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Updated: Apr 27, 2026
Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury
Published on: August 14, 2019
The difference in diffusion-weighted imaging with apparent diffusion coefficient between spontaneous and
Yeong-Jin Kim1, Kyung-Sub Moon, Seul Kee Kim
1Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School , Hwasun-gun, Jeollanamdo , Republic of Korea.
Background:
Although the roles of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) have been accepted as the initial or confirmatory diagnostic tool for spontaneous intracranial infections, the usefulness of these has rarely been investigated in intracranial infections after a craniotomy procedure. Through an analysis of the clinico-radiological characteristics of spontaneous and postoperative intracranial infections, the authors revealed the specific factors that affect the accuracy of DWI and ADC in diagnosing intracranial infections.
Methods:
The authors retrospectively analyzed 67 intracranial infections confirmed using preoperative MR imaging, including the DWI, ADC and gadolium-enhanced (Gd) images, and by peroperative pus drainage.
Results:
In 67 enrolled patients, no or uncertain diffusion restriction on DWI and ADC was found in 9 cases (13%). All the cases showed typical peripheral enhancement on Gd images. Among nine cases without diffusion restriction, postoperative infection was seen in five cases (62.5% [5/8 postoperative infection group] vs. 6.8% [4/59 spontaneous infection group], p = 0.001). On multivariate analysis, postoperative infection was the predictive factor for false-negative restriction on DWI and ADC (hazard ratio: 41.2, 95% confidential index: 2.39-710.25, p = 0.01).
Conclusion:
Despite the excellent availability of DWI and ADC for diagnosing spontaneous intracranial infections, negative restriction results of those images are not sufficient to exclude postoperative intracranial infection.
Insights
Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) are useful for diagnosing spontaneous intracranial infections. However, negative results do not rule out postoperative infections, which require further investigation.
Area of Science:
- Neuroimaging
- Radiology
- Infectious Diseases
Background:
- Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) are established tools for diagnosing spontaneous intracranial infections.
- Their utility in diagnosing intracranial infections post-craniotomy remains under-investigated.
- This study analyzes clinico-radiological features to identify factors affecting DWI/ADC accuracy in postoperative cases.
Purpose of the Study:
- To evaluate the diagnostic accuracy of DWI and ADC in intracranial infections following craniotomy.
- To compare the characteristics of spontaneous versus postoperative intracranial infections.
- To identify predictors of false-negative DWI/ADC results in intracranial infections.
Main Methods:
- Retrospective analysis of 67 patients with intracranial infections confirmed by MR imaging (including DWI, ADC, and gadolinium-enhanced sequences) and peroperative pus drainage.
- Comparison of clinico-radiological findings between spontaneous and postoperative infection groups.
Main Results:
- No or uncertain diffusion restriction on DWI/ADC was observed in 9 cases (13%), all showing peripheral enhancement on Gd-enhanced images.
- Postoperative infection was significantly associated with false-negative DWI/ADC findings (62.5% vs. 6.8%, p=0.001).
- Multivariate analysis identified postoperative infection as a strong predictor of false-negative DWI/ADC results (HR: 41.2, p=0.01).
Conclusions:
- While DWI and ADC are highly effective for spontaneous intracranial infections, negative findings do not exclude postoperative infections.
- Postoperative intracranial infections may present without characteristic diffusion restriction on DWI/ADC.
- Clinical correlation and further diagnostic steps are crucial when suspecting postoperative intracranial infection despite negative DWI/ADC.
