Brain abscess and necrotic or cystic brain tumor: discrimination with signal intensity on diffusion-weighted MR imaging.

Kim, Young Jun; Chang, Kee Hyun; Song, In Chan; Kim, Hong Dae; Seong, Su Ok; Kim, Young Hoon; Han, Moon Hee

doi:10.2214/ajr.171.6.9843275

Cited by 252 publications

(132 citation statements)

References 6 publications

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“…Diffusion-weighted imaging (DWI) is widely used in the detection and characterization of a large number of brain pathologies, such as stroke, abscess, encephalitis, and tumors involving the central nervous system (1)(2)(3)(4)(5)(6). The movement of water molecules is altered in a wide range of pathological conditions, resulting in high sensitivity and low specificity of DWI.…”

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confidence: 99%

Biological correlates of diffusivity in brain abscess

Mishra

Gupta

Saksena

et al. 2005

Magnetic Resonance in Med

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Restricted diffusion in brain abscess is assumed to be due to a combination of inflammatory cells, necrotic debris, viscosity, and macromolecules present in the pus. We performed diffusion-weighted imaging (DWI) on 41 patients with proven brain abscesses (36 pyogenic and five tuberculous), and correlated the apparent diffusion coefficient (ADC) from the abscess cavity with viable cell density, viscosity, and extracellular-protein content quantified from the pus. On the basis of the correlation between cell density and ADC in animal tumor models and human tumors in the literature, we assumed that the restricted ADC represents the cellular portion in the abscess cavity. We calculated restricted and unrestricted lesion volumes, and modeled cell density over the restricted area with viable cell density per mm 3 obtained from the pus. The mean restricted ADC in the cavity (0.65 ؎ 0.01 ؋ 10 -3 mm 2 /s) correlated inversely with restricted cell density in both the pyogenic (r ‫؍‬ -0.90, P ‫؍‬ <0.05) and tuberculous (0.60 ؎ 0.04 ؋ 10 -3 mm 2 /s, r ‫؍‬ -0.94, P ‫؍‬ <0.05) abscesses. We conclude that viable cell density is the main biological parameter responsible for restricted diffusion in brain abscess, and it is not influenced by the etiological agents responsible for its causation. Magn Reson Med 54:878 -885, 2005.

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confidence: 99%

Biological correlates of diffusivity in brain abscess

Mishra

Gupta

Saksena

et al. 2005

Magnetic Resonance in Med

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“…Pus is a viscous fl uid content of infl ammatory cells, mucoid protein, bacteria and necrotic tissue. Microscopic diffusion movement of water molecules are expected to be decreased in the cavity containing pus, whereas in necrotic tumor or cystic metastases, the cystic contents are less viscous, containing less infl ammatory cells and more serous fl uid 7,8 . So, bacterial abscess produce high signal on DWI and low ADC values, ranged from 0.45 to 0.8 9 .…”

Section: Discussionmentioning

confidence: 99%

“…So, bacterial abscess produce high signal on DWI and low ADC values, ranged from 0.45 to 0.8 9 . This variation might be related to a difference in the concentration of infl ammatory cells, and differences in necrotic tissue debris, bacteria, and viscosity of abscess fl uid [8][9][10] . Other infl ammatory processes as fungical disease, toxoplasmosis and necrotic portions of the tumors usually show lower signal intensity on DWI and higher ADCs 11 .…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance spectroscopy in the diagnosis and etiological definition of brain bacterial abscesses

Morais

Zanardi

Faria

2007

Arq. Neuro-Psiquiatr.

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-We report two patients with bacterial brain abscesses whose etiological diagnosis was correctly proposed by association of diffusion weighted images (DWI) and magnetic resonance spectroscopy (MRS) with conventional MRI. Both patients presented ring enhancing lesions with evidences of restricted diffusion. On MRS, the abscess caused by aerobic bacteria presented lactate and aminoacids peaks and the abscess caused by anaerobic facultative bacteria showed also acetate and succinate peaks. These results are in agreement with an unique previous study that related MRS pattern with bacterial etiology. Conventional MRI, associated with DWI and MRS is effective in diagnosing bacterial abscess and promising in exploring its etiology.KEY WORDS: pyogenic bacterial abscess, spectroscopy, diffusion, magnetic resonance. Espectroscopia por ressonância magnética no diagnóstico e definição etiológica dos abscessos bacterianos cerebraisRESUMO -Apresentamos dois pacientes com abscessos bacterianos cerebrais cujos diagnósticos etiológicos foram corretamente auxiliados pela associação de difusão e espectroscopia à ressonância magnética convencional. Ambos apresentavam lesões com captação anelar de contraste e evidências de restrição à difusão de moléculas de água. Na espectroscopia, o abscesso causado por bactéria aeróbia apresentou picos de lactato e aminoácidos, enquanto o abscesso causado por bactéria anaeróbia facultativa mostrou, além destes, picos de acetato e succinato. Tais resultados concordam com um único estudo prévio que relacionou o padrão de espectroscopia nos abscessos com sua etiologia bacteriana. A ressonância magnética convencional, associada à difusão e à espectroscopia é uma técnica eficiente no diagnóstico de abscessos bacterianos e promissora em explorar suas etiologias. PALAVRAS-CHAVE: abscesso cerebral piogênico, espectroscopia, difusão, ressonância magnética.

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“…The presence of haemorrhagic foci is revealed as focal native T1-hyperintensity. In late-stage abscesses, DWI is again accurately demonstrating pus [20][21][22]. Magnetic resonance spectroscopy has been used to analyse the central components of abscesses, revealing firstly the absence of normal brain metabolites (N-acetyl aspartate, choline, creatine), and secondly, the presence of residue from anaerobic glycolysis (lactate, lipids, acetate and succinate) and proteolysis (amino acids) [23,24].…”

Section: Bacterial Infectionmentioning

confidence: 99%

Neonatal brain infections

Schneider

2011

Pediatr Radiol

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Infections of the brain in the neonatal period differ considerably from infections in the older child, due to a variety of age-specific factors that are related not only to the child, but also to the mother, and to specific pathogenic organisms. It has been recognized that clinical and neurological signs are often non-specific, sometimes scarce, and seldom correlate with the extent of neuroimaging findings, thus warranting early imaging to ensure timely therapy and improved outcome.

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Brain abscess and necrotic or cystic brain tumor: discrimination with signal intensity on diffusion-weighted MR imaging.

Cited by 252 publications

References 6 publications

Biological correlates of diffusivity in brain abscess

Biological correlates of diffusivity in brain abscess

Magnetic resonance spectroscopy in the diagnosis and etiological definition of brain bacterial abscesses

Neonatal brain infections

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