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Diagnostic Value of Diffusion-Weighted Magnetic Resonance Imaging in Pelvic Abscesses

Nguyen, Truong Luong Francis MD*; Soyer, Philippe MD, PhD; Barbe, Coralie MD; Graesslin, Olivier MD, PhD§; Veron, Sophie MD*; Amzallag-Bellenger, Elisa MD*; Tomas, Catherine MD*; Hoeffel, Christine MD, PhD*

Journal of Computer Assisted Tomography: November/December 2013 - Volume 37 - Issue 6 - p 971–979
doi: 10.1097/RCT.0b013e31828bea16
Diffusion-Weighted MR Imaging

Objective: The objective of this study was to prospectively assess the added value of gadolinium-enhanced and diffusion-weighted (DWI) magnetic resonance imaging (MRI) to pelvic T2-weighted MRI for diagnosis of deep pelvic abscesses.

Methods: Twenty-nine patients with suspected abscess and a control group of 43 patients underwent T2-weighted, gadolinium-enhanced, T1-weighted and DWI magnetic resonance sequences. Three readers (R1, R2, R3) scored likelihood of abscess on standard MRI, standard MRI + gadolinium, and standard MRI + DWI.

Results: Twenty-nine patients had 36 abscesses. On standard MRI, R1 achieved area under the receiver operating characteristic (ROC) curve (AUC) of 0.97, sensitivity 92%, and specificity 100%. For R2, these figures were 0.87, 81%, and 100%, and for R3, these were 0.85, 83%, and 79%. After gadolinium, R2 improved AUC to 0.97 (P = 0.005), and R3 to 0.95 (P = 0.006). Standard MRI + DWI yielded improved AUC for all readers (P = 0.15, 0.001, and 0.001 for R1, R2, R3, respectively).

Conclusions: Addition of gadolinium or DWI to T2-weighted MRI improves performances for the diagnosis of deep pelvic abscess. Diffusion-weighted imaging may replace gadolinium.

From the *Department of Radiology, Hôpital Robert Debré, Reims; †Department of Radiology, Hôpital Lariboisière, Paris; and Departments of ‡Statistics and §Obstetrics and Gynaecology, Hôpital Robert Debré, Reims, France.

Received for publication September 11, 2012; accepted February 6, 2013.

Reprints: Truong Luong Francis Nguyen, MD, Department of Radiology, Hôpital Robert Debré, 51092 Reims Cedex France (e-mail: nguyen.tl.francis@gmail.com).

The authors have not received any funding for this research.

The authors have no conflict of interest to report.

© 2013 by Lippincott Williams & Wilkins