| Summary: | 碩士 === 國立陽明大學 === 臨床醫學研究所 === 98 === The purpose of this study was to demonstrate the clinical applications of diffusion-weighted MRI techniques for patients with pelvic abscesses. Eleven patients (age 37-78 years, average 42 years) with a final diagnosis of pelvic abscess in Kaohsiung Veterans General Hospital underwent pelvic MRI examinations, which included diffusion-weighted sequences at the two different b values (b=0 and1000 s/mm2) in addition to conventional MRI sequences. Pelvic abscesses were confirmed in all patients by surgery or needle aspiration. In six patients, pathogens, including Escherichia coli, Streptococcus and Actinomycosis have been identified. Pelvic abscesses were markedly homogeneously hyperintense on diffusion-weighted MRI and hypointense (restricted water diffusion) on apparent diffusion coefficient (ADC) map. The average of the mean ADC values at the pelvic abscesses of these eleven patients was 0.76 × 10 -3 mm2/s (range 0.53 -0.97 × 10 -3 mm 2/s). The average of mean ADC values of pelvic abscesses with negative or positive microorganisms in culture were 0.70 × 10−3 and 0.81× 10−3 mm2/s, respectively. This data showed that there was no significant difference in ADC values between positive and negative bacterial cultures (p=0.144). In addition, we also reviewed seven patients with pelvic cystic tumors and measured the mean ADC values of cystic tumors on MRI. The average of the mean ADC values at pelvic cystic component of masses in seven patients was 2.15 × 10 -3 mm2/s (range 1.51 -2.61 × 10 -3 mm2/s). The ADC values of pelvic cystic tumors were significantly higher than those of pelvic abscesses (p<0.001). DW-MRI provides the helpful information for interpreting pelvic equivocal cystic masses, especially differentiating pelvic abscess from cystic tumor.
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