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J Neuroradiol. 2014 Jul;41(3):153-67. doi: 10.1016/j.neurad.2014.05.004. Epub 2014 Jun 21.

Magnetic resonance features of pyogenic brain abscesses and differential diagnosis using morphological and functional imaging studies: a pictorial essay.

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  • 1Unit of Neuroradiology, Department of Neuroscience, Hospital "Gaetano Rummo", Benevento, Italy.
  • 2Unit of Neuroradiology, Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy.
  • 3Unit of Neuroradiology, Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy. Electronic address:
  • 4Unit of Neuroradiology, Department of Neuroscience, University "Santa Maria alle Scotte", Siena, Italy.
  • 5Department of Critical Care Medicine, Hospital "Fatebenefratelli", Benevento, Italy.
  • 6Unit of Radiology and Neuroradiology, Anthea Hospital, Bari, Italy.


The aim of this paper is to illustrate the potential of magnetic resonance imaging (MRI) in diagnosis, differential diagnosis, treatment planning and evaluation of therapy effectiveness of pyogenic brain abscesses, through the use of morphological (or conventional) and functional (or advanced) sequences. Conventional MRI study is useful for the identification of lesions, to determine the location and morphology and allows a correct hypothesis of nature in the most typical cases. However, the differential diagnosis from other brain lesions, such as non-pyogenic abscesses or necrotic tumors (high-grade gliomas and metastases) is often only possible through the use of functional sequences, as the measurement of diffusion with apparent diffusion coefficient (DWI-ADC), proton magnetic resonance spectroscopy ((1)H-MRS) and perfusion weighted imaging (PWI), which complement the morphological sequences and provide essential information on structural, metabolic and hemodynamic characteristics allowing greater neuroradiological confidence. Modern diagnostic MRI of pyogenic brain abscesses cannot be separated from knowledge, integration and proper use of the morphological and functional sequences.

Copyright © 2014 Elsevier Masson SAS. All rights reserved.


Cerebral abscesses; DWI; MR-spectroscopy; Magnetic resonance; PWI; Pyogenic abscesses

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