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Multilayer appearance on contrast-enhanced susceptibility-weighted images on patients with brain abscesses: Possible
Hing-Chiu Chang1, Tzu-Chao Chuang, Hsiao-Wen Chung
1Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan, Republic of China.
Purpose:
To demonstrate the presence of a multilayer appearance of the capsule on contrast-enhanced (CE) susceptibility-weighted imaging (SWI) in patients with pyogenic brain abscesses. Possible origins for the appearance and effects of postprocessing settings are discussed.
Materials And Methods:
Fourteen patients with pyogenic brain abscesses underwent post gadolinium-enhanced SWI at 1.5 T. All SWI images were postprocessed with various filter and mask settings to compare the image appearance. Computer simulations using a paramagnetic spherical shell model were performed to verify the clinical findings.
Results:
Pyogenic brain abscesses demonstrated a multilayer appearance with a darkened ring within the enhanced capsule on CE-SWI in all patients. The multilayer appearance was slice-orientation-dependent, decreased with larger widths of the high-pass filter, and increased with larger numbers of phase mask multiplication operations, consistently on both simulation results and the clinical images.
Conclusion:
CE-SWI shows the multilayer appearance of the capsule in pyogenic brain abscesses, which may arise from postprocessing procedures originally designed to enhance susceptibility contrast. Although SWI may provide additional information valuable in the diagnosis of pyogenic brain abscesses, image interpretation should be exercised with caution, particularly for CE-SWI.
Insights
Contrast-enhanced susceptibility-weighted imaging (CE-SWI) reveals a multilayer capsule appearance in pyogenic brain abscesses. This finding, influenced by postprocessing, aids diagnosis but requires careful interpretation.
Area of Science:
- Neuroradiology
- Medical Imaging
Background:
- Pyogenic brain abscesses present diagnostic challenges.
- Susceptibility-weighted imaging (SWI) is sensitive to magnetic susceptibility variations.
Purpose of the Study:
- To identify and characterize the multilayer capsule appearance of pyogenic brain abscesses on contrast-enhanced SWI (CE-SWI).
- To explore the influence of postprocessing techniques on this imaging feature.
Main Methods:
- SWI was performed on 14 patients with pyogenic brain abscesses post-gadolinium contrast administration at 1.5 T.
- Images were postprocessed with varying filter and mask settings.
- Computer simulations using a paramagnetic spherical shell model were conducted for verification.
Main Results:
- All patients exhibited a multilayer capsule appearance with a central hypointense ring on CE-SWI.
- This appearance was dependent on slice orientation and postprocessing parameters (filter width, phase mask multiplication).
- Simulation results corroborated the clinical observations.
Conclusions:
- CE-SWI demonstrates a characteristic multilayer capsule in pyogenic brain abscesses.
- The appearance is likely an artifact of postprocessing designed to enhance susceptibility contrast.
- While valuable for diagnosis, CE-SWI requires cautious interpretation in pyogenic brain abscesses.
