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Necrotizing fasciitis versus pyomyositis: discrimination with using MR imaging.

Seok JH, Jee WH, Chun KA, Kim JY, Jung CK, Kim YR, Eo WK, Kim YS, Chung YG - Korean J Radiol (2009)

Bottom Line: 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.MR imaging is helpful for differentiating between NF and PM.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, The Catholic University of Korea, Seoul, Korea.

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.

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51-year-old man with surgically confirmed necrotizing fasciitis.
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Figure 1: 51-year-old man with surgically confirmed necrotizing fasciitis.

Mentions: Patients with NF had a significantly greater prevalence of the following MR findings (p < 0.05): peripheral band-like hyperintense signals in muscles on the FS T2-weighted images (73% for the NF patients vs. 0% for the PM patients), peripheral band-like CE of muscles (82% vs. 0%, respectively), thin smooth enhancement of deep fascia (82% vs. 13%, respectively) and multicompartment involvement (91% vs. 38%, respectively) (Table 2) (Figs. 1, 2).


Necrotizing fasciitis versus pyomyositis: discrimination with using MR imaging.

Seok JH, Jee WH, Chun KA, Kim JY, Jung CK, Kim YR, Eo WK, Kim YS, Chung YG - Korean J Radiol (2009)

51-year-old man with surgically confirmed necrotizing fasciitis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2651441&req=5

Figure 1: 51-year-old man with surgically confirmed necrotizing fasciitis.
Mentions: Patients with NF had a significantly greater prevalence of the following MR findings (p < 0.05): peripheral band-like hyperintense signals in muscles on the FS T2-weighted images (73% for the NF patients vs. 0% for the PM patients), peripheral band-like CE of muscles (82% vs. 0%, respectively), thin smooth enhancement of deep fascia (82% vs. 13%, respectively) and multicompartment involvement (91% vs. 38%, respectively) (Table 2) (Figs. 1, 2).

Bottom Line: 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.MR imaging is helpful for differentiating between NF and PM.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, The Catholic University of Korea, Seoul, Korea.

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.

Show MeSH
Related in: MedlinePlus