title: Distinction between pyogenic brain abscess and necrotic brain tumour using 3-tesla MR spectroscopy, diffusion and perfusion imaging.
abstract: The purpose of this study is to compare the effectiveness of relative cerebral blood volume, apparent diffusion coefficient and spectroscopic imaging in differentiating between cerebral abscesses and necrotic tumours. In the prospective study, a 3-tesla MR unit was used to perform proton MR spectroscopy, diffusion and perfusion imaging in 20 patients with cerebral abscesses and 26 patients who had solitary brain tumours (14 high-grade gliomas and 12 metastases). We found the mean apparent diffusion coefficient value at the central cavities of the cerebral abscesses to be significantly lower than in necrotic tumours. The mean relative cerebral blood volume values of the necrotic tumour wall were statistically significantly higher than the mean relative cerebral blood volume values of the cerebral abscess wall by the Student's t-test. The proton spectra obtained revealed amino acids only in the cerebral abscesses. Although the conventional MRI characteristics of cerebral abscesses and necrotic tumours may sometimes be similar, diffusion, perfusion-weighted and spectroscopic MRI enables distinction between the two.
authors.affiliation: Department of Radiology, Kaohsiung Municipal Hsiao-Kang Hospital, 482 San-Ming Road, Hsiao-Kang District, Kaohsiung, Taiwan.
authors.forename: I-C
authors.initials: IC
authors.lastname: Chiang
authors.forename: T-J
authors.initials: TJ
authors.lastname: Hsieh
authors.forename: M-L
authors.initials: ML
authors.lastname: Chiu
authors.forename: G-C
authors.initials: GC
authors.lastname: Liu
authors.forename: Y-T
authors.initials: YT
authors.lastname: Kuo
authors.forename: W-C
authors.initials: WC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001810:Blood Volume / Q000502:physiology; D001921:Brain / Q000473:pathology; D001922:Brain Abscess / Q000175:diagnosis* / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D002560:Cerebrovascular Circulation; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010477:Perfusion / Q000379:methods; D011446:Prospective Studies