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Diagnostic value of diffusion-weighted magnetic resonance imaging in pelvic abscesses

Truong Luong Francis Nguyen1, Philippe Soyer, Coralie Barbe

  • 1From the *Department of Radiology, Hôpital Robert Debré, Reims; †Department of Radiology, Hôpital Lariboisière, Paris; and Departments of ‡Statistics and §Obstetrics and Gynaecology, Hôpital Robert Debré, Reims, France.

Journal of Computer Assisted Tomography
|November 26, 2013
PubMed
Abstract

Insights

Adding gadolinium contrast or diffusion-weighted imaging (DWI) to standard MRI significantly improves deep pelvic abscess diagnosis. DWI shows promise as a potential replacement for gadolinium contrast in MRI assessments.

Area of Science:

  • Radiology
  • Medical Imaging
  • Diagnostic Imaging

Background:

  • Deep pelvic abscesses require accurate and timely diagnosis for effective treatment.
  • Standard T2-weighted MRI is a primary imaging modality, but its diagnostic performance can be limited.

Purpose of the Study:

  • To evaluate the added diagnostic value of gadolinium-enhanced and diffusion-weighted (DWI) magnetic resonance imaging (MRI) sequences to standard T2-weighted MRI for deep pelvic abscess detection.

Main Methods:

  • A prospective study involving 29 patients with suspected deep pelvic abscesses and 43 controls.
  • All participants underwent standard T2-weighted, gadolinium-enhanced T1-weighted, and DWI MRI sequences.
  • Three radiologists independently assessed the likelihood of abscess using different MRI combinations.

Main Results:

  • Standard MRI demonstrated high diagnostic performance (AUC > 0.85 for all readers).
  • Gadolinium enhancement significantly improved AUC for two readers (P < 0.007).
  • Diffusion-weighted imaging (DWI) further enhanced AUC for all readers, with significant improvements for two (P < 0.002).

Conclusions:

  • Both gadolinium enhancement and DWI improve the diagnostic accuracy of T2-weighted MRI for deep pelvic abscesses.
  • Diffusion-weighted imaging (DWI) offers comparable or superior performance and may serve as an alternative to gadolinium contrast.

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