Diagnosis of prosthetic aortic graft infection by magnetic resonance imaging

The accuracy of magnetic resonance imaging (MRI) in the diagnosis of prosthetic aortic graft infection was evaluated in 18 patients with history and findings suggestive of this complication. The prospective interpretation of MRI was compared with surgical findings. Sixteen patients had a graft infection verified at operation. Fourteen patients had infection of the retroperitoneal portion of the graft; two patients had an infection limited to one of the groins; no graft infection was found at surgical exploration in the remaining two patients. Perigraft infection was correctly diagnosed on the basis of MRI findings in 14 of 16 cases; findings were false negative in one case, questionable in another case, and correctly excluded graft infection in two of two cases. MRI also defined the extent of infection in 14 of 16 cases. MRI findings that supported the clinical suspicion of graft infection were perigraft fluid collections remaining more than 3 months after surgery. Furthermore, local inflammation was suggested by an increased signal intensity of adjacent muscle on T2-weighted images in some cases. CT scans were performed in 12 patients; these enabled a correct diagnosis in five and provided indeterminate or false information in seven. These results indicate that MRI is helpful in the diagnosis of aortic graft infection. Furthermore, MRI provides information about the extent of infection crucial for planning therapy.