Bang Casper N, Obel Annette, Thomsen Carsten, Obel Niels
Hjertemedicinsk Klinik, Rigshospitalet, 2100 København Ø, Denmark.
Ugeskr Laeger. 2011 May 9;173(19):1364-6.
Early diagnosis of cerebral abscess, which is decisive for the prognosis, is often complicated by the lack of clinical signs. Conventional computed tomography and magnetic resonance imaging cannot always differentiate a cystic or necrotic tumor from an abscess. An abscess is therefore sometimes misdiagnosed as e.g. a glioblastoma or metastasis. Unfortunately, this is sometimes seen at our department and could maybe have been prevented. Diffusion-weighted imaging and apparent diffusion coefficient facilitate differentiation between cerebral tumor and abscess with a sensitivity of 95.2% (76.2-99.9%) and a specificity of 95.7% (78.1-99.9%).
脑脓肿的早期诊断对预后起决定性作用,但往往因缺乏临床症状而变得复杂。传统的计算机断层扫描和磁共振成像并不总能区分囊性或坏死性肿瘤与脓肿。因此,脓肿有时会被误诊为例如胶质母细胞瘤或转移瘤。不幸的是,这种情况在我们科室时有发生,也许本可避免。弥散加权成像和表观扩散系数有助于区分脑肿瘤和脓肿,其灵敏度为95.2%(76.2 - 99.9%),特异性为95.7%(78.1 - 99.9%)。