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Research ArticleBrain

Use of Diffusion-Weighted MR Imaging in Differential Diagnosis Between Intracerebral Necrotic Tumors and Cerebral Abscesses

Brigitte Desprechins, Tadeusz Stadnik, Guus Koerts, Wael Shabana, Catherine Breucq and Michel Osteaux
American Journal of Neuroradiology July 1999, 20 (7) 1252-1257;
Brigitte Desprechins
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Tadeusz Stadnik
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Guus Koerts
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Wael Shabana
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Catherine Breucq
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Michel Osteaux
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    fig 1.

    51-year-old man with cerebral abscess.

    A—C, T2-weighted fast spin-echo (5000/128/2/6 [TR/TE/excitations/slice thickness]) (A) and T1-weighted spin-echo without (600/14/2/6) (B) and with (C) gadolinium injection show nonspecific “ring-enhancing” mass.

    D—E, Diffusion-weighted (“z” sensitising direction) multishot echo-planar sequence (D) (800/123/5/6) and corresponding ADC map (E) show central hyperintensity on diffusion-weighted image with very low ADC values (.25—.33 × 10−3 mm2/sec).

  • fig 2.
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    fig 2.

    70-year-old man with cerebral abscess.

    A—C, T2-weighted fast spin-echo (5300/128/2/6) (A) and T1-weighted spin-echo images without (600/14/2/6) (B) and with (C) gadolinium injection show nonspecific “ring-enhancing” mass. Initial radiologic and clinical diagnosis was necrotic glioblastoma.

    D—E, Diffusion-weighted (“z” sensitizing direction) multishot echo-planar image (D) (800/123/5/6) and corresponding ADC map (E) show important decrease of diffusion with very low ADC values (.21—.34 × 10−3 mm2/sec) suggesting diagnosis of abscess.

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    fig 3.

    60-year-old man with glioblastoma multiforme.

    A—B, Using T2-weighted fast spin-echo (A)(6000/128/2/6) and enhanced T1-weighted spin-echo (B) (600/14/2/6) imaging, differential diagnosis between glioblastoma and abscess is impossible.

    C—D, Diffusion-weighted (“z” sensitizing direction) multishot echo-planar images (800/123/5/6) (C) and corresponding ADC map (D) show central hypointensity on diffusion-weighted image and hyperintensity on ADC map consistent with diagnosis of tumor.

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    fig 4.

    57-year-old woman with cerebral metastasis.

    A—B, On T2-weighted fast spin-echo (A)(6000/128/1/6) and enhanced T1-weighted spin-echo images (B) (600/14/2/6) the differential diagnosis between metastasis and abscess is impossible.

    C—D, Diffusion-weighted (“z” sensitizing direction) multishot echo-planar image (800/123/5/6) (C) and corresponding ADC map (D) show central hypointensity on diffusion-weighted image and hyperintensity on ADC map consistent with diagnosis of tumor.

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American Journal of Neuroradiology
Vol. 20, Issue 7
1 Jul 1999
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Cite this article
Brigitte Desprechins, Tadeusz Stadnik, Guus Koerts, Wael Shabana, Catherine Breucq, Michel Osteaux
Use of Diffusion-Weighted MR Imaging in Differential Diagnosis Between Intracerebral Necrotic Tumors and Cerebral Abscesses
American Journal of Neuroradiology Jul 1999, 20 (7) 1252-1257;

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Use of Diffusion-Weighted MR Imaging in Differential Diagnosis Between Intracerebral Necrotic Tumors and Cerebral Abscesses
Brigitte Desprechins, Tadeusz Stadnik, Guus Koerts, Wael Shabana, Catherine Breucq, Michel Osteaux
American Journal of Neuroradiology Jul 1999, 20 (7) 1252-1257;
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  • Restricted Diffusion within Ring Enhancement Is Not Pathognomonic for Brain Abscess
  • Diffusion-weighted MR Imaging of Intracerebral Masses: Comparison with Conventional MR Imaging and Histologic Findings
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