Diffusion-weighted magnetic resonance imaging for detection of postoperative intracranial pyogenic abscesses in neurosurgery.


Journal

Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000

Informations de publication

Date de publication:
05 2019
Historique:
received: 27 09 2018
accepted: 08 03 2019
pubmed: 28 3 2019
medline: 7 3 2020
entrez: 28 3 2019
Statut: ppublish

Résumé

Diffusion-weighted magnetic resonance imaging (MRI-DWI) is the modality of choice for detecting intracranial abscesses; however, it is unclear whether prior brain surgery has an influence on its diagnostic value. Thus, we assessed the robustness of MRI-DWI and determination of an ADC cutoff value for detecting intracranial abscesses in patients who underwent brain surgery. We retrospectively evaluated 19 patients prior to surgery for postoperative supratentorial parenchymal abscesses by means of MRI-DWI. Forty randomly selected patients with routine postoperative MRI-DWI were used for comparative analyses. Clinical and serum biomarkers (C-reactive protein, interleukin-6, white blood cell count) as well as from results of early postoperative imaging findings (computed tomography and/or MRI scan) were recorded. Additionally, ADC values, T1±gadolinium, and T2/fluid-attenuated inversion recovery sequences were investigated. After initial surgery, early postoperative control imaging showed evidence of hemorrhage and/or hemostatic agents within the resection cavity in 10/19 patients of the abscess group and in 16/40 patients of the control group. No postoperative ischemia was detected. Neither hemostatic agents nor blood affected the mean ADC values in both the reference group (blood 2.96 ± 0.22 × 10 MRI-DWI provides a robust tool to discriminate postoperative abscess formation from normal postoperative changes.

Sections du résumé

BACKGROUND
Diffusion-weighted magnetic resonance imaging (MRI-DWI) is the modality of choice for detecting intracranial abscesses; however, it is unclear whether prior brain surgery has an influence on its diagnostic value. Thus, we assessed the robustness of MRI-DWI and determination of an ADC cutoff value for detecting intracranial abscesses in patients who underwent brain surgery.
METHODS
We retrospectively evaluated 19 patients prior to surgery for postoperative supratentorial parenchymal abscesses by means of MRI-DWI. Forty randomly selected patients with routine postoperative MRI-DWI were used for comparative analyses. Clinical and serum biomarkers (C-reactive protein, interleukin-6, white blood cell count) as well as from results of early postoperative imaging findings (computed tomography and/or MRI scan) were recorded. Additionally, ADC values, T1±gadolinium, and T2/fluid-attenuated inversion recovery sequences were investigated.
RESULTS
After initial surgery, early postoperative control imaging showed evidence of hemorrhage and/or hemostatic agents within the resection cavity in 10/19 patients of the abscess group and in 16/40 patients of the control group. No postoperative ischemia was detected. Neither hemostatic agents nor blood affected the mean ADC values in both the reference group (blood 2.96 ± 0.22 × 10
CONCLUSION
MRI-DWI provides a robust tool to discriminate postoperative abscess formation from normal postoperative changes.

Identifiants

pubmed: 30915573
doi: 10.1007/s00701-019-03875-8
pii: 10.1007/s00701-019-03875-8
doi:

Substances chimiques

Biomarkers 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

985-993

Auteurs

Christoph Schwartz (C)

Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Department of Neurosurgery, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria.

Markus Lenski (M)

Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.

Alexander Romagna (A)

Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Department of Neurosurgery, Christian-Doppler-Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria.
Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Canada.

Christian Schichor (C)

Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.

Joerg-Christian Tonn (JC)

Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.

Hartmut Brueckmann (H)

Institute of Neuroradiology, University Hospital, LMU Munich, Munich, Germany.

Hendrik Janssen (H)

Institute of Neuroradiology, University Hospital, LMU Munich, Munich, Germany.
Department of Neuroradiology, Klinikum Ingolstadt, Ingolstadt, Germany.

Thomas Liebig (T)

Institute of Neuroradiology, University Hospital, LMU Munich, Munich, Germany.

Robert Forbrig (R)

Institute of Neuroradiology, University Hospital, LMU Munich, Munich, Germany.

Niklas Thon (N)

Department of Neurosurgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany. niklas.thon@med.uni-muenchen.de.

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