Diffusion Weighted Imaging in the Postsurgical Evaluation of Intracranial Abcess

Year 2005, Volume: 12 Issue: 2, 139 - 143, 01.04.2005

Ahmet Kemal Fırat Yezdan Fırat Hakkı Muammer Karakaş Çağatay Önal Bayram Kahraman Alpay Alkan Tayfun Altınok

Abstract

The most prominent MRI finding of abcess is the peripheric enhancement following gadolinium injection. This finding usually persists despite the reduced volume of abcess and clinical improvement. In this study we presented the succeeding diffusion weighted images of 45 years old patient with two brain abcesses representing pre and postsurgical period. Those abcesses were in the frontal lob and measuring about three centimeters. Though the size of the abcess decreased after surgery, the conrast enhancement was still present in the operation site. The restricted diffusion that was noted on the presurgical images was disappeared. As the persistent contrast enhancement in the operation site of abcess can be misleading, the diffusion weighted images should be prefered for the evaluation of postsurgical recurrence. Key words: Diffusion weighted imaging, Magnetic resonance imaging, Abcess

Keywords

Diffusion weighted imaging, Magnetic resonance imaging, Abcess

Postoperatif İntrakraniyal Apse İzleminde Difüzyon Ağırlıklı Görüntüleme

Abstract

Çevresel kontrastlanma intrakraniyal apselerin başlıca görüntüleme bulgusudur. Bu bulgu tedavi sonrası izlenen klinik düzelmeye ve lezyon boyutundaki azalmaya rağmen devam etmektedir. Bu çalışmada akut pansinüzit sonrası frontal lobda 3cm büyüklükte iki apse gelişen 45 yaşındaki bir olgunun tedavi sırası ve sonrasındaki izleminde difüzyon ağırlıklı görüntülemenin kullanımı sunulmaktadır. Cerrahi ve tıbbi tedavi sonrası lezyonların boyutları küçülmekle birlikte apse lojlarındaki kontrastlanma devam etmiştir. Difüzyon ağırlıklı görüntülerde ise tedavi öncesi izlenen kısıtlanmış difüzyonun kaybolduğu saptanmıştır. Apselerde izlenen patolojik kontrastlanma tedavi sonrası yanıltıcı yorumlara neden olabileceğinden, izlemde difüzyon ağırlıklı görüntüler birincil önem taşımalıdır. Anahtar kelimeler: Difüzyon ağırlıklı görüntüleme, Manyetik rezonans görüntüleme, Abse

Keywords

Difüzyon ağırlıklı görüntüleme, Manyetik rezonans görüntüleme, Abse

References

• Hart BL, Depper MH, Clercuzio CL. Neurocutaneus syndromes. In: Orrison WW (ed). Neuroimaging. 1st ed. Philedelphia: W.B. Saunders, 2000; 1717- 1759.
• Girolami U, Frosch M, Anthony DC. The central nervous system. In: Cotrans RS, Kumar V, Robbins SL (eds). Robbins pathologic basis of disease. 5th ed. Philedelphia: W.B. Saunders, 1994; 1316.
• Guo AC, Provenzale JM, Cruz ICH, Petrella JR. Cerebral abscess: investigation using apparent diffusion coefficient maps. Neuroradiol 2001; 43:370-374.
• Holtas S, Geijer B, Strömblad LGS, Maly-Sundgren P, Burtscher IM. A ring- enhancing metastasis with central high signal on diffusion-weighted imaging and low apparent diffusion coefficients. Neuroradiol 2000; 42:824-827.
• Park SH, Chang KH, Song IC, et al. Diffusion-weighted MRI in cystic or necrotic intracranial lesions. Neuroradiol 2000;42:716-721.
• Cartes-Zumelvu FW, Stayrau I, Castilo M, et al. Diffusion-weighted imaging in the assesment of brain abcesses theraphy. AJNR Am J Neuroradiol. 2004; 25:1310-7.
• Chen SC, Chung HW. Diffusion-weighted imaging parameters to track success of pyogenic brain abscess therapy. AJNR Am J Neuroradiol 2004;25:1303-4.
• Laissy JP, Soyer P, Parlier C, et al. Persitent enhancement after treatment for cerebral toxoplasmosis in patients with AIDS: predictive value for subsequent recurrence. AJNR 1994;15:1773-1778.
• Hakyemez B, Ergin N, Uysal S, Işık I, Kiliç E. Diffusion Weighted MRI in the differentiation of brain abcess and necrotic tumors. Tani Girisim Radyol 2004; 10:110-8.