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Detection of soft-tissue abscess: Comparison of diffusion-weighted imaging to contrast-enhanced MRI.

Detection of soft-tissue abscess: Comparison of diffusion-weighted imaging to contrast-enhanced MRI.
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Chun CW, Jung JY, Baik JS, Jee WH, Kim SK, Shin SH,


Chun CW, Jung JY, Baik JS, Jee WH, Kim SK, Shin SH, (click to view)

Chun CW, Jung JY, Baik JS, Jee WH, Kim SK, Shin SH,

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Journal of magnetic resonance imaging : JMRI 2017 04 22() doi 10.1002/jmri.25743
Abstract
PURPOSE
To compare the diagnostic performances of diffusion-weighted imaging (DWI)-combined magnetic resonance imaging (MRI) performed without intravenous contrast material with gadolinium contrast material-enhanced (CE) MRI for diagnosing soft-tissue abscesses.

MATERIALS AND METHODS
In all, 119 patients (mean age: 56 years) with skin and soft-tissue infection who underwent contrast-enhanced MRI with DWI (b = 0-800) were included. Two readers independently reviewed both image sets-nonenhanced conventional MR images (NECI)+DWI, and NECI+contrast enhanced fat-suppressed T1 -weighted imaging (CEFST1 )-for the presence of abscess. To compare the diagnostic performance for diagnosing abscess between NECI+DWI, and NECI+CEFST1 , McNemar tests for sensitivity and specificity, and areas under the receiver-operating characteristic curves (AUC) analyses, were performed. Interobserver agreements (κ) were calculated for each image set.

RESULTS
Forty of 119 patients were confirmed with abscess. Sensitivity and specificity were 90.0% and 88.6% for NECI+DWI, and 82.5% and 89.9% for NECI+CEFST1 in reader 1, whereas 77.5% and 88.6% for NECI+DWI, and 80.0% and 84.8% for NECI+CEFST1 in reader 2, respectively. There was no significant difference in sensitivities and specificities between NECI+DWI and NECI+CEFST1 (reader 1: P = 0.453, P = 0.999, reader 2: P = 0.999, P = 0.453, respectively). Likewise, AUC analyses demonstrated no significant difference between NECI+DWI and NECI+CEFST1 (P = 0.53 in reader 1, P = 0.97 in reader 2). Interobserver agreement between the two readers was substantial in both image sets: 0.80 (NECI+DWI), and 0.76 (NECI+CEFST1 ).

CONCLUSION
Noncontrast-enhanced MRI with DWI has comparable diagnostic performance to contrast-enhanced MRI for diagnosing soft-tissue abscesses.

LEVEL OF EVIDENCE
3 J. Magn. Reson. Imaging 2017.

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