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KMID : 0880420090100020121
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Korean Journal of Radiology
2009 Volume.10 No. 2 p.121 ~ p.128
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Necrotizing Fasciitis versus Pyomyositis: Discrimination with Using MR Imaging
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Seok Jee-Hyun
Jee Won-Hee
Chun Kyung-Ah
Kim Ji-Young
Kim Yang-Ree
Eo Wan-Kyu
Kim Yang-Soo
Chung Yang-Guk
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Abstract
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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.
Result : 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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KEYWORD
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Soft tissue, Infection, Necrotizing fasciitis, Pyomyositis, MR
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