Brain abscess differential diagnosis: Difference between revisions
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* The big differential is [[metastatic tumor]]: abscesses are often located in watershed regions, and [[tumor]]s often enhance diffusely with contrast. | * The big differential is [[metastatic tumor]]: abscesses are often located in watershed regions, and [[tumor]]s often enhance diffusely with contrast. | ||
* Diagnosis of brain abscesses and necrotic tumors is often impossible without conventional MR imaging.<ref name="pmid10472982">{{cite journal| author=Desprechins B, Stadnik T, Koerts G, Shabana W, Breucq C, Osteaux M| title=Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses. | journal=AJNR Am J Neuroradiol | year= 1999 | volume= 20 | issue= 7 | pages= 1252-7 | pmid=10472982 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10472982 }} </ref> | * Diagnosis of brain abscesses and necrotic tumors is often impossible without conventional MR imaging.<ref name="pmid10472982">{{cite journal| author=Desprechins B, Stadnik T, Koerts G, Shabana W, Breucq C, Osteaux M| title=Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses. | journal=AJNR Am J Neuroradiol | year= 1999 | volume= 20 | issue= 7 | pages= 1252-7 | pmid=10472982 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10472982 }} </ref> | ||
**Several studies demonstrate the utility of Diffusion-weighted imaging (DWI) to differentiate between necrotic or cystic lesions and brain abscesses.<ref name="pmid25904163">{{cite journal| author=Bavelloni A, Piazzi M, Raffini M, Faenza I, Blalock WL| title=Prohibitin 2: At a communications crossroads. | journal=IUBMB Life | year= 2015 | volume= 67 | issue= 4 | pages= 239-54 | pmid=25904163 | doi=10.1002/iub.1366 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25904163 }} </ref> | |||
*** DWI has a sensitivity and specificity of over 90% for distinguishing abscess (low ADC) from necrotic tumors (high ADC). | |||
Despite these differences, the true diagnosis is sometimes not made until [[biopsy]]. | Despite these differences, the true diagnosis is sometimes not made until [[biopsy]]. | ||
Revision as of 17:34, 19 October 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Brain abscess must be differentiated from metastatic tumors, necrotic tumors, and lymphomas.[1][2]
Differential Diagnosis
- Some studies suggest that indium scans can help differentiate abscess from CA, and thallium SPECT scans can distinguish CNS toxoplasmosis from lymphoma.[2]
- The big differential is metastatic tumor: abscesses are often located in watershed regions, and tumors often enhance diffusely with contrast.
- Diagnosis of brain abscesses and necrotic tumors is often impossible without conventional MR imaging.[1]
- Several studies demonstrate the utility of Diffusion-weighted imaging (DWI) to differentiate between necrotic or cystic lesions and brain abscesses.[3]
- DWI has a sensitivity and specificity of over 90% for distinguishing abscess (low ADC) from necrotic tumors (high ADC).
Despite these differences, the true diagnosis is sometimes not made until biopsy.
References
- ↑ 1.0 1.1 Desprechins B, Stadnik T, Koerts G, Shabana W, Breucq C, Osteaux M (1999). "Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses". AJNR Am J Neuroradiol. 20 (7): 1252–7. PMID 10472982.
- ↑ 2.0 2.1 Ruiz A, Ganz WI, Post MJ, Camp A, Landy H, Mallin W; et al. (1994). "Use of thallium-201 brain SPECT to differentiate cerebral lymphoma from toxoplasma encephalitis in AIDS patients". AJNR Am J Neuroradiol. 15 (10): 1885–94. PMID 7863938.
- ↑ Bavelloni A, Piazzi M, Raffini M, Faenza I, Blalock WL (2015). "Prohibitin 2: At a communications crossroads". IUBMB Life. 67 (4): 239–54. doi:10.1002/iub.1366. PMID 25904163.