ABSTRACT
PURPOSE: To describe magnetic resonance (MR) imaging findings in acute infectious cellulitis and assess its value for the diagnosis of severe necrotizing forms. MATERIALS AND METHODS: Spin-echo (SE) T1- and T2-weighted imaging was performed in 36 patients with acute infectious cellulitis. T1-weighted SE images obtained after injection of a paramagnetic contrast agent were also obtained when an abscess was suspected on precontrast images. Sixteen patients underwent surgical débridement, along with fascial and muscle biopsy. RESULTS: Distinct MR imaging features were found in patients with necrotizing soft-tissue infections, that is, hyperintense signal on T2-weighted images at the deep fasciae, poorly defined areas of hyperintense signal on T2-weighted images within muscles, and peripheral enhancement on contrast material-enhanced T1-weighted images. In nonnecrotizing cellulitis, signal intensity abnormalities were seen only in the subcutaneous fat. CONCLUSION: The precise extent of acute cellulitis and the presence of necrotizing soft-tissue infections can be determined with MR imaging, particularly on T2-weighted images.
Subject(s)
Cellulitis/diagnosis , Infections/complications , Magnetic Resonance Imaging , Abdominal Muscles , Abscess/diagnosis , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Cellulitis/etiology , Cellulitis/pathology , Extremities , Fasciitis/diagnosis , Fasciitis/pathology , Female , Humans , Male , Middle Aged , Necrosis , Prospective StudiesABSTRACT
To assess the influence of gestational age (GA) and sleep states on respiratory pauses (RP), apnea index (AI) and periodic breathing (PB), we made polygraphic recordings on 40 normal newborns with GA of 31-41 weeks. Only 2 out of a total of 2,406 RP were obstructive. We never recorded greater than 15-second duration central RP. 10-15 s RP were rare, 2% of the total number observed in newborns with a GA of 31-38 weeks. Selective flattening of thoracic respiratory movements (while abdominal and nasal respirations persisted) were observed in all age-groups. In all GA groups, RP frequency, AI and percent of PB were significantly higher in active sleep, compared to quiet sleep. In indeterminate sleep, values were intermediate. RP frequency and AI were high in newborns with GA of up to 38 weeks; they decreased significantly only at GA of 39-41 weeks; i.e. according to RP criteria, newborns with a GA of 37-38 weeks were similar to prematures, but not to 39- to 41-week GA newborns. There were no significant differences between twins and singletons. We did not find significant correlations between RP incidence on one hand and respiratory rate or out-of-phase occurrence of thoracic and abdominal respiratory movements in the other. 17% of RP occurred after gross body movements.