gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Article

Send article

Cerebral abscesses and necrotic cerebral tumors: differential diagnosis by perfusion-weighted magnetic resonance imaging

Meeting Abstract

Search Medline for

  • corresponding author G. Iorio - U.O.C. Neurochirurgia, Azienda Ospedaliera “G. Rummo”, Benevento, Italia
  • C. F. Muccio - U.O.C. Neuroradiologia, Azienda Ospedaliera “G. Rummo”, Benevento, Italia
  • A. Bartolini - U.O.C. Neurochirurgia, Azienda Ospedaliera “G. Rummo”, Benevento, Italia
  • A. Cerase - U.O.C. Neuroradiologia Policlinico “Santa Maria alle Scotte”, Siena, Italia
  • G. Esposito - U.O.C. Neuroradiologia, Azienda Ospedaliera “G. Rummo”, Benevento, Italia
  • G. Catapano - U.O.C. Neurochirurgia, Azienda Ospedaliera “G. Rummo”, Benevento, Italia

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 088

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc356.shtml

Published: May 30, 2008

© 2008 Iorio et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Evaluate the usefulness of Perfusion-weighted imaging (PWI) in the differential diagnosis of cerebral lesions presenting with “ring-enhancement” including abscesses, high-grade gliomas, and metastases.

Methods: Nine cerebral abscesses (5 from pyogenes, 4 from Toxoplasma Gondii), 10 glioblastomas, and 5 cerebral metastases in 19 patients underwent gadolinium-anhanced MRI, DWI including calculation of average value of apparent diffusion coefficient (DWI-ADC) of the lesions core, and PWI. At PWI, the medium value of the maximum relative cerebral blood volume (rCBV) was calculated in the gadolinium-enhancing peripheral solid areas and compared with that of the controlaterale normal-appearing white matter, as ratio = rCBV (lesion)/rCBV (controlaterale normal-appearing white matter).

Results: DWI-ADC achieved the differential diagnosis in all cases, except for the 4 abscesses from Toxoplasma Gondii. At PWI, the medium ratio of the rCBV of the capsular portion was 0.72±0.08 (range:0.6-0.82) in the piogenic abscesses, 0.84±0.07 (range:0.75-0.91) in the abscesses from Toxoplasma Gondii, 4.45±1.5 (range: 2.9-8)in the high-grade gliomas, and 3.58±0.68 (range: 3.28-4.27) in the metastases.

Conclusions: PWI seems to be useful in the differential diagnosis of cerebral lesions presenting with “ring-enhancement”. High rCBV values in the peripheral areas should indicate the possibility of a necrotic tumor, while low values tend to indicate an abscess.