, the different etiologies are also discussed as to the relative distribution of their patterns of enhancement, i.e.: homogeneous, ring, vermiform or mixed.