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Diffusion-weighted MRI of abscess formations in children and young adults
Henning Neubauer1, Isabel Platzer, Verena Rabea Mueller
1Institute of Radiology, Department of Pediatric Radiology, University Hospital Wuerzburg, Josef-Schneider-Straße 2, 97080, Wuerzburg, Germany. neubauer@roentgen.uni-wuerzburg.de
Background:
Diffusion-weighted MRI (DWI) is helpful for detection of brain abscess and pelvic abscess in adults. In the present study, we evaluated the diagnostic performance of DWI in children and young adults with abdominal and soft tissue abscess formations.
Methods:
Seventeen patients (11 females, aged 13 ± 6 years) with suspected abdominal or soft-tissue abscess underwent routine MRI including free-breathing DWI and contrast-enhanced T1w imaging. Seventeen random age-matched patients with non-purulent abdominal fluid collections served as controls. Mean apparent diffusion coefficent (ADC) was measured for abscess, muscle, liver, spleen and kidney tissue as well as for cerebrospinal fluid, urine and free abdominal fluid.
Results:
All fluid collections were identified on diffusion-weighted images. Thirteen of 14 confirmed abscess formations showed an ADC < 1.0 × 10(-3) mm(2)/s with a mean value of 0.80 ± 0.38 mm(2)/s. One tuberculous soft-tissue abscess had a higher ADC of 1.85 × 10(-3) mm(2)/s. Ring enhancement on T1w imaging was seen in three non-purulent fluid collections. There were no false-positive findings in the control group.
Conclusions:
Diffusion-weighted MRI is highly sensitive for abscess and may add specificity to contrast-enhanced T1w imaging of ring-enhancing fluid collections. DWI with free-breathing rapid image acquisition and without the need of intravenous contrast application constitutes a particularly useful choice in pediatric imaging.
Insights
Diffusion-weighted MRI (DWI) is a sensitive tool for detecting abscesses in children and young adults. This imaging technique aids in diagnosing abdominal and soft tissue abscesses without contrast agents.
Area of Science:
- Radiology
- Medical Imaging
- Pediatric Imaging
Background:
- Diffusion-weighted MRI (DWI) is established for detecting brain and pelvic abscesses in adults.
- The diagnostic utility of DWI for abdominal and soft tissue abscesses in pediatric populations requires further evaluation.
Purpose of the Study:
- To assess the diagnostic performance of DWI in children and young adults with abdominal and soft tissue abscesses.
- To compare DWI findings with contrast-enhanced T1w imaging in identifying purulent collections.
Main Methods:
- Seventeen pediatric patients with suspected abscesses underwent MRI, including free-breathing DWI and contrast-enhanced T1w imaging.
- Apparent diffusion coefficient (ADC) values were measured for abscesses and various tissues/fluids.
- A control group of age-matched patients with non-purulent fluid collections was included.
Main Results:
- All fluid collections, including abscesses, were visualized on DWI.
- Confirmed abscesses typically exhibited low ADC values (< 1.0 × 10(-3) mm(2)/s), with a mean of 0.80 ± 0.38 mm(2)/s.
- One tuberculous abscess showed a higher ADC; ring enhancement was observed in non-purulent collections, with no false positives in controls.
Conclusions:
- DWI demonstrates high sensitivity for abscess detection in pediatric patients.
- DWI can enhance the specificity of contrast-enhanced T1w imaging for ring-enhancing fluid collections.
- Free-breathing DWI is a valuable, contrast-free imaging option for pediatric abscess diagnosis.
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