Necrotizing Fasciitis versus Pyomyositis: Discrimination with Using MR Imaging.
10.3348/kjr.2009.10.2.121
- Author:
Jee Hyun SEOK
1
;
Won Hee JEE
;
Kyung Ah CHUN
;
Ji Young KIM
;
Chan Kwon JUNG
;
Yang Ree KIM
;
Wan Kyu EO
;
Yang Soo KIM
;
Yang Guk CHUNG
Author Information
1. Department of Radiology, The Catholic University of Korea, Korea. whjee@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Soft tissue;
Infection;
Necrotizing fasciitis;
Pyomyositis, MR
- MeSH:
Abscess/pathology;
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Diagnosis, Differential;
Fascia/pathology;
Fasciitis, Necrotizing/*pathology;
Female;
Humans;
Image Processing, Computer-Assisted;
*Magnetic Resonance Imaging;
Male;
Middle Aged;
Muscle, Skeletal/pathology;
Pyomyositis/*pathology;
Retrospective Studies;
Young Adult
- From:Korean Journal of Radiology
2009;10(2):121-128
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: We wanted to evaluate the MR findings for differentiating between necrotizing fasciitis (NF) and pyomyositis (PM). MATERIALS AND METHODS: The MR images of 19 patients with surgically confirmed NF (n = 11) and pathologically confirmed PM (n = 8) were retrospectively reviewed with regard to the presence or absence of any MRI finding criteria that could differentiate between them. RESULTS: The patients with NF had a significantly greater prevalence of the following MR findings (p < 0.05): a peripheral band-like hyperintense signal in muscles on fat-suppressed T2-weighted images (73% of the patients with NF vs. 0% of the patients with PM), peripheral band-like contrast enhancement (CE) of muscles (82% vs. 0%, respectively) and thin smooth enhancement of the deep fascia (82% vs. 13%, respectively). The patients with PM had a significantly greater prevalence of the following MRI findings (p < 0.05): a diffuse hyperintense signal in muscles on fat-suppressed T2-weighted images (27% of the patients with NF vs. 100% in the patients with PM), diffuse CE of muscles (18% vs. 100%, respectively), thick irregular enhancement of the deep fascia (0% vs. 75%, respectively) and intramuscular abscess (0% vs. 88%, respectively). For all patients with NF and PM, the superficial fascia and muscle showed hyperintense signals on T2-weighted images and CE was seen on fat-suppressed CE T1-weighted images. The subcutaneous tissue and deep fascia showed hyperintense signals on T2-weighted images and CE was seen in all the patients with NF and in seven (88%) of the eight patients with PM, respectively. CONCLUSION: MR imaging is helpful for differentiating between NF and PM.
