Noone T C, Semelka R C, Worawattanakul S, Marcos H B
Department of Radiology, University of North Carolina, Chapel Hill 27599-7510, USA.
Radiology. 1998 Aug;208(2):525-8. doi: 10.1148/radiology.208.2.9680587.
To prospectively investigate the diagnostic accuracy of and appearances at magnetic resonance (MR) imaging of patients clinically suspected to have intraperitoneal abscesses.
Sixty-seven consecutive patients underwent MR imaging for suspected intraperitoneal abscesses. MR images were prospectively interpreted for intraperitoneal abscesses; the results were correlated with surgical, histopathologic, and laboratory findings.
MR imaging revealed 25 fluid collections consistent with intraperitoneal abscesses in 22 of 67 patients (33%). Of these collections, 22 were intraperitoneal abscesses; one, a giant sigmoid diverticulum; and two, sterile fluid collections. The latter two patients had been receiving antibiotic therapy. MR imaging allowed exclusion of intraperitoneal abscesses in 45 patients (67%). All collections demonstrated decreased signal intensity on T1-weighted images; on T2-weighted images, 13 collections demonstrated homogeneously increased signal intensity and 12 demonstrated heterogeneously increased signal intensity. The abscesses were best demonstrated on gadolinium-enhanced T1-weighted fat-suppressed images as well-defined fluid collections with peripheral rim enhancement. Sensitivity was 100%; specificity, 94% (95% confidence interval = 83%, 99%); positive predictive value, 88% (95% confidence interval = 69%, 97%); negative predictive value, 100%; and accuracy, 96% (95% confidence interval = 88%, 99%).
MR imaging has high diagnostic accuracy in evaluation of acute intraperitoneal abscesses.
前瞻性研究临床怀疑有腹腔脓肿患者的磁共振（MR）成像诊断准确性及表现。
67例连续患者因怀疑腹腔脓肿接受MR成像检查。对MR图像进行前瞻性腹腔脓肿解读；结果与手术、组织病理学及实验室检查结果进行对比。
MR成像显示67例患者中有22例（33%）存在25个符合腹腔脓肿的液性聚集区。其中，22个为腹腔脓肿；1个为巨大乙状结肠憩室；2个为无菌性液性聚集区。后两位患者一直在接受抗生素治疗。MR成像排除了45例患者（67%）存在腹腔脓肿。所有液性聚集区在T1加权图像上信号强度降低；在T2加权图像上，13个液性聚集区信号强度均匀增加，12个信号强度不均匀增加。脓肿在钆增强T1加权脂肪抑制图像上显示最佳，表现为边界清晰的液性聚集区伴周边强化。敏感性为100%；特异性为94%（95%置信区间 = 83%，99%）；阳性预测值为88%（95%置信区间 = 69%，97%）；阴性预测值为100%；准确性为96%（95%置信区间 = 88%，99%）。
MR成像在评估急性腹腔脓肿方面具有较高的诊断准确性。
