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Diffusion-Weighted MR Imaging of Rim-Enhancing Brain Masses

Is Markedly Decreased Water Diffusion Specific For Brain Abscess?

Glenn A. Tung1, Peter Evangelista1, Jeffrey M. Rogg1 and John A. Duncan, III2

1 Department of Diagnostic Imaging, Brown University School of Medicine, Rhode Island Hospital, 593 Eddy St., Providence, RI 02903.
2 Department of Neurosurgery, Brown University School of Medicine, Rhode Island Hospital, Providence, RI 02903.



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  		Fig. 1A. —4-year-old girl with abscess after radiosurgery of pontine glioblastoma. Axial enhanced T1-weighted image (TR/TE, 650/15) shows large rim-enhancing pontine mass.

 


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  		Fig. 1B. —4-year-old girl with abscess after radiosurgery of pontine glioblastoma. Markedly increased signal is seen in mass (arrow) on trace-weighted diffusion-weighted image (b = 1000 mm2/sec).

 


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  		Fig. 1C. —4-year-old girl with abscess after radiosurgery of pontine glioblastoma. Apparent diffusion coefficient (ADC) map image shows markedly decreased signal in mass (arrow) compared with that in cerebrospinal fluid; mean ADC was 0.64 (± 0.02, 10-3 mm2/sec). One day later, purulent fluid was aspirated at surgery.

 


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  		Fig. 2A. —72-year-old man with necrotic squamous cell carcinoma metastasis. Axial T1-weighted image (TR/TE, 650/17) shows right parietal mass with irregular rim enhancement.

 


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  		Fig. 2B. —72-year-old man with necrotic squamous cell carcinoma metastasis. Trace-weighted diffusion-weighted image (b = 1000 mm2/sec) shows increased signal intensity in this mass (arrow) compared with cerebrospinal fluid.

 


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  		Fig. 2C. —72-year-old man with necrotic squamous cell carcinoma metastasis. Metastasis has marked low signal intensity (arrow) on apparent diffusion coefficient (ADC) map image; mean ADC was 0.70 (± 0.02, 10-3 mm2/sec).

 


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  		Fig. 3A. —58-year-old man with surgically proven radiation necrosis after radiotherapy for residual glioblastoma. Axial fat-saturated turbo spin-echo T2-weighted image (TR/TE, 4000/90) shows mass (arrow) and postoperative changes in left occipital lobe and edema in left temporal white matter.

 


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  		Fig. 3B. —58-year-old man with surgically proven radiation necrosis after radiotherapy for residual glioblastoma. Trace-weighted diffusion-weighted image (b = 1000 mm2/sec) shows marked hyperintense signal in occipital mass (arrow). The measured apparent diffusion coefficient was 0.32 (± 0.01, 10-3 mm2/sec).

 

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