Diffusion-weighted MR imaging of abdominopelvic abscesses

被引:41
作者
Oto A. [1 ]
Schmid-Tannwald C. [1 ,2 ]
Agrawal G. [1 ]
Kayhan A. [1 ]
Lakadamyali H. [1 ]
Orrin S. [1 ]
Sethi I. [1 ]
Sammet S. [1 ]
Fan X. [1 ]
机构
[1] Department of Radiology, University of Chicago, MC 2026, Chicago, IL 60637
[2] Department of Clinical Radiology, Ludwig-Maximilian-University Hospitals-Grosshadern, Munich 801377
关键词
Abdominopelvic abscesses; Diffusion-weighted imaging; Magnetic resonance imaging;
D O I
10.1007/s10140-011-0976-1
中图分类号
学科分类号
摘要
This study was conducted to determine the incremental value of diffusion-weighted MR imaging (DW-MRI) over T2-weighted imaging diagnosing abdominopelvic abscesses and compare apparent diffusion coefficient (ADC) values of abscesses and non-infected ascites. In this IRB-approved, HIPAA-compliant study, two radiologists retrospectively compared T2-weighted, T2-weighted+DW-MRI and T2-weighted+contrast enhanced MR images of 58 patients (29 with abscess, 29 with ascites) who underwent abdominal MRI for abscess detection. Confidence and sensitivity was compared using McNemar's test. ADC of abscesses and ascites was compared by t test, and a receiver operating characteristic (ROC) curve was constructed. Detection of abscesses and confidence improved significantly when T2-weighted images were combined with DW-MRI (sensitivity: observer 1-100%, observer 2-96.6%) or contrast enhanced images (sensitivity: both observers-100%) compared to T2-weighted images alone (sensitivity: observer 1-65.5%, observer 2-72.4%). All abscesses showed restricted diffusion. Mean ADC of abscesses (observer 1-1.17±0.42×10 -3mm2/s, observer 2-1.43±0.48×10 -3 mm2/s) was lower than ascites (observer 1-3.57±0.68×10 -3 mm2/s, observer 2-3.42±0. 67×10 -3 mm2/s) (p<0.01). ROC analysis showed perfect discrimination of abscess from ascites with threshold ADC of 2.0×10 -3 mm2/s (Az value 1.0). DW-MRI is a valuable adjunct to T2-weighted images diagnosing abdominopelvic abscesses. ADC measurements may have the potential to differentiate abdominal abscesses from ascites. © 2011 Am Soc Emergency Radiol.
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页码:515 / 524
页数:9
相关论文
共 22 条
[1]  
Guzman R., Barth A., Lovblad K.-O., El-Koussy M., Weis J., Schroth G., Seiler R.W., Use of diffusion-weighted magnetic resonance imaging in differentiating purulent brain processes from cystic brain tumors, Journal of Neurosurgery, 97, 5, pp. 1101-1107, (2002)
[2]  
Reddy J.S., Mishra A.M., Behari S., Husain M., Gupta V., Rastogi M., Gupta R.K., The role of diffusion-weighted imaging in the differential diagnosis of intracranial cystic mass lesions: A report of 147 lesions, Surgical Neurology, 66, 3, pp. 246-250, (2006)
[3]  
Leuthardt E.C., Wippold II F.J., Oswood M.C., Rich K.M., Diffusion-weighted MR imaging in the preoperative assessment of brain abscesses, Surgical Neurology, 58, 6, pp. 395-402, (2002)
[4]  
Wong A.M., Zimmerman R.A., Simon E.M., Pollock A.N., Bilaniuk L.T., Diffusion-weighted MR imaging of subdural empyemas in children, American Journal of Neuroradiology, 25, 6, pp. 1016-1021, (2004)
[5]  
Kiroglu Y., Calli C., Yunten N., Kitis O., Kocaman A., Karabulut N., Isaev H., Yagci B., Diffusion-weighted MR imaging of viral encephalitis, Neuroradiology, 48, 12, pp. 875-880, (2006)
[6]  
Han K.-T., Choi D.S., Ryoo J.W., Cho J.M., Jeon K.N., Bae K.-S., You J.J., Chung S.H., Koh E.H., Park K.-J., Diffusion-weighted MR imaging of pyogenic intraventricular empyema, Neuroradiology, 49, 10, pp. 813-818, (2007)
[7]  
Kim Y.J., Chang K.-H., Song I.C., Kim H.D., Seong S.O., Kim Y.H., Han M.H., Brain abscess and necrotic or cystic brain tumor: Discrimination with signal intensity on diffusion-weighted MR imaging, American Journal of Roentgenology, 171, 6, pp. 1487-1490, (1998)
[8]  
Spuntrup E., Bucker A., Adam G., Van Vaals J.J., Gunther R.W., Differenzierung seröser und putrider flüssigkeiten in vitro und in vivo mit diffusionsgewichteter MRT, RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren, 173, 1, pp. 65-71, (2001)
[9]  
Chan J.H.M., Tsui E.Y.K., Luk S.H., Fung A.S.L., Yuen M.K., Szeto M.L., Cheung Y.K., Wong K.P.C., Diffusion-weighted MR imaging of the liver: Distinguishing hepatic abscess from cystic or necrotic tumor, Abdominal Imaging, 26, 2, pp. 161-165, (2001)
[10]  
Chan J.H.M., Tsui E.Y.K., Luk S.H., Fung S.L., Cheung Y.K., Chan M.S.M., Yuen M.K., Mak S.F., Wong K.P.C., MR diffusion-weighted imaging of kidney: Differentiation between hydronephrosis and pyonephrosis, Clinical Imaging, 25, 2, pp. 110-113, (2001)