Discrimination of brain abscess from necrotic or cystic tumors by diffusion-weighted echo planar imaging

Ebisu, Toshihiko; Tanaka, Chuzo; Umeda, Masahiro; Kikuchi, Makoto; Shoji, Nobuyuki; Higuchi, Toshihiro; Ueda, Satoshi; Sato, Hiroshi

doi:10.1016/s0730-725x(96)00237-8

Cited by 309 publications

(172 citation statements)

References 11 publications

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“…In patients with brain abscess, viscosity has been considered to be an important factor in causing restricted diffusion (3,13,14). We did not observe any correlation between the viscosity and the mean wholecavity ADC of the brain abscesses.…”

Section: Discussioncontrasting

confidence: 52%

“…An inverse correlation has been shown between the ADC and the cell density in brain tumor in humans, as well as in animal models (11,12). A number of studies have discussed the possible causes of restricted diffusion in brain abscesses, and attributed it to a combination of cells, necrotic debris, viscosity, and macromolecules present in the pus (13,14). The exact mechanism of restricted diffusion in brain abscesses is not known.…”

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confidence: 99%

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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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Section: Discussioncontrasting

confidence: 52%

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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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“…Abscesses and thrombi are believed to impede the diffusivity of water molecules because of their hyperviscous nature (Desprechins et al, 1999;Kwee et al, 2010). The pus structure itself is responsible for the low ADC values, and the heavily impeded water mobility of pus may be related to its high cellularity and viscosity (Ebisu et al,1996). In the interpretation of DWI, 22% of benign lesions can exhibit restricted diffusion in images with high b values (Feuerlein et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Diffusion Weighted Imaging of Malignant and Benign Pulmonary Nodules and Masses: Comparison with Positron Emission Tomography

Usuda

Sagawa

Motono

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…4,8) MR imaging, particularly diffusion-weighted imaging, is efficacious for differentiating brain abscesses from metastatic brain tumors. 1,7) Although markedly decreased water diffusion is not absolutely specific for brain abscess, 9) it is still a reliable marker for differentiating brain abscesses from metastatic brain tumors. 1,7) Biopsy is the definitive method for establishing the histological diagnosis of a brain tumor and for identifying the microorganisms responsible in brain abscess, but carries substantial perioperative risks in patients with debilitating medical conditions.…”

Section: Discussionmentioning

confidence: 99%

Ring-enhanced Mass in the Brain of a Woman With Systemic Lupus Erythematosus and Elevated Serum CA19-9 Level: Brain Abscess or Metastatic Tumor? Case Report.

Inamasu

Nakamura

Saito

et al. 2003

Neurol. Med. Chir.(Tokyo)

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A 70-year-old woman with systemic lupus erythematosus presented with a brain abscess manifesting as progressive monoparesis of the right lower extremity over 4 days. She had had no episodes of fever, and did not complain of headache or exhibit any signs of meningeal irritability. Computed tomography of the brain showed a round, low-density mass with strong ring enhancement in the left frontal lobe. Laboratory examination found a moderately elevated serum level of CA19-9, a marker of some digestive organ cancers. Together with the absence of febrile episodes, headache, and a rise in leukocyte count, the initial suspicion was metastatic brain tumor rather than brain abscess. However, diffusion-weighted magnetic resonance imaging depicted the mass as a very hyperintense area. The neuroimaging diagnosis was brain abscess. After conservative treatment with intravenous antibiotics for 6 weeks, the brain abscess completely resolved, and the patient was discharged without neurological deficits.

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Discrimination of brain abscess from necrotic or cystic tumors by diffusion-weighted echo planar imaging

Cited by 309 publications

References 11 publications

Biological correlates of diffusivity in brain abscess

Biological correlates of diffusivity in brain abscess

Diagnostic Performance of Diffusion Weighted Imaging of Malignant and Benign Pulmonary Nodules and Masses: Comparison with Positron Emission Tomography

Ring-enhanced Mass in the Brain of a Woman With Systemic Lupus Erythematosus and Elevated Serum CA19-9 Level: Brain Abscess or Metastatic Tumor? Case Report.

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