 Good morning everyone. I am Pooja T from Atma Gandhi Medical College. I am here to present a paper on the topic role of MR spectroscopy in evaluation of ring enhancing lesions in brain. Introduction the most common abnormality seen in CT or MRA in young Indian patients presenting with epilepsy are small ring or disc enhancing lesions. The two most common differential diagnosis of this lesion in green nickel practice include neurocysteysercosis and tuberculoma. These lesions may present as solitary or multiple and are characterized by a contrast enhancing halo with a non-enancing center. This is still a challenge to differentiate neurocysteysercosis and tuberculoma on MRI brain. The purpose of this study was to examine intracranial ring enhancing mass lesions with advanced MRI techniques that is MR spectroscopy and to evaluate the contribution of these techniques to differential diagnosis. Another objective to assist the role of MR spectroscopy as an urgent to routine MRA in the evaluation of ring enhancing lesions, study type cross sectional observational study, keywords neurocysteysercosis and tuberculoma. This study is performed in the department of radiology in Mahatma Gandhi college and research institute. Phillips 1.5 Tesla machine was used for the study. 64 patients with intracranial ring enhancing lesions on post contrast MRI were included in the study. Once the routine sequences were over MR spectroscopy was done and analyzed for N-acetyl-aspartate, colon, creatin and lipid lactate peak. Additional peaks succinate acetate amino acid were also analyzed. Role of MR spectroscopy in confirmation or modification of the diagnosis or in narrowing of the differential diagnosis were studied. Results were correlated with clinical follow up findings obtained with the addition of advanced MR imaging techniques were correlated with the final diagnosis and its usefulness over conventional MRI was studied. This is an image of tuberculoma T2 and post contrast image showing ring enhancing lesions with surrounding perillational edema in the left cerebellar lobe and vermice. Largest lesion is noted in the left cerebellar lobe. MR spectroscopy in the same patient shows lipid lactate peak. This is another case of tuberculoma. Ring enhancing lesion is noted in the right frontal lobe. The lesion shows surrounding T2 bar flare hyperintensive signal in the right frontal lobe, suggestive of surrounding perillational edema. There was no evidence of blooming on FFE sequence. The lesion shows evidence of lipid lactate peak on MRS. This is the case of a neurocyste circumstances showing ring enhancing cystic lesion in the right occipital lobe, that is the parasurgical region. The MRS in this shows evidence of amino acid peak. Statistics, patient who had intracranial ring enhancing lesions were analyzed by MR spectroscopy. 64 patients were included in the study. These include 34 male and 30 female. Age range of the patients were between 10 to 80 years with mean age of 32.4 years. Distribution of various lesion. Neurocystic circuses were seen in 20 patients. Tuberculoma was seen in 27 patients. Tumor 16 patients. Hematomata lesion 1 patient. Neurocystic circuses showed evidence of elevated lactate, alleline and succinate levels. There was reduced levels of N-acetylaspidate and colon. Tuberculoma showed decreased colon N-acetylaspidate and colon creat ratios and 80% of them predominantly had lipid lactate peak. Tumor predominantly showed increased colon peak. High grade glioma also showed evidence of lipid lactate peaks. From our study, we found very specific marker for Tuberculoma, lipid lactate peak and for neurocystic circuses amino acid peak. The accuracy of diagnosis was a year with additional advanced MR imaging techniques to conventional MR than with conventional MR alone. Discussion. In day to day clinical practice, the diagnosis of intracranial ring enhancing lesions may not be always straightforward. The clinical history and neurological findings may sometimes be ambiguous. The differentiation of the lesion and narrowing of the differential diagnosis in the radiological report may be a tool to guide the patients for the management. In this contest, the addition of advanced MR imaging tool like MR spectroscopy to the routine conventional MRI may serve as a problem solving tool. The MR spectroscopy predominantly showed lipid lactate peak in Tuberculoma and increased amino acid peak in neurocystic circuses. With the use of advanced MR imaging technique, the accuracy of diagnosis significantly increased. Thus, the value of these advanced imaging tools as an urgent to routine conventional MRI was appreciated. Conclusion, MR spectroscopy serve as valuable and extremely useful, urgent to imaging tool in characterization and accurate diagnosis of intracranial ring enhancing lesions to differentiate between neurocystic circuses in Tuberculoma. These are my references. Thank you.