Poster électronique

Apport de l'imagerie de diffusion dans le diagnostic des abcès pelviens en IRM
TL. Nguyen, C. Barbe, M. Loock, O. Graesslin, C. Marcus, C. Hoeffel - Reims - France
Congrès 2011
Résumé
Objectifs
Evaluer les performances diagnostiques des séquences de diffusion pour le diagnostic d'abcès pelvien.
Matériels et méthodes
Inclusion prospective des patients adressés pour IRM à la recherche ou pour faire le bilan d'abcès pelvien. Des séquences T2 + axiale de diffusion + axiale après gadolinium ont été relues par trois radiologues indépendants et l'interprétation gradée de 0 à 4 (1) sur les séquences T2, (2) T2 + diffusion, (3) T2 + gadolinium, (4) toutes les séquences. Le diagnostic a été porté sur les prélèvements chirurgicaux et/ou de ponction (n=21) et/ou sur l'évolution clinique.
Résultats
25 patients inclus (14 femmes, 11 hommes, âge moyen=48, 18-90) avec 32 abcès pelviens d'origines gynécologique (n=7), appendiculaire (n=2), postopératoire (n=6), rectosigmoïdienne (n=10), Crohnienne (n=2), diverses (n=5). Les séquences T2 ont détecté pour les lecteurs 1, 2 et 3 respectivement de 87.5 à 90,63 %; T2 + gadolinium de 90,63 à 96,88 %; T2 + diffusion et toutes les séquences 100 % des abcès. La concordance interobservateur était de  0.48 à 0.78 pour un protocole standard (T2+ gado) versus 0.65 à 1 après diffusion.
Conclusion
Les séquence de diffusion en complément des séquences T2 peuvent suppléer l'injection de gadolinium et augmentent l'accord interobservateur.
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