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Rofo 2001; 173(1): 65-71
DOI: 10.1055/s-2001-10231
EXPERIMENTELLE RADIOLOGIE
ORIGINALARBEIT
© Georg Thieme Verlag Stuttgart · New York

Differenzierung seröser und putrider Flüssigkeiten in vitro und in vivo mit diffusionsgewichteter MRT

E. Spüntrup1 A. Bücker1 G. Adam1 J. J. van Vaals2 R. W. Günther1
  • 1Klinik für Radiologische Diagnostik, Medizinische Einrichtungen der RWTH Aachen
  • 2Philips Medical Systems, 5680 Best, The Netherlands
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Publication History

Publication Date:
31 December 2001 (online)

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Zusammenfassung:

Ziel: Das Ziel dieser Arbeit war es, die Möglichkeit der Differenzierung seröser und putrider Flüssigkeiten mit diffusionsgewichteter MRT zu untersuchen und drei verschiedene Sequenzschemata zu vergleichen. Material und Methoden: Hierzu wurden 13 Punktatproben (aus 6 serösen und 7 putriden Flüssigkeitsansammlungen) sowie 19 Patienten (mit 12 serösen und 7 putriden Flüssigkeitsansammlungen) mit einer diffusionsgewichteten Spin Echo-(SE), stimulierten Echo-(STE) und fettunterdrückten SE-Sequenz (SE-SPIR) untersucht. In vitro wurden 4 b-Faktoren (0, 87, 355, 798 s/mm2 für SE und SE-SPIR, 0, 51, 204, 460 s/mm2 für STE) gewählt sowie der ADC (apparent diffusion coefficient) berechnet. Bei den in vivo-Untersuchungen wurden bei ansonsten identischen Sequenzen nur zwei b-Faktoren akquiriert (0 und 598 s/mm2 für SE und SE-SPIR, 0 und 360 s/mm2 für STE) und die normalisierte Signalreduktion nach Schaltung der Diffusionsgradienten bestimmt. Eine Navigatorecho-Technik und eine periphere Pulstriggerung dienten der Bewegungsartefaktreduktion. Ergebnisse: In vitro lag der ADC in seröser Flüssigkeit nahe demjenigen freien Wassers, während sich in putriden Flüssigkeiten ein deutlich geringerer ADC fand. In vivo zeigten die diffusionsgewichteten Bilder in serösen Flüssigkeitsansammlungen eine deutliche Signalreduktion (auf 22-32 % der Ausgangswerte), während in putriden Flüssigkeitsansammlungen nur eine geringe Signalreduktion (auf 86-94 % der Ausgangswerte) nachweisbar war (p < 0,05). Diskussion: Mit allen drei untersuchten diffusionsgewichteten Sequenzen können seröse und putride Flüssigkeiten differenziert werden.

Differentiation of Serous and Purulent Fluids in vitro and in vivo by Means of Diffusion-Weighted MR Imaging.

Aim: The aim of this study was to test the feasibility for differentiation of serous fluid collections and abscess fluid with diffusion-weighted imaging and to compare three different diffusion sequences. Material and Methods: Thirteen puncture samples (6 serous, 7 purulent) and 19 patients with either serous fluid collections (n = 12) or abscesses (n = 7) were examined with diffusion-weighted spin-echo (SE), stimulated-echo (STE), and fat-suppressed SE (SE-SPIR) sequences. For in vitro studies 4 different b-factors (0, 87, 355, 798 s/mm2 in SE and SE-SPIR and 0, 51, 204, 460 s/mm2 in STE) were chosen and the apparent diffusion coefficient (ADC) was calculated. For in vivo measurements identical sequences with two b-factors (0,598 s/mm2 in SE and SE-SPIR and 0,360 s/mm2 in STE) were applied and the normalized signal attenuation was calculated. A navigator-echo technique and peripheral pulse triggering was used for motion artifact reduction. Results: The in vitro study yielded an ADC of serous fluid, which was close to that of free water, whereas for purulent fluid a significantly lower ADC was calculated. During in vivo examinations, serous fluids showed a strong signal attenuation (down to 22 - 32 % of basic value) compared to a minor signal attenuation in purulent fluids (down to 86 - 94 % of basic value) (p < 0.05). Conclusions: In summary, with all three investigated diffusion schemes serous and purulent fluids can be clearly differentiated.

Schlüsselwörter:

Diffusionsgewichtete Magnetresonanztomographie - Abszess - Serom

Key words:

Diffusion-weighted magnetic resonance imaging - Abscess - Seroma

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Dr. med. Elmar Spüntrup

Klinik für Radiologische DiagnostikMedizinische Einrichtungen der RWTH Aachen

Pauwelsstraße 30, 52057 Aachen

Phone: 0241-8088332

Fax: 0241-8888499

Email: spuenti@rad.rwth-aachen.de

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