Type:
Educational Exhibit
Keywords:
Paediatric, CT, MR, Ultrasound, Diagnostic procedure, Abscess, Infection
Authors:
R. JAIN1, G. AGGARWAL2, A. Sahu2, B. AGGARWAL3; 1DELHI, DELHI/IN, 2NEW DELHI/IN, 3NEW DELHI, DELHI/IN
DOI:
10.26044/ecr2019/C-1315
Findings and procedure details
Eight infants who were admitted in our pediatric intensive care unit and who were diagnosed as having abscesses in view of clinical findings and imaging were included in the study.
The patients’ demographic properties,
baseline clinical findings,
time of clinical improvement,
and ultrasound,
computed tomography and magnetic resonance imaging (MRI) at the time of diagnosis and in the follow-up period were obtained.
Radiologist with over 20 years of experience evaluated all the imaging.
Three infants had liver abscesses; two among these had bacterial infection and one had amoebic infection.
Ultrasound was the initial modality used and showed poorly demarcated heterogenous predominantly hypoechoic (with some internal echoes) lesions with lack of central perfusion on color doppler images.
MRI was performed and revealed T1 hypointense,
T2 hyperintense peripherally enhancing lesions with central diffusion restriction and corresponding ADC drop.
Perilesional edema was also noted.
Two infants had retropharyngeal abscesses diagnosed on MRI show lobulated collection filling retropharyngeal space.
Collection showed marked mass effect with encroachment of airway.
There are enhancing septations and thick enhancing wall.
The lesions are T1 hypointense and T2/STIR hyperintense with diffusion restriction.
One infant had muscle abscess showing large multi-loculated pockets of fluid intensity collections with adjacent signal alterations at the level of vastus intermedius and lateralis.
There was associated periosteal elevation in the shaft of the femur with diffuse marrow signal alterations.
Two had lung abscess showing thick walled round cavities with air-fluid level and adjacent lung consolidation.
Pt No
|
Sex
|
Organ involved
|
Clinical features
|
ICU stay
|
Ward Stay
|
|
|
|
|
|
|
1
|
M
|
Liver
|
Pain fever
|
2
|
8
|
2
|
F
|
Liver
|
Pain fever
|
1
|
5
|
3
|
M
|
Liver
|
Pain fever
|
0
|
5
|
4
|
M
|
Muscle
|
Pain fever
|
3
|
8
|
5
|
F
|
Lung
|
Cough fever
|
5
|
10
|
6
|
F
|
Lung
|
Cough fever
|
6
|
10
|
7
|
F
|
Retropharynx
|
odynophagia
|
4
|
7
|
8
|
M
|
Retropharynx
|
odynophagia
|
3
|
8
|