[Magnetic resonance imaging (MRI) of liver and brain in hematologic-oncologic patients with fever of unknown origin].
OBJECTIVE
To examine the advantage of liver and brain MRI in clinically anomalous haematological patients with fever of unknown origin.


METHODS
Twenty liver MRI (T2-TSE, T2-HASTE, T1-FLASH +/- Gd dynamic) and 16 brain MRI (T2-TSE, FLAIR, T1-TSE +/- Gd) were performed searching for a focus of fever with a suspected organ system. Comparison with clinical follow-up.


RESULTS
A focus was detected in 11/20 liver MRI. Candidiasis (n = 3), mycobacteriosis (n = 2), relapse of haematological disease (n = 3), graft versus host disease (n = 1), non-clarified (n02). The remaining 9 cases with normal MRI were not suspicious of infectious hepatic disease during follow-up. In brain MRI, 3/16 showed a focus (toxoplasmosis, aspergillosis, mastoiditis). Clinical indication for an infectious involvement of the brain was found in 4/16 cases 2-5 months after initially normal brain MRI. No suspicion of an infectious involvement of brain was present in the remaining 9/16 cases.


CONCLUSIONS
In case of fever of unknown origin and suspicion of liver involvement, MRI of the liver should be performed due to data given in literature and its sensitivity of 100%. Because of the delayed detectability of cerebral manifestations, in cases of persisting suspicion even a previously normal MRI of the brain should be repeated.
Heussel
C P
CP
Klinik und Poliklinik für Radiologie, Johannes Gutenberg-Universität Mainz. HEUSSEL@GOOFY.ZDV.UNI-MAINZ.DE
Kauczor
H U
HU
Heussel
G
G
Poguntke
M
M
Schadmand-Fischer
S
S
Mildenberger
P
P
Thelen
M
M
D001228:Aspergillosis / Q000150:complications / Q000175:diagnosis; D001921:Brain / Q000473:pathology*; D002177:Candidiasis / Q000175:diagnosis; D003141:Communicable Diseases / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology*; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000175:diagnosis; D019337:Hematologic Neoplasms / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009164:Mycobacterium Infections / Q000175:diagnosis; D012008:Recurrence; D016781:Toxoplasmosis, Cerebral / Q000175:diagnosis