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Cent Eur Neurosurg 2005; 66(3): 119-125
DOI: 10.1055/s-2005-836478
Original Article

© Georg Thieme Verlag Stuttgart · New York

Importance of Diffusion-Weighted Imaging in the Diagnosis of Cystic Brain Tumors and Intracerebral Abscesses

Bedeutung der Diffusionsbildgebung für die Diagnose von zystischen Gehirntumoren und zerebralen AbszessenA. Bink1 , J. Gaa1 , K. Franz2 , S. Weidauer1 , B. Yan1 , H. Lanfermann1 , V. Seifert2 , F. E. Zanella1
  • 1Institute of Neuroradiology, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
  • 2Department of Neurosurgery, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
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Publication History

Publication Date:
22 August 2005 (online)

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Abstract

Objective: It is often difficult to decide whether a cystic brain lesion is a tumor or an abscess by means of conventional MRI techniques. The immediate diagnosis of a brain abscess is important for the patient's outcome. Our goal was to study the ability of diffusion-weighted imaging and calculation of the apparent diffusion coefficient (ADC) to differentiate between these two pathologies. Patients and Methods: Ten patients (five men, five women) with cystic brain lesions were examined with MRI. The ADC maps were calculated for each subject and the ADC value of each lesion was measured. Histology revealed glioblastoma multiforme in six patients and abscess in four patients. Results: All brain abscesses showed markedly hyperintense signal changes on diffusion-weighted imaging, whereas the appearance of glioblastoma varied from slightly hyperintense to hypointense signal conversion. The mean ADC value calculated in the six patients with cystic brain tumor was: 2.05 × 10-3 mm²/s (1.38-2.88 × 10-3 mm²/s). The mean ADC value of the four patients with brain abscess was: 0.57 × 10-3 mm²/s (0.38-0.77 × 10-3 mm²/s). Conclusion: Diffusion-weighted imaging and calculation of ADC maps constitute a helpful tool to differentiate between cystic brain tumors and brain abscesses.

 Zusammenfassung

Einleitung: In der konventionellen MRT ist die Entscheidung häufig schwierig, ob es sich bei einer zystischen intrakraniellen Läsion um einen malignen Tumor oder einen Abszess handelt. Die sofortige Diagnose eines Hirnabszesses ist jedoch von entscheidender Bedeutung für die Prognose des Patienten. Unser Ziel war es, zu prüfen, ob die Diffusionsbildgebung und die Berechnung des apparent diffusion coefficient (ADC) in der Lage sind, beide Pathologien voneinander zu differenzieren. Patienten und Methoden: Es wurden zehn Patienten (fünf männlich, fünf weiblich) mittels MRT untersucht. Bei allen Patienten erfolgte eine Diffusionsbildgebung mit Berechnung der ADC-Karten sowie eine anschließende Messung des ADC der Raumforderung. Die histologische Untersuchung ergab sechs Patienten mit Glioblastom und vier Patienten mit Abszess. Ergebnisse: Sämtliche Abszesse zeigten deutlich erhöhte Signalintensitäten in der Diffusionswichtung, während die Glioblastome geringe Signalanhebungen bis Signalreduktionen aufwiesen. Der mittlere ADC-Wert der sechs Patienten mit zystischem Hirntumor betrug: 2,05 × 10-3 mm²/s (1,38-2,88 × 10-3 mm²/s). Der mittlere ADC-Wert der vier Patienten mit Abszess war: 0,57 × 10-3 mm²/s (0,38-0,77 × 10-3 mm²/s). Schlussfolgerung: Die diffusionsgewichtete MR-Bildgebung mit Berechnung der ADC-Karten ist eine hilfreiche Methode zwischen zystischem Hirntumor und Hirnabszess zu unterscheiden.

Key words

diffusion-weighted imaging - cystic brain tumor - intracerebral abscess

Schlüsselwörter

Diffusionsbildgebung - zystischer Gehirntumor - zerebraler Abszess

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A. BinkMD 

Institute of Neuroradiology · Johann Wolfgang Goethe University, Frankfurt

Schleusenweg 2-16 (Haus 95)

60528 Frankfurt/Main

Phone: +49/69/63 01 54 63

Fax: +49/69/63 01 59 89

Email: andrea.bink@kgu.de

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