Evaluation of cerebral abscesses by diffusion-weighted MR imaging and MR spectroscopy

Tsui, Edmund; Chan, J. H. M.; Cheung, Y.K; Lai, K F; Fong, Dawson; Sh, Ng

doi:10.1016/s0895-6111(02)00018-6

Cited by 19 publications

(8 citation statements)

References 13 publications

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“…The underlying pathophysiology is not known but probably due to sterile liquefaction necrosis. In sterile liquefaction necrosis, it may contain creamy pus like material with polymorphonuclear leukocytes 12 .…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance spectroscopy in the diagnosis and etiological definition of brain bacterial abscesses

Morais

Zanardi

Faria

2007

Arq. Neuro-Psiquiatr.

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-We report two patients with bacterial brain abscesses whose etiological diagnosis was correctly proposed by association of diffusion weighted images (DWI) and magnetic resonance spectroscopy (MRS) with conventional MRI. Both patients presented ring enhancing lesions with evidences of restricted diffusion. On MRS, the abscess caused by aerobic bacteria presented lactate and aminoacids peaks and the abscess caused by anaerobic facultative bacteria showed also acetate and succinate peaks. These results are in agreement with an unique previous study that related MRS pattern with bacterial etiology. Conventional MRI, associated with DWI and MRS is effective in diagnosing bacterial abscess and promising in exploring its etiology.KEY WORDS: pyogenic bacterial abscess, spectroscopy, diffusion, magnetic resonance. Espectroscopia por ressonância magnética no diagnóstico e definição etiológica dos abscessos bacterianos cerebraisRESUMO -Apresentamos dois pacientes com abscessos bacterianos cerebrais cujos diagnósticos etiológicos foram corretamente auxiliados pela associação de difusão e espectroscopia à ressonância magnética convencional. Ambos apresentavam lesões com captação anelar de contraste e evidências de restrição à difusão de moléculas de água. Na espectroscopia, o abscesso causado por bactéria aeróbia apresentou picos de lactato e aminoácidos, enquanto o abscesso causado por bactéria anaeróbia facultativa mostrou, além destes, picos de acetato e succinato. Tais resultados concordam com um único estudo prévio que relacionou o padrão de espectroscopia nos abscessos com sua etiologia bacteriana. A ressonância magnética convencional, associada à difusão e à espectroscopia é uma técnica eficiente no diagnóstico de abscessos bacterianos e promissora em explorar suas etiologias. PALAVRAS-CHAVE: abscesso cerebral piogênico, espectroscopia, difusão, ressonância magnética.

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Section: Discussionmentioning

confidence: 99%

Magnetic resonance spectroscopy in the diagnosis and etiological definition of brain bacterial abscesses

Morais

Zanardi

Faria

2007

Arq. Neuro-Psiquiatr.

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“…Therefore, no peaks of NAA, Cr, or Cho should be detected. A typical abscess spectrum shows the presence of cytosolic amino acids (leucine, isoleucine, and valine) [Garg et al, 2004;Kadota et al, 2001;Lai et al, 2002;Remy et al,1995;Tsui et al, 2002], which are the products of proteolysis caused by enzymes released from neutrophil cells. Because these metabolites have never been detected in neoplasms, their detection is strongly indicative of a cerebral abscess [Kapsalaki et al, 2008].…”

Section: Abscessesmentioning

confidence: 99%

The Role of Magnetic Resonance Spectroscopy in the Diagnosis of Ring Enhancing Lesions

Eftychia¹,

Gotsis²,

Tsougos³

et al. 2012

Neuroimaging - Clinical Applications

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“…3). 5,7,8,10,11,14,18,19,23,25,26,30,32,36,38,39,42,46,47,51,52,58 Cerebral abscesses contain no normal neurons. 11,32 Therefore, no peaks of NAA or PCr/Cr should be detected.…”

Section: Spectral Characteristicsmentioning

confidence: 99%

“…11,32 Cytosolic amino acids (leucine, isoleucine, and valine) are usually detected in cerebral abscesses. 11,14,23,30,32,39,47,52,58 The detected amino acids are the products of proteolysis caused by enzymes released from neutrophil cells. 23,32,47 Because these metabolites have never been detected in neoplasms, their detection is strongly indicative of a cerebral abscess.…”

Section: Spectral Characteristicsmentioning

confidence: 99%

“…32,47 The presence of succinate has therefore been seen by most investigators as evidence of anaerobic bacterial activity. 23,32,46,58 The presence of acetate and succinate peaks has been associated with pyogenic brain abscesses, especially those involving obligate anaerobes or a mixture of obligate and facultative anaerobes. 13,23,32,46 On the other hand, the absence of acetate and succinate has been associated with abscesses caused by aerobes and facultative anaerobes.…”

Section: Neurosurg Focus / Volume 24 / June 2008mentioning

confidence: 99%

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The role of proton magnetic resonance spectroscopy in the diagnosis and categorization of cerebral abscesses

Eftychia¹,

Gotsis

Fountas

2008

FOC

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✓ Despite recent advances in neuroimaging, differentiation between cerebral abscesses and necrotic tumors with ring-type contrast enhancement can be puzzling at times. The introduction of advanced imaging techniques, such as diffusion-weighted imaging, has contributed to the identification of cerebral abscesses. However, differentiation may be impossible with imaging only. In this review the authors evaluate the role of proton magnetic resonance (MR) spectroscopy in differentiating between cerebral abscesses and necrotic tumors and address the spectral characteristics of intracranial abscesses. A large number of metabolites not detected in the normal brain spectra may be detected and give valuable information regarding the nature of the abscesses. Proton MR spectroscopy is a safe, noninvasive diagnostic modality, which could significantly increase the accuracy and specificity of conventional MR imaging in differentiating between malignant tumors and cerebral abscesses and provide valuable information regarding the cause of an abscess, as well as, its response to the chosen treatment.

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Evaluation of cerebral abscesses by diffusion-weighted MR imaging and MR spectroscopy

Cited by 19 publications

References 13 publications

Magnetic resonance spectroscopy in the diagnosis and etiological definition of brain bacterial abscesses

Magnetic resonance spectroscopy in the diagnosis and etiological definition of brain bacterial abscesses

The Role of Magnetic Resonance Spectroscopy in the Diagnosis of Ring Enhancing Lesions

The role of proton magnetic resonance spectroscopy in the diagnosis and categorization of cerebral abscesses

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