Preamputation MR imaging in meningococcemia and comparison to conventional arteriography

Meningococcemia is a life-threatening infection which produces purpura fulminans and extremity gangrene in its most severe form. In patients with gangrene, amputation is usually necessary. The amputations frequently need revision as ischemic changes in the underlying soft tissues and bone are difficult to evaluate at the time of surgery. These ischemic changes often have non-vascular distributions and progress over time. We present two patients in whom MR imaging and MR angiography were performed prior to planned amputation. These cases demonstrate the potential utility of MR imaging in this setting, and compare the MR angiographic results to conventional arteriography in one of these patients.