Author Affiliations: Institute of Radiology, Department of Pediatric Radiology, University Hospital Wuerzburg, Josef-Schneider-Straße 2, 97080 Wuerzburg, Germany (Neubauer H, Platzer I, Beer M); Department of Pediatrics, University Hospital Wuerzburg, Josef-Schneider-Straße 2, 97080 Wuerzburg, Germany (Mueller V, Liese J); Pediatric Surgery Unit, Department of Surgery, University Hospital Wuerzburg, Oberduerrbacher Str. 6, 97080 Wuerzburg, Germany (Meyer T); Institute of Radiology, University Hospital Wuerzburg, Oberduerrbacher Str. 6, 97080 Wuerzburg, Germany (Koestler H, Hahn D)

Corresponding Author: Henning Neubauer, MD, MBA, Institute of Radiology, Department of Pediatric Radiology, University Hospital Wuerzburg, Josef-Schneider-Straße 2, 97080 Wuerzburg, Germany (Tel: 0049-931-201-34715; Fax: 0049-931-201-34857; Email: neubauer@roentgen.uni-wuerzburg.de)

doi: 10.1007/s12519-012-0362-4

Background: Diffusion-weighted MRI (DWI) is helpful for detection of brain abscess and pelvic abscess in adults. In the present study, we evaluated the diagnostic performance of DWI in children and young adults with abdominal and soft tissue abscess formations.

Methods: Seventeen patients (11 females, aged 13 ± 6 years) with suspected abdominal or soft-tissue abscess underwent routine MRI including free-breathing DWI and contrast-enhanced T1w imaging. Seventeen random age-matched patients with non-purulent abdominal fluid collections served as controls. Mean apparent diffusion coefficent (ADC) was measured for abscess, muscle, liver, spleen and kidney tissue as well as for cerebrospinal fluid, urine and free abdominal fluid.

Results: All fluid collections were identified on diffusion-weighted images. Thirteen of 14 confirmed abscess formations showed an ADC < 1.0 × 10^-3 mm²/s with a mean value of 0.80 ± 0.38 mm²/s. One tuberculous soft-tissue abscess had a higher ADC of 1.85 × 10^-3 mm²/s. Ring enhancement on T1w imaging was seen in three non-purulent fluid collections. There were no false-positive findings in the control group.

Conclusions: Diffusion-weighted MRI is highly sensitive for abscess and may add specificity to contrast-enhanced T1w imaging of ring-enhancing fluid collections. DWI with free-breathing rapid image acquisition and without the need of intravenous contrast application constitutes a particularly useful choice in pediatric imaging.

Key words: abscess; contrast medium; diffusion-weighted imaging; magnetic resonance imaging; pediatric

World J Pediatr 2012;8(3):229-234