- 뇌종양의 병기결정에서 자기공명영상의 유용성:가토를 이용한 실험 모델과 임상 증례 비교
- ㆍ 저자명
- 정용연,강형근,서정진,김윤현,박진균,김재규,정현대,오종석,이민철
- ㆍ 간행물명
- 대한방사선의학회지
- ㆍ 권/호정보
- 1997년|37권 6호|pp.975-984 (10 pages)
- ㆍ 발행정보
- 대한영상의학회
- ㆍ 파일정보
- 정기간행물| PDF텍스트
- ㆍ 주제분야
- 기타
Purpose:The purpose of this study is to evaluate th usefulness of MR imaging in the staging of brain abscesses and to determine the correlations between pathologic and MR findings. Materials and Methods: Experimental brain abscesses were induced by direct inoculation of 1ml suspension of $10^6$/ml Streptococcus pneumoniae into the brain parenchyma of ten New Zealand white rabbits. The evolution of abscess formation was divided inro four stages, based on pathological, criteria : early cerebritis (days 1 to 5), late cerebritis )days 6 to 10), early capsular (days 11 to 15), and late capsular (day 16 and later). The brain abcsess of each animal was exmained by MR imaging and light microscopy at 3, 8, 13, and 28 days;T1-weighted, T2-weighted and Gd-enhanced images were obtained. The MR images and pathologic findings of 13 pathologically confirmed clinical cases were compared to MR images of the experimental model. Results:In the experimental model, signal intensity of the abcsess content was at all stages hypointense on T1-weighted and hyperintense on T2-weighted images. In all ten cases, Gd-enhanced images showed an ill-defined contrast-enhanced leison at the early cerebritis stage, and in four of seven cases, irregular ring enhancement at the late cerebritis stage. Pathologic specimens at this latter stage revealed prominent vascular proliferation and infiltration to chronic inflammatory cells. Signal intensity of the abscess wall during the capsular stage showed isointense relative brain parenchyma on T1-weighted images and this was hypointense on T2-weighted images. Gd-enhanced images demonstrated smooth ring enhancement of the abscess wall. At the early capsular stage, pathologic specimens revealed a discrete necrotic center surrounded by infiltration of reticulin and some collagen;at the late capsular stage, these specimens showed marked infiltration of collagen. In clinical cases, the signal intensity of abscess content was at all stages demonstrated ill-defined subtle contrast enhancement at the early cerebritis stage and irresular ring enhancement at the late cerebritis stage. In all cases, signal intensity of the abscess wall during the capsular stage was hypointense on T2-weighted images;at this stage, the abscess wall was showed a pattern of smooth ring enhancement. In clinical cases, hypointensity of the abscess wall, as seen on T2-weighted images, and the enhancement pattern of this wall were identical to these findings in the experimental model. Conclusion:In an experimental model, correlation between sequential MR findinds can be used to predict the stage of a brain abscess;in clinical cases essential indicators are hypointensity and enhancement pattern of the abscess wall, as seen on T2-weighted images. In cases of brain abscess, MRI is a useful diagnostic modality, and in such cases, also helps determine the most suitable treatment.