Discriminating pyogenic brain abscesses, necrotic glioblastomas, and necrotic metastatic brain tumors by means of susceptibility-weighted imaging.
Eur Radiol
; 25(5): 1413-20, 2015 May.
Article
em En
| MEDLINE
| ID: mdl-25465712
ABSTRACT
OBJECTIVES:
To investigate the feasibility of using susceptibility-weighted imaging (SWI) to discriminate abscesses and necrotic tumours.METHODS:
Twenty-one patients with pyogenic abscesses, 21 patients with rim-enhancing glioblastomas and 23 patients with rim-enhancing metastases underwent SWI. Intralesional susceptibility signal (ILSS) was analyzed employing both qualitative (QL) and semi-quantitative (SQ) methods. Logistic regression models and receiver operating characteristic analysis were used to demonstrate the discriminating power.RESULTS:
In QL analysis, ILSSs were seen in 12 of 21 abscesses, in 20 of 21 glioblastomas, and in 16 of 23 metastases. In SQ analysis, a low degree of ILSS (85.8 %) was in the majority of abscesses and a high degree of ILSS (76.2 %) was in the majority of glioblastomas. SQ model was significantly better than QL model in distinguishing abscesses from glioblastomas (P < .001). A derived ILSS cutoff grade of 1 or less was quantified as having a sensitivity of 85.7 %, specificity of 90.5 %, accuracy of 88.1 %, PPV of 90.0 %, and NPV of 86.4 % in distinguishing abscesses from glioblastomas.CONCLUSIONS:
A high-grade ILSS may help distinguish glioblastomas from abscesses and necrotic metastatic brain tumours. The lack of ILSS or low-grade ILSS can be a more specific sign in the imaging diagnosis of abscesses. KEY POINTS ⢠ILSS of SWI can contribute to differential diagnosis of rim-enhanced mass. ⢠Low-grade ILSS can be a more specific sign in abscesses. ⢠High-grade ILSS may help distinguish necrotic glioblastomas from abscesses. ⢠ILSS spreads across the four ILSS categories in metastases.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Encéfalo
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Abscesso Encefálico
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Neoplasias Encefálicas
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Imageamento por Ressonância Magnética
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Glioblastoma
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Qualitative_research
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article