Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging?

Kyoung Tae Kim, Yeo Ju Kim, Ju Won Lee, Youn Jeong Kim, Sun Won Park, Myung Kwan Lim, Chang Hae Suh

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Purpose: To retrospectively evaluate whether magnetic resonance (MR) imaging findings can be used to differentiate necrotizing infectious fasciitis (NIF) from nonnecrotizing infectious fasciitis (non-NIF). Materials and Methods: Institutional review board approval was obtained, but patient consent was not required for this retrospective review of records and images because patient anonymity was preserved. Thirty patients (seven with NIF, 23 with non-NIF) were included in the study. The following imaging findings were analyzed on fat-suppressed T2-weighted MR images: (a) signal intensity in the deep fascia (low, high, or mixed high and low), (b) thickness of abnormal signal intensity in the deep fascia (≥3 mm or <3 mm), (c) pattern of abnormal signal intensity in muscle (no abnormality, peripheral bandlike signal intensity, or patchy high signal intensity), (d) degree of deep fascia involvement (partial or extensive), and (e) degree of compartment involvement (fewer than three compartments or three or more compartments). On contrast material-enhanced fat-suppressed T1-weighted images, the contrast enhancement patterns of the abnormal deep fascia (no enhancement, enhancement, or enhancement with nonenhancing portion) and the muscle (no abnormality, peripheral band-like signal intensity, or patchy high signal intensity) were evaluated. The presence of abscesses in the subcutaneous fat layer was evaluated with all sequences. Results: The patients with NIF had a significantly greater frequency of (a) thick (≥3 mm) abnormal signal intensity on fatsuppressed T2-weighted images, (b) low signal intensity in the deep fascia on fat-suppressed T2-weighted images, (c) a focal or diffuse nonenhancing portion in the area of abnormal signal intensity in the deep fascia, (d) extensive involvement of the deep fascia, and (e) involvement of three or more compartments in one extremity (P < .05). Conclusion: MR imaging is potentially helpful for differentiating NIF from non-NIF.

Original languageEnglish
Pages (from-to)816-824
Number of pages9
JournalRadiology
Volume259
Issue number3
DOIs
StatePublished - 1 Jun 2011

Fingerprint

Fasciitis
Necrotizing Fasciitis
Fascia
Magnetic Resonance Imaging
Fats
Image Enhancement
Muscles
Research Ethics Committees
Subcutaneous Fat
Abscess
Contrast Media
Magnetic Resonance Spectroscopy
Extremities

Cite this

Kim, Kyoung Tae ; Kim, Yeo Ju ; Lee, Ju Won ; Kim, Youn Jeong ; Park, Sun Won ; Lim, Myung Kwan ; Suh, Chang Hae. / Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging?. In: Radiology. 2011 ; Vol. 259, No. 3. pp. 816-824.
@article{ef82a43de10f4ee8b9fd2a2747332f69,
title = "Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging?",
abstract = "Purpose: To retrospectively evaluate whether magnetic resonance (MR) imaging findings can be used to differentiate necrotizing infectious fasciitis (NIF) from nonnecrotizing infectious fasciitis (non-NIF). Materials and Methods: Institutional review board approval was obtained, but patient consent was not required for this retrospective review of records and images because patient anonymity was preserved. Thirty patients (seven with NIF, 23 with non-NIF) were included in the study. The following imaging findings were analyzed on fat-suppressed T2-weighted MR images: (a) signal intensity in the deep fascia (low, high, or mixed high and low), (b) thickness of abnormal signal intensity in the deep fascia (≥3 mm or <3 mm), (c) pattern of abnormal signal intensity in muscle (no abnormality, peripheral bandlike signal intensity, or patchy high signal intensity), (d) degree of deep fascia involvement (partial or extensive), and (e) degree of compartment involvement (fewer than three compartments or three or more compartments). On contrast material-enhanced fat-suppressed T1-weighted images, the contrast enhancement patterns of the abnormal deep fascia (no enhancement, enhancement, or enhancement with nonenhancing portion) and the muscle (no abnormality, peripheral band-like signal intensity, or patchy high signal intensity) were evaluated. The presence of abscesses in the subcutaneous fat layer was evaluated with all sequences. Results: The patients with NIF had a significantly greater frequency of (a) thick (≥3 mm) abnormal signal intensity on fatsuppressed T2-weighted images, (b) low signal intensity in the deep fascia on fat-suppressed T2-weighted images, (c) a focal or diffuse nonenhancing portion in the area of abnormal signal intensity in the deep fascia, (d) extensive involvement of the deep fascia, and (e) involvement of three or more compartments in one extremity (P < .05). Conclusion: MR imaging is potentially helpful for differentiating NIF from non-NIF.",
author = "Kim, {Kyoung Tae} and Kim, {Yeo Ju} and Lee, {Ju Won} and Kim, {Youn Jeong} and Park, {Sun Won} and Lim, {Myung Kwan} and Suh, {Chang Hae}",
year = "2011",
month = "6",
day = "1",
doi = "10.1148/radiol.11101164",
language = "English",
volume = "259",
pages = "816--824",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "3",

}

Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging? / Kim, Kyoung Tae; Kim, Yeo Ju; Lee, Ju Won; Kim, Youn Jeong; Park, Sun Won; Lim, Myung Kwan; Suh, Chang Hae.

In: Radiology, Vol. 259, No. 3, 01.06.2011, p. 816-824.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging?

AU - Kim, Kyoung Tae

AU - Kim, Yeo Ju

AU - Lee, Ju Won

AU - Kim, Youn Jeong

AU - Park, Sun Won

AU - Lim, Myung Kwan

AU - Suh, Chang Hae

PY - 2011/6/1

Y1 - 2011/6/1

N2 - Purpose: To retrospectively evaluate whether magnetic resonance (MR) imaging findings can be used to differentiate necrotizing infectious fasciitis (NIF) from nonnecrotizing infectious fasciitis (non-NIF). Materials and Methods: Institutional review board approval was obtained, but patient consent was not required for this retrospective review of records and images because patient anonymity was preserved. Thirty patients (seven with NIF, 23 with non-NIF) were included in the study. The following imaging findings were analyzed on fat-suppressed T2-weighted MR images: (a) signal intensity in the deep fascia (low, high, or mixed high and low), (b) thickness of abnormal signal intensity in the deep fascia (≥3 mm or <3 mm), (c) pattern of abnormal signal intensity in muscle (no abnormality, peripheral bandlike signal intensity, or patchy high signal intensity), (d) degree of deep fascia involvement (partial or extensive), and (e) degree of compartment involvement (fewer than three compartments or three or more compartments). On contrast material-enhanced fat-suppressed T1-weighted images, the contrast enhancement patterns of the abnormal deep fascia (no enhancement, enhancement, or enhancement with nonenhancing portion) and the muscle (no abnormality, peripheral band-like signal intensity, or patchy high signal intensity) were evaluated. The presence of abscesses in the subcutaneous fat layer was evaluated with all sequences. Results: The patients with NIF had a significantly greater frequency of (a) thick (≥3 mm) abnormal signal intensity on fatsuppressed T2-weighted images, (b) low signal intensity in the deep fascia on fat-suppressed T2-weighted images, (c) a focal or diffuse nonenhancing portion in the area of abnormal signal intensity in the deep fascia, (d) extensive involvement of the deep fascia, and (e) involvement of three or more compartments in one extremity (P < .05). Conclusion: MR imaging is potentially helpful for differentiating NIF from non-NIF.

AB - Purpose: To retrospectively evaluate whether magnetic resonance (MR) imaging findings can be used to differentiate necrotizing infectious fasciitis (NIF) from nonnecrotizing infectious fasciitis (non-NIF). Materials and Methods: Institutional review board approval was obtained, but patient consent was not required for this retrospective review of records and images because patient anonymity was preserved. Thirty patients (seven with NIF, 23 with non-NIF) were included in the study. The following imaging findings were analyzed on fat-suppressed T2-weighted MR images: (a) signal intensity in the deep fascia (low, high, or mixed high and low), (b) thickness of abnormal signal intensity in the deep fascia (≥3 mm or <3 mm), (c) pattern of abnormal signal intensity in muscle (no abnormality, peripheral bandlike signal intensity, or patchy high signal intensity), (d) degree of deep fascia involvement (partial or extensive), and (e) degree of compartment involvement (fewer than three compartments or three or more compartments). On contrast material-enhanced fat-suppressed T1-weighted images, the contrast enhancement patterns of the abnormal deep fascia (no enhancement, enhancement, or enhancement with nonenhancing portion) and the muscle (no abnormality, peripheral band-like signal intensity, or patchy high signal intensity) were evaluated. The presence of abscesses in the subcutaneous fat layer was evaluated with all sequences. Results: The patients with NIF had a significantly greater frequency of (a) thick (≥3 mm) abnormal signal intensity on fatsuppressed T2-weighted images, (b) low signal intensity in the deep fascia on fat-suppressed T2-weighted images, (c) a focal or diffuse nonenhancing portion in the area of abnormal signal intensity in the deep fascia, (d) extensive involvement of the deep fascia, and (e) involvement of three or more compartments in one extremity (P < .05). Conclusion: MR imaging is potentially helpful for differentiating NIF from non-NIF.

UR - http://www.scopus.com/inward/record.url?scp=79956327713&partnerID=8YFLogxK

U2 - 10.1148/radiol.11101164

DO - 10.1148/radiol.11101164

M3 - Article

C2 - 21406630

AN - SCOPUS:79956327713

VL - 259

SP - 816

EP - 824

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 3

ER -