The Diagnostic Value of Diffusion-Weighted Magnetic Resonance Imaging in Soft Tissue Abscesses

Abstract

Purpose: To study the diagnostic value of diffusion-weighted imaging (DWI) in soft tissue abscesses. Materials and methods: Fifty patients were included in this study who were thought to have soft tissue abscess or cystic lesion as a result of clinical and radiological examinations. Localisations of the lesions were: 1 periorbital, 3 breast, 14 intraabdominal, and 32 intramuscular lesions. After other radiological examinations, DWI was performed. The signal intensity values of the lesions were evaluated qualitatively according to the hyperintensity on b-1000 DWI, using 1.5 T MR system. All of the lesions were aspirated after DWI, and detection of pus in the aspiration material was accepted as gold standard for the diagnosis of abscess. Results: In 38 of the 50 patients, hyperintensity was obtained on diffusion-weighted images. False-positive results were maintained in 2 of these patients, and true-positive results were maintained in 36 of them. In 11 of the 50 patients, hypointensity was visualised on diffusion-weighted images. False-negative results were maintained in 3 of these patients, and true-negative results were maintained in 8 of them. An abscess which was seen on post-contrast conventional MRI could not be seen on DWI, and this was regarded as false-negative. Conclusion: The sensitivity and specificity of diffusion-weighted images for detecting soft tissue abscesses were found to be 92% and 80%, respectively. DWI has a high diagnostic value in soft tissue abscesses, and is an important imaging modality that may be used for the differentiation of cysts and abscesses. (C) 2009 Elsevier Ireland Ltd. All rights reserved.