Muhammad Saad Ahmed, Muhammad Kashif Shazlee, Rahila Usman, Kamran Hamid, Junaid Iqbal, Imaad Hussain, Sumayya Fatima.
Diagnostic Accuracy of Diffusion-Weighted Magnetic Resonance Imaging in the Diagnosis of Brain Abscess.
Pak J Radiol Jan ;26(4):305-11.

INTRODUCTION: Brain abscess is a serious life threatening infection of brain parenchyma. There is a high mortality rate of approximate 10% and may reach up to 80%. Due to its high morbidity and mortality, there is a need of early diagnosis and prompt treatment.MRI plays an important role to differentiate various brain lesions due to its multiplaner capability and high resolution. Diffusion-weighted MRI (DWI) has been reported to be very sensitive and efficient tool than conventional MRI in diagnosing brain abscess by virtue of restricted diffusion. To our knowledge, no local data is focused on Diffusion-weighted MRI sensitivity in the diagnosis of brain abscess.. Early diagnosis through Diffusion-weighted MRI would eliminate the need for invasive diagnostic and surgical procedures and lead to earlier starting of treatment and hence will substantially reduce the morbidity of this condition. The objective of this study was to determine the diagnostic accuracy of Diffusion-Weighted MRI in the diagnosis of brain abscesses taking histopathological findings as gold standard. material and methods: This descriptive study was conducted in radiology department of ziauddin university hospital during a period of six months from May 2013 to october 2013.136 patients were selected through non probability purposive sampling. RESULT: A group of 136 patients in which 90 patients were males and 46 patients were females with clinical suspicion of brain abscess were included in this study. Out of 136 patients, 86 patients diagnosed as brain abscess on histopathology. Out of 86 patients, 85 were positive on Diffusion weighted images. Therefore, Diffusion Weighted MRI had 98.83% sensitivity, 94.0% specificity and 97.05% diagnostic accuracy for the diagnosis of brain abscess. CONCLUSION: Diffusion weighted sequence in MRI examination has an important role in the diagnosis of brain abscess. The overall diagnostic accuracy of diffusion weighted MRI in the diagnosis of brain abscess in patients with clinical signs and symptoms are very close to histopathological findings. Diffusion weighted MRI should be recommended as a routine method in patients with clinical suspicion of brain abscess..

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