Low Field MRI in the Diagnosis of Bacterial Abscess of liver
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Objective:To study the value of low field MRI in the diagnosis of bacterial abscess of liver. Methods:Of 19 patients,23 bacterial abscesses of liver which were proved by pathology or clinical follow-up,the MRI findings before and after Gd-DTPA enhancement were retrospectively analyzed.Results:The location of the 23 lesions were in right lobe (n=14) and left lobe (n=9).Typical MR manifestations were seen in 7 lesions,presenting as ring sign,double-target sign,central liquified necrosis,air bubble or air-fluid level within the lesion and peri-lesional oedema.16 lesions had atypical features,which varied according to different stages of the abscess,displayed as cluster sign,honeycomb sign,spider-feet sign etc.Conclusion:Various characteristic findings in different stages of bacterial abscess could be assessed by low field MRI,and the diagnostic accuracy could be improved.Keywords:
Brain abscess
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Objective To analyze the features of diagnostic imaging findings of bacterial liver abscess(BLA).Methods A retrospective analysis was performed on clinical data(including clinical manifestations,imaging presentations of ultrasound,CT and MRI)of 56 patients diagnosed as BLA by surgery,puncture,follow-ups.Results There was significant difference in symptom and sign incidence between 56 BLA patients(χ2=135.49,P0.01).Thereinto incidence of fever was significantly different from that of ague(P0.05),but not from that of liver pain and percussion pain(P0.05).Lesion abscess included single lesion(42 cases),2 lesions(5 cases),over 3 lesions(9 cases).Forty-two patients had ultrasound,38 of whom were diagnosed as BLA typically showing hypoechoic or anechoic area in liver parenchyma and mild abscess posterior echo enhancement.Floating mobile phenomenon appeared in liquid anechoic area in 8 patients,honeycomb structure in 15.Fifty-six patients had CT,53 diagnosed as BLA(94.6%),plain scan showing one or more low-density liver lesions,with unsharp or sharp edge,uneven density,ring-and loculation-like changes being seen.Lesions associated with gas in 6,scan soft tissue density in 3.Enhanced scanning performances were:(a) in arterial phase,marked enhancement of liver tissues around low-density lesions,but the lesions themselves with mild or no marked enhancement,transient enhancement of companion liver segment in 4 cases.(b) in portal venous phase,different forms of enhancement in 5 cases,ring sign(single,second,third ring sign) in 34,separation-or petal-like enhancement in 6.(c) in lag period,edema disappeared or blurred,parietal or atrial septum enriched continuous enhancement in 36 cases.Twelve patients received MRI,9 diagnosed as BLA,3 not excluded.BLA typical manifestations by MRI were T1WI being heterogeneous low signal,T2WI abscess necrotic area being round or oval lamellar high signal area,around which were moderate high signal.After enhanced MRI scan,no enhancement was noted in abscess necrosis area but abscess wall enhanced markedly in 6 patients;2 patients showed multilocular separated enhancement;1 showed ring-like enhancement of liver multiple lesions.Conclusion Radiology imaging,a method of diagnosis and differential diagnosis of BLA,is of very important value when applied in combination with clinical fever history and elevated white blood cells.
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OBJECTIVE To study the MRI features of abscess and cystic tumor during the cerebellar envelope period so as to improve the accuracy of MRI in diagnosis of abscess during the cerebellar envelope period.METHODS The imaging and clinical data of 48 patients with cerebellar cystic swelling lesions,which included 11 cases with cerebellum package tacit abscess,were retrospectively analyzed.Before the treatment,all the 48 patients with cerebellar cystic lesions underwent the conventional MRI scan and enhanced DWI examination.A comparative study of the enrolled cases was performed according to eight MRI features including the large cyst and small nodules levy,T2 low signal ring sign,ring enhancement levy(with or without mural nodules),diffuse high signal levy,small focal edema levy,vascular flow void sign,pseudopodia sign,and multi-room levy.RESULTS T2 low signal ring levy emerged in 100.0% of the abscess cases during the cerebellar envelope period,and did no occur in any case with the cystic tumors;The positive rates of the ring enhancement levy in the cases with cerebellum capsule abscess and the cases with other cystic tumors were 100.0% and 78.3%,respectively,but the abscess cases were with thin wall and were without mural nodule shape.The cystic tumors cases were with uneven wall thickness of ring enhancement levy,in which 64.8% were complicated with mural nodules.CONCLUSION The MRI characteristic performance has great value in the differential diagnosis of the cerebellar capsule period abscess and cystic tumor.
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Objective To study the diagnostic value of diffusion-weighted imaging(DWI) in soft tissue abscesses.Methods The study enrolled 48 patients who were thought to have soft tissue abscess or cystic lesion as result of clinical and radiological examinations.Localizations of the lesions were:periorbital 1,breast 3,intraabdominal cavity 13,and intramuscular lesions 31.After other radiological examinations,DWI was performed with 1.5T MR system.The signal intensity values of the lesions were evaluated qualitatively according to the hyperintensity on b-1000 DWI.All of the lesions were aspirated after DWI,and detection of pus in the aspiration material was accepted as gold standard for the diagnosis of abscess.Results In 37 of the 48 patients,hyperintensity was obtained on diffusion-weighted images.False-positive results were maintained in 2 of these patients,and true-positive results were maintained in 35 of them.In 10 of the 48 patients,hypointensity was visualized on diffusion-weighted images.False-negative results were maintained in 2 of these patients,and true-negative results were maintained in 8 of them.An abscess which was seen on post-contrast conventional MRI could not be seen on DWI,and this was regarded as false-negative.The sensitivity and specificity of diffusion-weighted images for detecting soft tissue abscesses were found to be 92.1% and 80.0%,respectively.Conclusion DWI has high diagnostic value in soft tissue abscesses,and it is an important imaging modality that may be used for the differentiation of cysts and abscesses.
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Brain abscess
T2 weighted
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Objective
To discuss the MRI findings of hepatic epithelioid hemangioendothelioma (EHE).
Methods
MRI and clinical data of 8 EHE patients confirmed by pathology in PLA General Hospital were retrospectively analyzed.
Results
8 patients included 3 male and 5 female. 1 patient had single lesion and 7 patients had multiple lesions. A total of 162 lesions were detected and most of the lesions were in the peripheral liver. For T1WI, 100 lesions (61.7%) showed slightly low signal, and 62 lesions (38.3%) showed lower signal intensity in the center of the lesion and appeared as target sign . For T2WI, the center of 29 lesions (17.9%) showed two-loop target sign , 66 lesions (40.7%) showed three-loop target sign , and 67 lesions (41.4%) showed slightly homogeneous higher signal. For DWI, 116 lesions (71.6%) showed halo-like high signal and 46 lesions (28.4%) showed uniform high signal. For dynamic enhancement, the lesions showed slightly enhancement in the arterial phase, and persistent enhancement in portal venous phase, the center of 122 lesions (about 75.3%) showed enhancement and 40 lesions (24.7%) showed no enhancement in delayed phase. 1 patient with hepatobiliary specific contrast was enhanced in hepatobiliary phase. Hepatic capsule depression was observed in 30 lesions. 7 lesions appeared as lollipop sign , and were enveloped in 16 lesions.
Conclusion
MRI, DWI and dynamic contrast-enhanced scanning of EHE in liver are characteristic, which is helpful for qualitative diagnosis before surgery.
Key words:
Epithelioid hemangioendothelioma; Magnetic resonance imaging (MRI); Diffusion weighted imaging (DWI)
Epithelioid Hemangioendothelioma
Capsule
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Objective:To explore the MR findings of abdominopelvic abscess in order to improve diagnostic level.Methods:Retrospective analysis and summarization of the MR findings of 15 cases with abdominopelvic abscesses were made.All cases underwent T1WI,T2WI and DWI examinations.Results:A total of 22 lesions in 15 cases were studied.①Position:32% lesions (7/22) were located in right paracolic gutter,27% lesions (6/22) in subphrenic space and 18% (4/22) in women pelvic cavity;②Shape:68% lesions (15/22) were round or round-like,86% lesions (19/22) had capsule,23% lesions (5/22) had septation;③Signal:Early stage of the abscess-formation:8 lesions in 5 cases.In this stage,the signal of abscess cavity on T1WI was low and on T2WI was high;3 lesions had high-signal on DWI,and 5 lesions had low-signal;The capsules were incomplete or absent,their signal was low or equal on T1WI and low on T2WI.There was effusion around the lesions,with obscure boundary.Typical stage and late stage of abscess-formation:14 lesions in 10 cases,the signal on T1WI was low,on T2WI and DWI was high or slightly high;when capsules were complete,the peplos signals were low on T1WI and T2WI.All lesions had a clear boundary or relatively clear boundary;the intestine or omentum might gather together.Conclusion:DWI and common MRI are helpful in diagnosing abdominopelvic abscess.
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Objective:To discuss the application value of MRI to the brain abscess diagnosis.Methods: 35 cases with the brain abscess,which were verified through clinical,surgical,or pathological diagnosis,were examined through conventional plain scanning,enhancement,FLAIR and DWI,respectively.Results: 45 lesions were found on the 35 cases with brain abscess.Among the 45 lesions,15 displayed the dark line sign on T1W1,19 the shade sign on T2WI,15 the bright band sign on FLAIR;19 lesions displayed hyperintense signal to variable degrees on DWI with low value of ADC,and six hypointense or isointense signal on DWI with high value of ADC;45 lesions had obvious enhancement in the abscess wall and showed a abscess cavity,abscess wall,and edema zone.Conclusions:The dark line sign and ADC value are valuable for MRI diagnosis of brain abscess.DWI should be incorporated into routine examination.
Fluid-attenuated inversion recovery
Brain abscess
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Objective To explore brain abscess in CT scanning technique and diagnostic value. Methods On the operation of puncture and41 pathologically confirmed cases of brain abscess in patients with CT plain scan and enhanced, the CT findings were retrospectively analyzed. Results Of the 41 cases, 12 cases of multiple cerebral abscesses, solitary brain abscess in 29 cases. Solitary brain abscess9 cases which occurred in the parietal lobe, temporal lobe in 7 cases, 5 cases of frontal and parietal lobe, occipital lobe in 5 cases, bilateral ventricles and ventricular anterior horn in 1 cases, 1 cases of 1 cases of cerebellum, thalamus. Ping sweep for the area of low density, low density ring whose inner is visible, enhanced visible morphology is not consistent with ring enhancement. Conclusions Abscess of brain CT image has the character of, the scanning techniques and methods of diagnosis, clinical treatment options and prognosis significance.
Brain abscess
Parietal lobe
Occipital lobe
Lateral ventricles
Frontal lobe
Lobe
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Objective To discuss MRI features of the brain abscess. Methods MRI features of 46 cases with brain abscess, which were proved by biopsy and surgery,were analyzed retrospectively,and a comparision with pathologic findings was made. Results Songle lesion was observed in 36 (78.2%) cases,roughly round shape in 36cases(78.2)%. Evident circular enhancement in imaging enhanced procedure,regular inner margin in 84.6%,regular outer margin in 73.1%,uniformity thickness of circular enhancement in 80.7%. Central fluid-fluid plane sign was observed in 30 cases; Mural nodular was observed in 3 sases;Vice ring sign was observed in23 brain abscesses; No multi locular sign was observed; low signal circular sign on T2-weignted imaging was observed in 34 cases;Ⅱ degree edema was observed in 28 cases. Infective symptom and sign of clinical manifestions were observed in 20 cases. Conclusion Circular enhancement,low signal circular sign on T2-weighted imaging,central fluid-fluid sign, vice ring sign are particular sign of brain abscess. Regular outer and inner margin,uniformity thickness,no mural nodular and pitting on the wall, and infective symptom and sign are very helpful for differential diagnosis.
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Objective To analyze the MRI appearance of liver abscess, especially abnormal hepatic segmental signal, and investigates diagnostic value of abnormal hepatic segmental signal of MRI in liver abscess. Materials and Methods The MRI data of 41 lesions in 24 cases with liver abscess proved by clinical or pathological was analyzed retrospectively.Results Of 24 cases, 13 cases were single lesion, including 7 solitary and 6 multiocular, 11 cases were multiple lesions. 29 lesions was abnormal hepatic segmental signal with hyperintensity in T_2WI and 4 lesions with hypointensity in T_1WI and the other was normal in T_1WI. 22 lesions were wedge shaped, 7 were round shaped, with the scope and size differently. Among 8 cases of MRI enhancement, 5 cases which showed abnormal hepatic segmental signal on plain scan were hepatic segmental enhancement, and other 2 lesions were transient hepatic segmental on CT enhancement which showed hepatic segmental hyperintensity in T_2WI on plain MR scan. The enhanced shape and size on either MRI or CT was same to abnormal hepatic segmental signal in plain scan of MRI.Conclusion Abnormal hepatic segmental signal of MRI, as a consequence of stenosis of portal vein branch, decrease of blood flow, and compensatory increase of hepatic artery flow, it have the important value for diagnosis of liver abscess.
Hepatic abscess
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