title: Diagnostic value of diffusion-weighted magnetic resonance imaging in pelvic abscesses.
abstract: OBJECTIVE
  The objective of this study was to prospectively assess the added value of gadolinium-enhanced and diffusion-weighted (DWI) magnetic resonance imaging (MRI) to pelvic T2-weighted MRI for diagnosis of deep pelvic abscesses.
  
  
  METHODS
  Twenty-nine patients with suspected abscess and a control group of 43 patients underwent T2-weighted, gadolinium-enhanced, T1-weighted and DWI magnetic resonance sequences. Three readers (R1, R2, R3) scored likelihood of abscess on standard MRI, standard MRI + gadolinium, and standard MRI + DWI.
  
  
  RESULTS
  Twenty-nine patients had 36 abscesses. On standard MRI, R1 achieved area under the receiver operating characteristic (ROC) curve (AUC) of 0.97, sensitivity 92%, and specificity 100%. For R2, these figures were 0.87, 81%, and 100%, and for R3, these were 0.85, 83%, and 79%. After gadolinium, R2 improved AUC to 0.97 (P = 0.005), and R3 to 0.95 (P = 0.006). Standard MRI + DWI yielded improved AUC for all readers (P = 0.15, 0.001, and 0.001 for R1, R2, R3, respectively).
  
  
  CONCLUSIONS
  Addition of gadolinium or DWI to T2-weighted MRI improves performances for the diagnosis of deep pelvic abscess. Diffusion-weighted imaging may replace gadolinium.
authors.affiliation: From the *Department of Radiology, Hôpital Robert Debré, Reims; †Department of Radiology, Hôpital Lariboisière, Paris; and Departments of ‡Statistics and §Obstetrics and Gynaecology, Hôpital Robert Debré, Reims, France.
authors.forename: Truong Luong Francis
authors.initials: TL
authors.lastname: Nguyen
authors.forename: Philippe
authors.initials: P
authors.lastname: Soyer
authors.forename: Coralie
authors.initials: C
authors.lastname: Barbe
authors.forename: Olivier
authors.initials: O
authors.lastname: Graesslin
authors.forename: Sophie
authors.initials: S
authors.lastname: Veron
authors.forename: Elisa
authors.initials: E
authors.lastname: Amzallag-Bellenger
authors.forename: Catherine
authors.initials: C
authors.lastname: Tomas
authors.forename: Christine
authors.initials: C
authors.lastname: Hoeffel
mesh_terms: D000038:Abscess / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D034161:Pelvic Infection / Q000473:pathology*; D010388:Pelvis / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine