Magnetic resonance imaging in the evaluation of abscesses

Ten patients with percutaneous biopsy or surgically proven abscesses were evaluated with magnetic resonance imaging (MRI) to describe the appearance of abscesses, define the capability of MRI to localize abscesses, and compare the capabilities of MRI and CT for the diagnosis and determination of the extent of an abscess. Comparative CT scans were available in six cases. The most common MRI finding was an abnormal area of low signal intensity, either homogeneous or heterogeneous, on the short repetition rate (500 msec TR) images with a relative increase in signal intensity on the longer repetition rate (1500 or 2000 msec TR) images. MRI demonstrated a more clear delineation of the extent of inflammatory changes than did CT, and MRI demonstrated the abscess as a collection distinct from surrounding structures on at least one repetition rate. Intravenous contrast medium was unnecessary with MRI to evaluate vasculature or to define the capsule around an abscess. With CT, unless an abscess contained air or was of low attenuation, it often blended with the surrounding structures and was difficult to differentiate from them. Surgical clips in the postoperative patient with an abscess did not degrade the MR images as often occurred with CT. This study describes the MRI appearance of abscess and indicates a potential value of the use of MRI to evaluate abscess outside the central nervous system and spine.