The open-ring sign is often present in large, contrast-enhancing demyelinating lesions and helps to differentiate them from neoplasms and infections.

Occasionally, demyelinating disease of the brain presents with ring-enhancing lesions, many times the diagnosis is not clear and demyelination has been mistaken for neoplasm or infection.We reviewed the literature to test the specificity fo r demyelinating disease of an open-ring or crescent pattern of contrast enhancement present only in the white matter. The open-ring sign was more common in demyelinating lesions than in infections or tumors and is helpful for differential diagnosis. The open-ring sign was more frequent in demyelinating lesions than in infections or tumors.The open-ring sign is often present in large, contrast-enhancing, demyelinating lesions of the brain and helps to differentiate them from tumors and, particularly, f rom infections.

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