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Updated: Jun 3, 2026
Quantitative Magnetic Resonance Imaging of Skeletal Muscle Disease
Published on: December 18, 2016
Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging?
Kyoung-Tae Kim1, Yeo Ju Kim, Ju Won Lee
1Department of Radiology, Inha University Hospital, 3-ga Shinheung-dong, Choong-gu, Incheon 400-700, South Korea.
Purpose:
To retrospectively evaluate whether magnetic resonance (MR) imaging findings can be used to differentiate necrotizing infectious fasciitis (NIF) from nonnecrotizing infectious fasciitis (non-NIF).
Materials And Methods:
Institutional review board approval was obtained, but patient consent was not required for this retrospective review of records and images because patient anonymity was preserved. Thirty patients (seven with NIF, 23 with non-NIF) were included in the study. The following imaging findings were analyzed on fat-suppressed T2-weighted MR images: (a) signal intensity in the deep fascia (low, high, or mixed high and low), (b) thickness of abnormal signal intensity in the deep fascia (≥3 mm or <3 mm), (c) pattern of abnormal signal intensity in muscle (no abnormality, peripheral bandlike signal intensity, or patchy high signal intensity), (d) degree of deep fascia involvement (partial or extensive), and (e) degree of compartment involvement (fewer than three compartments or three or more compartments). On contrast material-enhanced fat-suppressed T1-weighted images, the contrast enhancement patterns of the abnormal deep fascia (no enhancement, enhancement, or enhancement with nonenhancing portion) and the muscle (no abnormality, peripheral bandlike signal intensity, or patchy high signal intensity) were evaluated. The presence of abscesses in the subcutaneous fat layer was evaluated with all sequences.
Results:
The patients with NIF had a significantly greater frequency of (a) thick (≥3 mm) abnormal signal intensity on fat-suppressed T2-weighted images, (b) low signal intensity in the deep fascia on fat-suppressed T2-weighted images, (c) a focal or diffuse nonenhancing portion in the area of abnormal signal intensity in the deep fascia, (d) extensive involvement of the deep fascia, and (e) involvement of three or more compartments in one extremity (P < .05).
Conclusion:
MR imaging is potentially helpful for differentiating NIF from non-NIF.
Supplemental Material:
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101164/-/DC1.
Insights
Magnetic resonance (MR) imaging can help distinguish necrotizing infectious fasciitis (NIF) from nonnecrotizing infectious fasciitis (non-NIF). Key MR findings like deep fascia signal intensity and extent of involvement aid in differentiating these serious infections.
Area of Science:
- Radiology
- Medical Imaging
- Infectious Diseases
Background:
- Distinguishing necrotizing infectious fasciitis (NIF) from nonnecrotizing infectious fasciitis (non-NIF) is crucial for timely and appropriate treatment.
- Magnetic resonance (MR) imaging is a valuable tool in evaluating soft tissue infections.
Purpose of the Study:
- To retrospectively evaluate the utility of specific magnetic resonance (MR) imaging findings in differentiating necrotizing infectious fasciitis (NIF) from nonnecrotizing infectious fasciitis (non-NIF).
Main Methods:
- Retrospective analysis of MR imaging findings in 30 patients (seven with NIF, 23 with non-NIF).
- Evaluation of fat-suppressed T2-weighted and contrast-enhanced fat-suppressed T1-weighted MR images for deep fascia and muscle signal intensity, thickness, enhancement patterns, and extent of involvement.
- Assessment for abscesses in the subcutaneous fat layer.
Main Results:
- Patients with NIF showed significantly higher frequencies of thick (≥3 mm) abnormal deep fascia signal intensity on T2-weighted images.
- Low signal intensity in the deep fascia on T2-weighted images was more common in NIF.
- NIF cases frequently exhibited focal or diffuse nonenhancing portions in the deep fascia, extensive deep fascia involvement, and involvement of three or more compartments.
Conclusions:
- Magnetic resonance (MR) imaging findings are potentially helpful in differentiating necrotizing infectious fasciitis (NIF) from nonnecrotizing infectious fasciitis (non-NIF).
- Specific imaging features, including fascia signal intensity and extent of involvement, are key discriminators.
