Open AccessCOMPARISON STUDY OF DIFFUSION WEIGHTED IMAGING VERSUS CONVENTIONAL SEQUENCES OF MRI IN DIFFERENTIATING BRAIN ABSCESS AND CYSTIC/ NECROTIC BRAIN TUMORS
Author(s) -
Manish Bhagat,
Akanksha Malviya
Publication year - 2021
Publication title -
paripex indian journal of research
Language(s) - English
DOI - 10.36106/paripex/9210194
Subject(s) - fluid attenuated inversion recovery , medicine , magnetic resonance imaging , effective diffusion coefficient , brain abscess , diffusion mri , radiology , abscess , nuclear medicine , fast spin echo , surgery
AIM: To compare the effectiveness of diffusion Weighted Imaging (DWI) sequence with other routine magneticresonance imaging(MRI) sequences in the detection of cystic/necrotic brain tumors and brain abscess.MATERIALS&METHODS: The study was carried out at Department of Radio-diagnosis, S.A.I.M.S, Indore fromOctober,2018 to March,2020 after clearance from the Institutional Ethical committee.The sample size consists of 54patients[11 patients with brain abscess and 43 with cystic/necrotic brain tumors]. The MRI was performed using 1.5-Tsystem including fast spin-echo T1-weighted image (T1WI),contrast-enhanced T1WI,T2-weighted image(T2WI), fluidattenuated inversion recovery(FLAIR) sequence and DWI with apparent diffusion coefficient(ADC) maps.ADC valueswere noted in cystic portion, wall, and perilesional edema of the lesions. Most of the brain abscess RESULTS: es andbrain tumors appeared hypointense on T1WI and hyperintense on T2WI/FLAIR. All patients with brain abscess exceptone on treatment, showed high core signal intensity(SI) on DWI and low SI on ADC maps with mean ADC value of0.637±0.141x10-3mm2/s. Mean ADC value in the wall of brain abscess was higher (1.369X10-3mm2/s) than its core. Allpatients with cystic/necrotic brain tumors except two, showed low core SI on DWI and high SI on ADC maps with meanADC value of 2.446±0.613x10-3mm2/s. The mean ADC value of wall of cystic brain tumor (1.012±0.264X10-3mm2/s) wascomparatively lower than its core. Almost similar ADC values were noted in perilesional edema around both lesions. Thesensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) in diagnosing brain abscessand brain tumor with DWI+ADC map were higher than conventional MRI sequences alone. CONCLUSION:Conventional MRI has limited application and DWI-ADC map is a good tool for differentiating brain abscess from cysticor necrotic brain tumors with few exceptions. Diffusion imaging can also be used for follow-up of brain abscess afterantibiotic therapy.