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Diffusion-weighted MRI of abscess formations in children and young adults

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Abstract

Background

Diffusion-weighted MRI (DWI) is helpful for detection of brain abscess and pelvic abscess in adults. In the present study, we evaluated the diagnostic performance of DWI in children and young adults with abdominal and soft tissue abscess formations.

Methods

Seventeen patients (11 females, aged 13 ± 6 years) with suspected abdominal or soft-tissue abscess underwent routine MRI including free-breathing DWI and contrast-enhanced T1w imaging. Seventeen random age-matched patients with non-purulent abdominal fluid collections served as controls. Mean apparent diffusion coefficent (ADC) was measured for abscess, muscle, liver, spleen and kidney tissue as well as for cerebrospinal fluid, urine and free abdominal fluid.

Results

All fluid collections were identified on diffusion-weighted images. Thirteen of 14 confirmed abscess formations showed an ADC < 1.0 × 10−3 mm2/s with a mean value of 0.80 ± 0.38 mm2/s. One tuberculous softtissue abscess had a higher ADC of 1.85 × 10−3 mm2/s. Ring enhancement on T1w imaging was seen in three nonpurulent fluid collections. There were no false-positive findings in the control group.

Conclusions

Diffusion-weighted MRI is highly sensitive for abscess and may add specificity to contrast-enhanced T1w imaging of ring-enhancing fluid collections. DWI with free-breathing rapid image acquisition and without the need of intravenous contrast application constitutes a particularly useful choice in pediatric imaging.

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Authors and Affiliations

  1. Institute of Radiology, Department of Pediatric Radiology, University Hospital Wuerzburg, Josef-Schneider-Straße 2, 97080, Wuerzburg, Germany

    Henning Neubauer, Isabel Platzer & Meinrad Beer

  2. Department of Pediatrics, University Hospital Wuerzburg, Josef-Schneider-Straße 2, 97080, Wuerzburg, Germany

    Verena Rabea Mueller & Johannes Liese

  3. Pediatric Surgery Unit, Department of Surgery, University Hospital Wuerzburg, Oberduerrbacher Str. 6, 97080, Wuerzburg, Germany

    Thomas Meyer

  4. Institute of Radiology, University Hospital Wuerzburg, Oberduerrbacher Str. 6, 97080, Wuerzburg, Germany

    Herbert Koestler & Dietbert Hahn

Authors
  1. Henning Neubauer
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  2. Isabel Platzer
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  3. Verena Rabea Mueller
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  4. Thomas Meyer
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  5. Johannes Liese
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  6. Herbert Koestler
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  7. Dietbert Hahn
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  8. Meinrad Beer
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Correspondence to Henning Neubauer.

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Neubauer, H., Platzer, I., Mueller, V.R. et al. Diffusion-weighted MRI of abscess formations in children and young adults. World J Pediatr 8, 229–234 (2012). https://doi.org/10.1007/s12519-012-0362-4

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  • DOI: https://doi.org/10.1007/s12519-012-0362-4

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