title: MRI-DWI improves the early diagnosis of brain abscess induced by Candida albicans in preterm infants.
abstract: OBJECTIVE
  To investigate the diagnostic value of magnetic resonance imaging (MRI) in brain abscess induced by invasive fungal infection (IFI) of the central nervous system.
  
  
  METHODS
  The clinical data of eight preterm infants with IFI of the central nervous system were retrospectively analyzed. All these eight children received three sequential brain MRI modes T1WI, T2WI and DWI during hospitalization and after discharge.
  
  
  RESULTS
  All these eight preterm infants were infected with Candida albicans, seven of which were manifested by brain abscess and four were accompanied by meningitis. MRI of seven infants with brain abscess indicated extensive invasion including involvement of subcortical white matter, deep periventricular white matter and semiovale center white matter. MRI examination was conducted within 11 d following infection on four cases and showed diffuse or multiple miliary nodules, hyper-intense signal on DWI, while insignificant signal changes on T1WI and T2WI. DWI signal nearly disappeared three weeks later. T1WI/T2WI signal changed most significantly 2-4 weeks following infection, with nodules ring-shaped, hyper-intense signal around T1WI and hypo-intense signal in the center. Signal on T2WI was just on the opposite. Severe cases presented fusion of different degrees. Significant enhanced effect was observed on T1WI. Four weeks later, the lesion gradually became fewer and smaller on T1WI, transferred into dot or line-like hyper-intense signal and presented obviously hypo-intense signal on T2WI. Dynamic MRI of two cases showed delayed myelination and corpus callosum thinning.
  
  
  CONCLUSIONS
  MRI-DWI and dynamic MRI changes can improve the early diagnosis of brain abscess induced by Candida albicans in preterm infants.
authors.affiliation: 1 Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang 110004, China ; 2 Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Mao
authors.affiliation: 1 Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang 110004, China ; 2 Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.affiliation: 1 Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang 110004, China ; 2 Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Chen
authors.affiliation: 1 Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang 110004, China ; 2 Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: 1 Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang 110004, China ; 2 Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
authors.forename: Ya-Nan
authors.initials: YN
authors.lastname: Du
authors.affiliation: 1 Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang 110004, China ; 2 Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
authors.forename: Ying-Jie
authors.initials: YJ
authors.lastname: Wang
authors.affiliation: 1 Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang 110004, China ; 2 Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: 1 Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang 110004, China ; 2 Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: 1 Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang 110004, China ; 2 Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Chen
authors.affiliation: 1 Department of Pediatrics, Shengjing Hospital, China Medical University, Shenyang 110004, China ; 2 Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Wang
keywords: Brain abscess; Candida albicans; magnetic resonance imaging; preterm infants
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