Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 1999 Aug;20(7):1252-7.

Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses

B Desprechins  1 , T Stadnik, G Koerts, W Shabana, C Breucq, M Osteaux
Affiliations
Case Reports

Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses

B Desprechins et al. AJNR Am J Neuroradiol. 1999 Aug.

Abstract

The differential diagnosis between intracerebral necrotic tumors and cerebral abscesses is frequently impossible with conventional MR imaging. We report two cases of cerebral abscesses that showed high signal on diffusion-weighted echo planar imaging and a strongly reduced apparent diffusion coefficient. This appearance was not present in our cases of necrotic/cystic gliomas (eight cases) and necrotic metastases (two cases). We believe that diffusion-weighted MR imaging may be a diagnostic clue in cases of cerebral "ring-enhancing" masses.

PubMed Disclaimer

Figures

<sc>fig</sc> 1.
fig 1.
51-year-old man with cerebral abscess. A—C, T2-weighted fast spin-echo (5000/128/2/6 [TR/TE/excitations/slice thickness]) (A) and T1-weighted spin-echo without (600/14/2/6) (B) and with (C) gadolinium injection show nonspecific “ring-enhancing” mass. D—E, Diffusion-weighted (“z” sensitising direction) multishot echo-planar sequence (D) (800/123/5/6) and corresponding ADC map (E) show central hyperintensity on diffusion-weighted image with very low ADC values (.25—.33 × 10−3 mm2/sec).
<sc>fig</sc> 2.
fig 2.
70-year-old man with cerebral abscess. A—C, T2-weighted fast spin-echo (5300/128/2/6) (A) and T1-weighted spin-echo images without (600/14/2/6) (B) and with (C) gadolinium injection show nonspecific “ring-enhancing” mass. Initial radiologic and clinical diagnosis was necrotic glioblastoma. D—E, Diffusion-weighted (“z” sensitizing direction) multishot echo-planar image (D) (800/123/5/6) and corresponding ADC map (E) show important decrease of diffusion with very low ADC values (.21—.34 × 10−3 mm2/sec) suggesting diagnosis of abscess.
<sc>fig</sc> 3.
fig 3.
60-year-old man with glioblastoma multiforme. A—B, Using T2-weighted fast spin-echo (A)(6000/128/2/6) and enhanced T1-weighted spin-echo (B) (600/14/2/6) imaging, differential diagnosis between glioblastoma and abscess is impossible. C—D, Diffusion-weighted (“z” sensitizing direction) multishot echo-planar images (800/123/5/6) (C) and corresponding ADC map (D) show central hypointensity on diffusion-weighted image and hyperintensity on ADC map consistent with diagnosis of tumor.
<sc>fig</sc> 4.
fig 4.
57-year-old woman with cerebral metastasis. A—B, On T2-weighted fast spin-echo (A)(6000/128/1/6) and enhanced T1-weighted spin-echo images (B) (600/14/2/6) the differential diagnosis between metastasis and abscess is impossible. C—D, Diffusion-weighted (“z” sensitizing direction) multishot echo-planar image (800/123/5/6) (C) and corresponding ADC map (D) show central hypointensity on diffusion-weighted image and hyperintensity on ADC map consistent with diagnosis of tumor.
See this image and copyright information in PMC

Comment in

References

    1. Osborn AG. Pyogenic Parenchymal Infections. In: Osborn AG, ed. Diagnostic Neuroradiology St. Louis, MO: Mosby Year-Book; 1994;688-692
    1. Poptani H, Gupta RK, Roy R, Pandey R, Jain VK, Chhabra DK. Characterization of intracranial mass lesions with in vivo proton MR spectroscopy. AJNR Am J Neuroradiol 1995;16:1593-1603 - PMC - PubMed
    1. Ott D, Hennig J, Ernst T. Human brain tumors: assessment with in vivo proton MR spectroscopy. Radiology 1993;186:745-752 - PubMed
    1. Schumacher DJ, Nelson TR, van Sonnenberg E, Meng TC, Hlavin P. Quantification of amino acids in human body fluids by 1H magnetic resonance spectroscopy: a specific test for the identification of abscess. Invest Radiol 1992;27:999-1004 - PubMed
    1. T Ebisu, C Tanaka, M Umeda, et al. Discrimination of brain abscess from necrotic or cystic tumors by diffusion-weighted echo planar imaging. Magn Reson Imaging 1996;14:1113-1116 - PubMed

Publication types