Artikel
MRI technology diffusion in managing therapy of brain abscesses
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Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: Evaluate the efficacy of the technique by measuring the apparent diffusion coefficient (DWI-ADC) in RM control of therapy of cerebral abscesses (CA).
Methods: Five patients (4 F 1M; age 39-80 years) with 6 CA from pyogeni (3F and 1M) and 4 CA from Toxoplasma gondii (1F) were studied with MRI 1.5T including DWI-ADC at time of diagnosis and after therapy (range control RM: 1-20 months). Three CA from pyogeni were treated surgically using stereotactic biopsy, three CA from pyogeni and abscesses from Toxoplasma were treated with antibiotic therapy alone. MRI signal, DWI and ADC measure in abscessual cavity were correlated with the clinical data.
Results: At time of diagnosis, the abscesses from pyogeni had signal T1 hypointense, T2 and DWI hyiperintense and low ADC values (0.46±0.07x10-3 mm2/sec), those from Toxoplasma showed a signal T1 and DWI hysointense, T2 hyperintense and high ADC values (mean: 1.12±0.14x10-3 mm2/sec). Two abscesses from pyogeni surgically treated and those three treated with antibiotic therapy, showed an increase in ADC values, together with clinical improvement. An abscess surgically drained at the MRI control presented again low ADC values in the cavity evacuated, as re-accumulation of pus, along with clinical deterioration. During the medical treatment, Toxoplasma abscesses showed reduction of ADC values.
Conclusions: The technique DWI-ADC is useful to evaluate the efficacy of therapy of brain abscesses. The changes in ADC values seem to correlate with a good therapeutic response.