Umeda Satoshi, Fujikawa Akira, Tsuchiya Kazuhiro
Department of Radiology, Self-Defence Forces Central Hospital.
No Shinkei Geka. 2021 Mar;49(2):368-374. doi: 10.11477/mf.1436204400.
Although the prognosis of brain abscesses has historically improved, the mortality rate still ranges from 5 to 32%, with ventricular perforation reaching 50% and 85-100% in fungal brain abscesses. The characteristic finding of ring-like enhancement by contrast-enhanced imaging is non-specific, and DWI, SWI and MR spectroscopy are very useful in differentiating brain abcesses from necrotizing brain tumors. Brain abscesses show apparent diffusion restriction on the DWI/apparent diffusion coefficient(ADC) map, whereas necrotizing brain tumors often show a weak diffusion restriction. The "dual rim sign" on SWI is also a highly specific finding of brain abscess.
尽管脑脓肿的预后在历史上已有改善,但死亡率仍在5%至32%之间,脑室穿孔的死亡率在真菌性脑脓肿中达到50%,在其他情况下为85 - 100%。对比增强成像显示的环状强化这一特征性表现并无特异性,而扩散加权成像(DWI)、磁敏感加权成像(SWI)和磁共振波谱成像在鉴别脑脓肿与坏死性脑肿瘤方面非常有用。脑脓肿在DWI/表观扩散系数(ADC)图上表现为明显的扩散受限,而坏死性脑肿瘤通常表现为轻度扩散受限。SWI上的“双环征”也是脑脓肿的高度特异性表现。