Imaging of necrotizing fasciitis
Sergey Kochkine1, David L Payne1, Katherine Chung1
1Department of Radiology, Stony Brook Medicine, Health Science Center, Level 4, Room 120, 101 Nicolls Road, Stony Brook, NY 11794, United States of America.
Abstract:
Necrotizing Fasciitis (NF) is a rare, but highly lethal, rapidly progressive necrotic infection of the soft-tissue fascia. More common in immunocompromised patients, NF typically affects the extremities, perineal area, genital area (Fournier gangrene), and less commonly the torso. Although classically a clinical diagnosis, imaging is a powerful adjunct to facilitate early diagnosis in equivocal cases. The key features of NF of radiography, ultrasound, CT, and MRI are reviewed, as are the inherent limitations of NF diagnosis for each modality. With a high level of sensitivity, specificity, and soft tissue contrast, MRI remains the gold standard imaging method for evaluation of NF.
Insights
Necrotizing fasciitis (NF) is a severe soft-tissue infection. MRI offers the highest accuracy for diagnosing NF, making it the gold standard imaging technique.
Area of Science:
- Medical Imaging
- Infectious Diseases
- Radiology
Background:
- Necrotizing fasciitis (NF) is a rare, rapidly progressive, and lethal soft-tissue infection.
- It predominantly affects immunocompromised individuals and commonly occurs in the extremities and perineal regions.
Purpose of the Study:
- To review the key imaging features of NF across various modalities.
- To discuss the diagnostic limitations of each imaging technique for NF.
Main Methods:
- Review of radiography, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) features in NF.
- Analysis of the sensitivity, specificity, and soft tissue contrast of each modality.
Main Results:
- While radiography, ultrasound, and CT can aid in diagnosis, they have limitations.
- MRI demonstrates high sensitivity, specificity, and superior soft tissue contrast for NF evaluation.
Conclusions:
- Imaging is crucial for early diagnosis of NF, especially in ambiguous cases.
- MRI is the gold standard for imaging-based diagnosis of necrotizing fasciitis due to its comprehensive visualization capabilities.
