Brain Abscess

Brain-Abscess-A-Axi-T1WI.jpg

A

Brain-Abscess-B-Axi-T2WI.jpg

B

Brain-Abscess-C-Axi-T1WI+C.jpg

C

Brain-Abscess-D-Sag-T1WI+C.jpg

D

Clinical History: 
This 35-year-old man presented to the emergency department complaining of intermittent headaches, paresthesias, and weakness of his left thumb for nine days. The patient reported a history of fever along with these symptoms. After the MRI examination illustrated herein, the patient underwent successful surgical treatment.

Diagnosis:
Right parietal lobe abscess.

MR Technique:
MR images were obtained at 1.5 T utilizing an 8-channel head coil. (A) axial pre-contrast spin echo T1WI (TR/TE 380/14 ms, 320×192 matrix), (B) fat-suppressed fast spin echo T2WI (TR/TE 3900/84 ms) images as well as (C)axial and (D)sagittal fat-suppressed, post-contrast spin echo T1WI were obtained utilizing a slice thickness of 5 mm.

Imaging Findings:
Post-contrast imaging reveals a large, intra-axial ring-enhancing lesion within the right parietal lobe. The image is associated with prominent vasogenic edema within the adjacent white matter, demonstrating hyperintensity and hypointensity to parenchyma on T2 and T1WI, respectively. The enhancing abscess rim demonstrates a characteristically irregular but well-demarcated border, while its inner necrotic cord does not enhance. There is a smaller second, posteriorly-adjacent lesion with a similar appearance.