Magnetic resonance imaging in adults presenting with severe acute infectious cellulitis

Saiag, P.

doi:10.1001/archderm.130.9.1150

Cited by 24 publications

(20 citation statements)

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“…The development of more evocative symptoms often reflects the severity of the infectious process [1, 15]. The infection spreads rapidly to adjacent areas, the skin takes a more dusky tone with diffuse erythema and oedema, and blisters that are typically haemorrhagic may appear [7, 16].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…It has been suggested that magnetic resonance imaging (MRI) may represent an accurate, non-invasive tool for the early diagnosis of fascial necrosis [15, 22, 23, 24]. In patients with negligible or absent skin disease and acute swelling, MRI findings (thickening of the skin and high T 2 -weighted image intensity) are limited to the skin adipose tissue and superficial fascia.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…In patients with negligible or absent skin disease and acute swelling, MRI findings (thickening of the skin and high T 2 -weighted image intensity) are limited to the skin adipose tissue and superficial fascia. In patients with skin disease and systemic manifestations (confusion, hypovolaemia, septic shock), these MRI findings are also present in the deep fascia or muscle [15, 24]. By precisely defining the extent of the infection, MRI may also help to plan surgical treatment [15, 22].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…However, no MRI sign alone is diagnostic of any particular type of infection, and many other diseases may result in an increased water content of the soft tissue [15, 23]. More particularly, confusion between cellulitis and NF can occur with MRI [23].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…Compared with MRI studies, sonography and CT do not have as high an accuracy for differentiation between cellulitis and NF because of their lower sensitivity in detecting deep fascial fluid [15, 22]. …”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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Group A Beta-Haemolytic Streptococcal Necrotising Fasciitis: Early Diagnosis and Clinical Features

Simonart

2004

Dermatology

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Necrotising fasciitis (NF) due to group A β-haemolytic streptococci (GAS) is a rare but still life-threatening soft-tissue infection characterised by rapidly spreading inflammation and subsequent necrosis of the muscle fascia and of the surrounding tissues. Previous studies have emphasised that the outcome of patients with NF depends essentially on early diagnosis and treatment, consisting of extensive surgical debridement, along with appropriate antibiotic therapy. However, one of the striking features of the published series of GAS NF is that there was a delay in diagnosis in several cases, which underscores the difficulty of the early diagnosis of the condition. The goal of this article was to review the clinical features and diagnostic tools that could facilitate the early recognition of GAS NF.

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Section: Clinical Featuresmentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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Group A Beta-Haemolytic Streptococcal Necrotising Fasciitis: Early Diagnosis and Clinical Features

Simonart

2004

Dermatology

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Diagnosis of Skin Disease

BSc¹,

BSc²

2010

Rook's Textbook of Dermatology

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Detection of soft‐tissue abscess: Comparison of diffusion‐weighted imaging to contrast‐enhanced MRI

Chun

Jung

Baik

et al. 2017

Magnetic Resonance Imaging

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Purpose: To compare the diagnostic performances of diffusion-weighted imaging (DWI)-combined magnetic resonance imaging (MRI) performed without intravenous contrast material with gadolinium contrast material-enhanced (CE) MRI for diagnosing soft-tissue abscesses. Materials and Methods: In all, 119 patients (mean age: 56 years) with skin and soft-tissue infection who underwent contrast-enhanced MRI with DWI (b 5 0-800) were included. Two readers independently reviewed both image setsnonenhanced conventional MR images (NECI)1DWI, and NECI1contrast enhanced fat-suppressed T 1 -weighted imaging (CEFST 1 )-for the presence of abscess. To compare the diagnostic performance for diagnosing abscess between NECI1DWI, and NECI1CEFST 1 , McNemar tests for sensitivity and specificity, and areas under the receiver-operating characteristic curves (AUC) analyses, were performed. Interobserver agreements (j) were calculated for each image set. Results: Forty of 119 patients were confirmed with abscess. Sensitivity and specificity were 90.0% and 88.6% for NECI1DWI, and 82.5% and 89.9% for NECI1CEFST 1 in reader 1, whereas 77.5% and 88.6% for NECI1DWI, and 80.0% and 84.8% for NECI1CEFST 1 in reader 2, respectively. There was no significant difference in sensitivities and specificities between NECI1DWI and NECI1CEFST 1 (reader 1: P 5 0.453, P 5 0.999, reader 2: P 5 0.999, P 5 0.453, respectively). Likewise, AUC analyses demonstrated no significant difference between NECI1DWI and NECI1CEFST 1 (P 5 0.53 in reader 1, P 5 0.97 in reader 2). Interobserver agreement between the two readers was substantial in both image sets: 0.80 (NECI1DWI), and 0.76 (NECI1CEFST 1 ). Conclusion: Noncontrast-enhanced MRI with DWI has comparable diagnostic performance to contrast-enhanced MRI for diagnosing soft-tissue abscesses. Level of Evidence: 3 Technical Efficacy: Stage 2

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Magnetic resonance imaging in adults presenting with severe acute infectious cellulitis

Cited by 24 publications

References 0 publications

Group A Beta-Haemolytic Streptococcal Necrotising Fasciitis: Early Diagnosis and Clinical Features

Group A Beta-Haemolytic Streptococcal Necrotising Fasciitis: Early Diagnosis and Clinical Features

Diagnosis of Skin Disease

Detection of soft‐tissue abscess: Comparison of diffusion‐weighted imaging to contrast‐enhanced MRI

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