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Open-Ring Imaging Sign Neurol 54:1427-1433, Masdeu,J.C.,et al, 2000 See this aricle in Pubmed Article Abstract The open-ring sign clearly distinguished demyelinating lesions from neoplasms and infections. For demyelination versus neoplasm or infection, the specificity of the reading by the first neuroradiologist was 93.8 (95% CI, 86 to 98), and that of the second was 84.4 (95% CI, 74 to 92). The likelihood ratio of demyelination versus neoplasm averaged 5.2, and versus infection, 17.2. That is, if the lesions had the same incidence in the population, in the presence of an open-ring sign demyelination would be five times more likely than neoplasm and 17 times more likely than infection. However, given the much higher incidence of neoplasms and infections, these lesions are still frequently responsible for open-ring enhancement. The open-ring sign is often present in large, contras-enhancing demyelinating lesions and helps to differentiate them from neoplasms and infections.

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