Naslov
Differentiation of pyogenic and fungal brain abscesses with susceptibility-weighted MR sequences

Autori
Antulov, Ronald ; Dolić, Krešimir ; Fruehwald-Pallamar, J. ; Miletić, Damir ; Thurnher, Majda M.

Izvornik
Neuroradiology (0028-3940) 56 (2014), 11; 937-945

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
susceptibility-weighted MR sequences; susceptibility-weighted imaging; fungal brain abscesses; pyogenic brain abscesses; double rim sign

Sažetak
INTRODUCTION:Conventional magnetic resonance imaging (MRI) techniques are insufficient to determine the causative agent of brain abscesses. We investigated: (1) the value of susceptibility- weighted MR sequences (SWMRS) in the differentiation of fungal and pyogenic brain abscesses ; and (2) the effect of different SWMRS (susceptibility-weighted imaging (SWI) versus venous blood oxygen level dependent (VenoBOLD)) for the detection of specific imaging characteristics of pyogenic brain abscesses. METHODS: We studied six patients with fungal and ten patients with pyogenic brain abscesses. Imaging characteristics on conventional MRI, diffusion- weighted imaging (DWI) and SWMRS were recorded in all abscesses. All lesions were assessed for the presence of a "dual-rim sign" on SWMRS. RESULTS: Homogenously hyperintense lesions on DWI were present in 60 % of patients with pyogenic abscesses, whereas none of the patients with fungal abscesses showed such lesions. On SWMRS, 90 % of patients with pyogenic abscesses and 60 % of patients with fungal abscesses had only lesions with a low-signal-intensity rim. On SWI, the dual- rim sign was apparent in all pyogenic abscesses. None of the fungal abscesses on SWI (P = 0.005) or any of the pyogenic abscesses on VenoBOLD (P =  0.005) were positive for a dual-rim sign. CONCLUSIONS: In fungal abscesses, the dual-rim sign is not present but a prominent peripheral rim or central susceptibility effects on SWI will be seen. The appearance of pyogenic abscesses on SWMRS depends on the used sequence, with the dual-rim sign a specific feature of pyogenic brain abscesses on SWI.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA