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首页> 外文期刊>British journal of neurosurgery >The difference in diffusion-weighted imaging with apparent diffusion coefficient between spontaneous and postoperative intracranial infection
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The difference in diffusion-weighted imaging with apparent diffusion coefficient between spontaneous and postoperative intracranial infection

机译：自发性和术后颅内感染之间弥散加权成像与明显弥散系数的差异

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摘要

Background. Although the roles of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) have been accepted as the initial or confirmatory diagnostic tool for spontaneous intracranial infections, the usefulness of these has rarely been investigated in intracranial infections after a craniotomy procedure. Through an analysis of the clinico- radiological characteristics of spontaneous and postoperative intracranial infections, the authors revealed the specifi c factors that affect the accuracy of DWI and ADC in diagnosing intracranial infections. Methods. The authors retrospectively analyzed 67 intracranial infections confirmed using preoperative MR imaging, including the DWI, ADC and gadolium- enhanced (Gd) images, and by peroperative pus drainage. Results. In 67 enrolled patients, no or uncertain diffusion restriction on DWI and ADC was found in 9 cases (13%). All the cases showed typical peripheral enhancement on Gd images. Among nine cases without diffusion restriction, postoperative infection was seen in five cases (62.5% [5/8 postoperative infection group] vs. 6.8% [4/59 spontaneous infection group], p = 0.001). On multivariate analysis, postoperative infection was the predictive factor for false- negative restriction on DWI and ADC (hazard ratio: 41.2, 95% confidential index:2.39-710.25, p = 0.01). Conclusion. Despite the excellent availability of DWI and ADC for diagnosing spontaneous intracranial infections, negative restriction results of those images are not sufficient to exclude postoperative intracranial infection.
机译：背景。尽管弥散加权成像（DWI）和表观弥散系数（ADC）的作用已被接受为自发性颅内感染的初始或确证性诊断工具，但在开颅手术后颅内感染中很少研究其有效性。通过对自发性和术后颅内感染的临床放射学特征的分析，作者揭示了影响DWI和ADC诊断颅内感染准确性的特定因素。方法。作者回顾性分析了术前MR影像证实的67例颅内感染，包括DWI，ADC和g增强（Gd）影像，以及术中脓液引流。结果。在67例入组患者中，有9例（13％）未发现DWI和ADC的扩散受限或不确定。所有病例在Gd图像上均表现出典型的外周增强。在9例无扩散限制的病例中，有5例发生了术后感染（62.5％[5/8术后感染组]比6.8％[4/59自发感染组]，p = 0.001）。在多变量分析中，术后感染是DWI和ADC假阴性限制的预测因素（危险比：41.2，95％机密指数：2.39-710.25，p = 0.01）。结论。尽管DWI和ADC可用于诊断自发性颅内感染，但是这些图像的阴性限制性结果不足以排除术后颅内感染。

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