Pyogenic Abscess Case Studies

2. Conventional Imaging findings
All of the cases shows hypointense on T1-weighted image and hyperintense on T2-weighted image. Mean of the lesion size in pyogenic, fungal, and Tuberculous abscess were measured 3.2 cm, 2.9 cm, and 2.7 cm, respectively. In the wall of pyogenic abscess were smooth or lobulated (n=8, 82%). Irregular wall was found only in 4 cases (18%) of pyogenic abscess. In the tuberculous abscess, there were smooth/lobulated wall (n=7, 77.8%) and irregular wall (n=2, 22.2%). The fungal abscess have irregular wall (n=8, 66.7%) and smooth/lobulated wall (n=4, 33.3%). There is significantly more irregular wall in fungal abscess comparing with bacterial group (p= 0.003). The mean of wall thickness were measured 3.2 cm, 2.9 cm,
There is significantly more heterogeneous of hyperintense DWI cavity in fungal abscess (n = 10, p = 0.009). Pyogenic, fungal and tuberculous brain abscesses show restricted diffusion portion in the central cavity. There is higher proportion of cases with non-restricted portion in the central cavity in tuberculous (n=4/7, 57.1%) and fungal (n=7/12, 58.3%) abscesses. Three out of 16 cases (18.75%) with pyogenic brain abscess show non-restricted portion in the central cavity. Mean ADC value of the wall, restricted and non-restricted portions of the pyogenic 0.12 +/- 0.51, 0.76 +/- 0.22, and 2.34 +/- 1.09 x 10-3 mm2/s. In fungal abscess, mean ADC of the wall, restricted and non-restricted portion were 1.33 +/- 0.50, 0.80 +/- 0.18, and 2.16 +/- 0.68 x 10-3 mm2/s. Meanwhile, in tuberculous abscess, the mean ADC value of the wall, restricted, and non-restricted portions were 1.53 +/- 0.36, 0.84 +/- 0.29, and 2.44 +/- 0.73 x 10-3 mm2/s. There is no significantly difference in mean ADC wall, restricted, and non-restricted portions among these 3 groups of abscess. Intracavitary projection was present in 6 cases of fungal abscess (50%) and 1 case of pyogenic abscess. There is no intracavitary projection found in tuberculous or toxoplasmosis abscess. In fungal abscess, there is significantly lower ADC value of the projection than wall (p =
On SWMRS, 10/13 cases (76.9%) of pyogenic brain abscess show complete low signal intensity rim (LSIR) with 8/13 cases (61.5%) regular LSIR. In fungal abscess, there were 5/9 cases (55.6%) with incomplete LSIR and 5/9 cases (55.6%) with irregular LSIR. Meanwhile, 2/3 cases (66.7%) of tuberculous abscess show complete LSIR and 2/3 cases (66.7%) show regular LSIR. Central low signal intensity (CLSI) found more in fungal abscess (n=4, 44%), comparing with pyogenic (n=2, 15.3%). Neither tuberculous nor toxoplasmosis abscess show CLSI. Dual rim sign was present in 6/13 cases of pyogenic abscess, 2/9 cases of fungal abscess, and 2/3 cases of pyogenic abscess. This sign can be seen in both SWI and SWAN