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Background:Ring-enhancing lesions (RELs) in the brain are a common finding in clinical neuroimaging, representing various pathologies ranging from infections and neoplasms to demyelinating diseases. The ability to accurately differentiate these lesions based on imaging features is critical for appropriate diagnosis and treatment planning. Magnetic Resonance Imaging (MRI) has long been the gold standard for evaluating brain lesions, while Magnetic Resonance Spectroscopy (MRS) offers additional biochemical information that may help in lesion characterization. Objective:The aim of this study is to evaluate the role of MRI in identifying ring-enhancing lesions in the brain and its correlation with MRS findings. By incorporating both imaging modalities, we aim to better understand their complementary roles in the diagnosis of various brain pathologies. Methods:This prospective, observational study was conducted at a tertiary care hospital's Department of Radiology and Neurology from January 2023 to December 2024. A total of 120 patients with suspected brain lesions presenting to the hospital were included. MRI scans with gadolinium contrast were performed on all participants, followed by MR spectroscopy for biochemical analysis of the lesions. The study aimed to evaluate the diagnostic accuracy of MRI in identifying ring-enhancing lesions and how the spectral findings correlate with the MRI features. Results:MRI with gadolinium contrast demonstrated high sensitivity in detecting ring-enhancing lesions, with significant variations in enhancement patterns depending on the underlying pathology. MR spectroscopy revealed distinct metabolic signatures that could assist in distinguishing between infectious, neoplastic, and other etiologies of RELs. Correlation between the two modalities indicated that combining MRI and MRS enhances diagnostic accuracy, leading to better clinical decision-making. Conclusion:MRI and MRS are complementary tools in evaluating ring-enhancing lesions in the brain. This study highlights the added value of MR spectroscopy in conjunction with MRI, especially in distinguishing between different pathologies associated with RELs, ultimately aiding in more accurate diagnosis and improved managemen