Document Detail


Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging?
MedLine Citation:
PMID:  21406630     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To retrospectively evaluate whether magnetic resonance (MR) imaging findings can be used to differentiate necrotizing infectious fasciitis (NIF) from nonnecrotizing infectious fasciitis (non-NIF).
MATERIALS AND METHODS: Institutional review board approval was obtained, but patient consent was not required for this retrospective review of records and images because patient anonymity was preserved. Thirty patients (seven with NIF, 23 with non-NIF) were included in the study. The following imaging findings were analyzed on fat-suppressed T2-weighted MR images: (a) signal intensity in the deep fascia (low, high, or mixed high and low), (b) thickness of abnormal signal intensity in the deep fascia (≥3 mm or <3 mm), (c) pattern of abnormal signal intensity in muscle (no abnormality, peripheral bandlike signal intensity, or patchy high signal intensity), (d) degree of deep fascia involvement (partial or extensive), and (e) degree of compartment involvement (fewer than three compartments or three or more compartments). On contrast material-enhanced fat-suppressed T1-weighted images, the contrast enhancement patterns of the abnormal deep fascia (no enhancement, enhancement, or enhancement with nonenhancing portion) and the muscle (no abnormality, peripheral bandlike signal intensity, or patchy high signal intensity) were evaluated. The presence of abscesses in the subcutaneous fat layer was evaluated with all sequences.
RESULTS: The patients with NIF had a significantly greater frequency of (a) thick (≥3 mm) abnormal signal intensity on fat-suppressed T2-weighted images, (b) low signal intensity in the deep fascia on fat-suppressed T2-weighted images, (c) a focal or diffuse nonenhancing portion in the area of abnormal signal intensity in the deep fascia, (d) extensive involvement of the deep fascia, and (e) involvement of three or more compartments in one extremity (P < .05).
CONCLUSION: MR imaging is potentially helpful for differentiating NIF from non-NIF.
SUPPLEMENTAL MATERIAL: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101164/-/DC1.
Authors:
Kyoung-Tae Kim; Yeo Ju Kim; Ju Won Lee; Youn Jeong Kim; Sun-Won Park; Myung Kwan Lim; Chang Hae Suh
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-03-15
Journal Detail:
Title:  Radiology     Volume:  259     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-23     Completed Date:  2011-08-11     Revised Date:  2012-03-02    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  816-24     Citation Subset:  AIM; IM    
Copyright Information:
RSNA, 2011
Affiliation:
Department of Radiology, Inha University Hospital, 3-ga Shinheung-dong, Choong-gu, Incheon 400-700, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cellulitis / diagnosis*,  microbiology*
Contrast Media / diagnostic use
Diagnosis, Differential
Fasciitis / diagnosis*
Fasciitis, Necrotizing / diagnosis*,  microbiology*
Female
Gadolinium DTPA / diagnostic use
Humans
Image Interpretation, Computer-Assisted
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Retrospective Studies
Soft Tissue Infections / diagnosis*,  microbiology*
Chemical
Reg. No./Substance:
0/Contrast Media; 122795-43-1/gadodiamide; 80529-93-7/Gadolinium DTPA
Comments/Corrections
Comment In:
Radiology. 2011 Dec;261(3):994; author reply 994-5   [PMID:  22095999 ]
Radiology. 2012 Feb;262(2):732-3; author reply 733   [PMID:  22282192 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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