Cerebral abscesses imaging: A practical approach

Paola Feraco; Davide Donner; Cesare Gagliardo; Irene Leonardi; Silvia Piccinini; Anna Del Poggio; Rossana Franciosi; Benedetto Petralia; Luc van den Hauwe

doi:10.15586/jptcp.v27i3.688

Paola Feraco

Department of Neuroradiology, Ospedale S. Chiara, Azienda Provinciale per i Servizi Sanitari, Trento, Italy; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy.

https://orcid.org/0000-0002-3707-018X
Davide Donner

Department of Nuclear Medicine, S. Chiara Hospital, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.

Cesare Gagliardo

Section of Radiological Sciences, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy.

https://orcid.org/0000-0003-4088-2020
Irene Leonardi

Department of Neuroradiology, Ospedale S. Chiara, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.

Silvia Piccinini

Neuroradiology Unit, Ospedale Civile S. Agostino-Estense University Hospital, Modena, Italy.

Anna Del Poggio

Neuroradiology Department, San Raffaele Scientific Institute, Milan, Italy;

Rossana Franciosi

Radiology Unit, S. Maria del Carmine Hospital, Rovereto, Italy.

Benedetto Petralia

Department of Neuroradiology, Ospedale S. Chiara, Azienda Provinciale per i Servizi Sanitari, Trento, Italy.

Luc van den Hauwe

Department of Radiology, University of Antwerp, Antwerp, Belgium.

Keywords

brain abscess, magnetic resonance imaging (MRI), diffusion weighted imaging (DWI), magnetic resonance spectroscopy (MRS)

Abstract

Brain abscesses (BAs) are focal infections of the central nervous system (CNS) that start as a localised area of weakening of the brain parenchyma (cerebritis) and develops into a collection of pus surrounded by a capsule. Pyogenic (bacterial) BAs represent the majority of all BAs; in some cases, the diagnostic and therapeutic management can be challenging. Imaging has a primary role in differentiating BAs from other lesions. Conventional magnetic resonance imaging (cMRI) is essential for the identification of the lesion, its localisation and its morphological features. However, cMRI does not allow to reliably differentiate BAs from other intracranial mass lesions such as necrotic tumours. Advanced sequences, such as diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI) and proton MR spectroscopy (¹H-MRS) are very useful in the differential diagnosis from other brain lesions, such as non-pyogenic abscesses or necrotic tumours, and provide essential information on structural, vascular and meta-bolic characteristics allowing greater neuroradiological confidence. The aim of this pictorial review is to provide a practical approach showing the added value of more advanced MRI techniques in their diagnostic management.

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Published

Jul 11, 2020

DOI https://doi.org/10.15586/jptcp.v27i3.688

How to Cite

Feraco, P., Donner, D., Gagliardo, C., Leonardi, I., Piccinini, S., Del Poggio, A., Franciosi, R., Petralia, B., & den Hauwe, L. van. (2020). Cerebral abscesses imaging: A practical approach. Journal of Population Therapeutics and Clinical Pharmacology, 27(3), e14-e27. https://doi.org/10.15586/jptcp.v27i3.688