Differentiation of pyogenic and fungal brain abscesses with susceptibility-weighted MR sequences

Antulov, Ronald; Dolić, Krešimir; Fruehwald-Pallamar, Julia; Miletić, Damir; Thurnher, Majda M.

doi:10.1007/s00234-014-1411-6

Cited by 35 publications

(18 citation statements)

References 25 publications

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“…In a patient with widespread metastatic disease, a peripherally enhancing intracranial mass is likely a metastasis. 5,6 In conclusion, combining advanced MRI sequences and novel PET tracers may allow a confident diagnosis of intracranial lesions. GaTate-PET/CT targets masses expressing somatostatin receptors and is widely used for evaluating neuroendocrine tumours.…”

Section: Discussionmentioning

confidence: 95%

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Complementary role of MRI and positron emission tomography in diagnosing cerebral abscess in a patient with metastatic paraganglioma

Lasocki

Hicks

2018

J Med Imag Rad Onc

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Technological advances have increased the ability of imaging to provide an accurate preoperative diagnosis of an intracranial mass. We present the case of a patient with metastatic paraganglioma, who presented with headache and depressed conscious state. We had chronic tachycardia and low-grade fevers due to increased catecholamine secretion, which limited his clinical assessment. The combination of novel positron emission tomography tracers and advanced magnetic resonance imaging techniques was able to provide a confident preoperative diagnosis of a pyogenic intracranial abscess, which was not suspected clinically. This allowed appropriate therapy to be instituted until the patient's clinical state improved sufficiently for neurosurgery to be performed.

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Section: Discussionmentioning

confidence: 95%

“…The diagnosis of an abscess became confident after MRI demonstrated a characteristic 'dualrim sign' on SWI, which has been reported as being specific for pyogenic abscesses. 5,6 In conclusion, combining advanced MRI sequences and novel PET tracers may allow a confident diagnosis of intracranial lesions.…”

Section: Discussionmentioning

confidence: 95%

Complementary role of MRI and positron emission tomography in diagnosing cerebral abscess in a patient with metastatic paraganglioma

Lasocki

Hicks

2018

J Med Imag Rad Onc

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“…9 Recent investigations into susceptibility-weighted MRI sequences have been helpful in identifying differentiating characteristics between bacterial and fungal abscesses. 3 As will be discussed, neuroradiological techniques can be useful for differentiating an abscess from other etiologies of intracranial mass lesions. In our case series, we presented 2 unique cases.…”

Section: Discussionmentioning

confidence: 99%

Nocardia amikacinitolerans and cytomegalovirus: distinctive clinical and radiological characterization of the rare etiologies of brain abscesses: report of 2 cases

Quinoa¹,

Jumah²,

Narayan³

et al. 2019

Neurosurgical Focus

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Central nervous system infections in immunosuppressed patients are rare but potentially lethal complications that require swift diagnoses and intervention. While the differential diagnosis for new lesions on neuroradiological imaging of immunosuppressed patients typically includes infections and neoplasms, image-based heuristics to differentiate the two has been shown to have variable reliability.The authors describe 2 rare CNS infections in immunocompromised patients with atypical physical and radiological presentations. In the first case, a 59-year-old man, who had recently undergone a renal transplantation, was found to have multifocal Nocardia amikacinitolerans abscesses masquerading as neoplasms on diffusion-weighted imaging (DWI); in the second case, a 33-year-old man with suspected recurrent Hodgkin’s lymphoma was found to have a nonpyogenic abscess with cytomegalovirus (CMV) encephalitis.As per review of the literature, this appears to be the first case of brain abscess caused by N. amikacinitolerans, a recently isolated superbug. Despite confirmation through brain biopsy later on in case 1, the initial radiological appearance was atypical, showing subtle diffusion restriction on DWI. Similarly, the authors present a case of CMV encephalitis that presented as a ring-enhancing lesion, which is extremely rare. Both cases draw attention to the reliability of neuroimaging in differentiating an abscess from a neoplasm.

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“…9) [41]. Susceptibility-weighted imaging in a pyogenic abscess can demonstrate a thin rim of hypointensity or dual-rim sign but in fungal abscesses, one finds a prominent peripheral rim or central susceptibility effects [42,43]. These appearances are different than for CNS-PTLD which demonstrates a peripheral pattern of punctate susceptibility-weighted hypointensities.…”

Section: Abscessmentioning

confidence: 99%

Primary central nervous system post-transplant lymphoproliferative disorders: the spectrum of imaging appearances and differential

et al. 2019

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Objective: Central nervous system post-transplant lymphoproliferative disorder (CNS-PTLD) is a rare disease that presents with non-specific signs and symptoms. The purpose of this article is to present the imaging appearances of CNS-PTLD by magnetic resonance imaging. We highlight the differential diagnostic considerations including primary central nervous system lymphoma, glioblastoma, cerebral abscess, and metastatic disease. This is an important topic to review since in daily practice the diagnosis of CNS-PTLD is often not initially considered when present due to its rarity and the lack of radiologists' familiarity with the disease. Conclusion: Knowing the unique imaging features of CNS-PTLD narrows the differential diagnosis, facilitates the diagnostic work-up, and optimizes making the diagnosis. Advanced MRI data for CNS PTLD is limited but is promising for helping with narrowing the differential diagnosis.

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Differentiation of pyogenic and fungal brain abscesses with susceptibility-weighted MR sequences

Cited by 35 publications

References 25 publications

Complementary role of MRI and positron emission tomography in diagnosing cerebral abscess in a patient with metastatic paraganglioma

Complementary role of MRI and positron emission tomography in diagnosing cerebral abscess in a patient with metastatic paraganglioma

Nocardia amikacinitolerans and cytomegalovirus: distinctive clinical and radiological characterization of the rare etiologies of brain abscesses: report of 2 cases

Primary central nervous system post-transplant lymphoproliferative disorders: the spectrum of imaging appearances and differential

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