Diffusion imaging may help in the differential diagnosis of cerebral abscess versus necrotic neoplasm.
This is a rapid acquisition with moderate spatial resolution that can yield information on the entire brain and multiple lesions, even in agitated patients.
Optimizing echo-planar scan parameters (phase offset and delay) is important to obtain high-quality diffusion images. For this reason, the scan is often simulated prior to being run to allow optimization of these parameters. This may take 1 to 3 min. The values obtained are then passed to the scanner and the sequence performed. (This is unique to Marconi's system.)
Acquire images at b-values of both 0 and 1000 sec/mm2, each applied in three orthogonal directions.
These data provide raw diffusion-weighted multishot echo-planar images and is used to process apparent diffusion coefficient (ADC) maps.
DWI / ADC features for Abscess
- high DWI signal is usually present centrally
- often this represents true restricted diffusion (low signal on ADC)
- peripheral or patchy restricted diffusion may also be seen; this finding is however not as constant as one may think, with up to half of rim enhancing lesions demonstrating some restriction not proving to be abscesses 2.
- in many instances high DWI are associated with high ADC signal, consistent with T2 shine through of the central necrotic portion
2 comments:
question:
is DWI reference line for MRI BRAIN is the same with T2 and T1?
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