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토끼 뇌농양의 환상-조영증강 병소에 대한 실험연구 : MRI 소견 및 병리조직학적 소견의 분석
Experimental Study on the Rim-Enhancing Lesion of Rabbit Brain Abscess : MR Imaging and Histopathologic Correlation

이희정    (계명대학교 의과대학 진단방사선과학교실  );
  • 초록

    Purpose : To evaluate on the basis of histopathologic carrelation the MR findings of mature brain abscess inthe rabbit, with particular attention to rim-enhancing lesions. Materials and Methods : The evolution of abscessformation was obtained by the direct inoculation of Staphylococcus aureus into the gray-white matter junctions ofthe brains of 16 rabbits. The stages of brain abscesses were divided into four : early cerebritis (days 1 to 5after inoculation of the organism) ; late cerebritis (days 6 to 14) ; early capsular (days 16 to 21) ; and latecapsular (days 22 to 28). The available MR images showed 14 cases at the stage of early cerebritis, seven at thelate cerebritis stage, three at the early capsular, and one at the late capsular stage. According to the knownpathology of brain abscesses and on the basis of both MR imaging and histopathologic findings, the lesions weregrouped according to whether they were found in the central necrotic, border, or peripheral zone. We analyzed thepatterns of rim-enhancement (completeness of the rim, thickness, and margin) and the signal intensities of theabscess walls on MR images at each stage. Histopathologic correlation was performed in one case of each stage. Weevaluated the presence or absence and degree of infiltration by inflammatory granulation tissue, microhemorrhage,reticulin, collagen, and hemosiderin of the abscess walls. Results : Rim-enhancing lesions were present in threeof 14 cases at the late cerebritis stage, in all three cases at the early capsular, in one at the late capsular,but in none at the early cerebritis stage. The enhancing pattern of the late cerebritis stage wasirregular-margined incomplete rim-enhancement, with irregular thickness of the abscess walls (3/3). The enhancingpattern of the capsular stages was well-defined, complete rim-enhancement with uniform thickness of the abscesswalls (3/4). The signal intensities of the abscess walls at the late cerebritis and early capsular stages werevariable. The late capsular stage was characterized by hypointensity of the abscess wall on both T1- andT2-weighted images. Histopathologically, the capsular stages were distinguished from the late cerebritis stage bythe marked infiltration of reticulin and the presence of collagen in the abscess walls. The most conspicuouspathologic finding distinguishing the late from the early capsular stage was abundant infiltration of the abscesswall by collagen and hemosiderin. Conclusion : The enhancing pattern of a brain abscess with mature capsuleformation was characterized by a well-defined, complete rim-enhancing abscess wall of uniform thickness. Themature abscess wall was hypointense on both T1- and T2-weighted images, may be explained by marked infiltration bymature collagen and hemosiderin.


  • 주제어

    Animals .   Brain, abscess .   Brain, MR .   Magnetic resonance(MR), contrast enhancement.  

  • 참고문헌 (19)

    1. 뇌농양의 CT소견과 병리조직소견의 비교분석. , 이문규;최병연;장기현;지제근 , 대한방사선의학회지 / v.19,pp.645-651,
         
    2. Neuropathological and computerized tomographic findings in experimental brain abscess , Brit RH;Enzmann DR;Yeager AS , J Neurosurg / v.55,pp.290-603,
    3. 뇌농양의 CT소견 : CT소견과 병리조직소견의 비교 , 문정미;박지현;김지향;임능개;송익훈;김병현 , 대한방사선의학회지 / v.31,pp.391-397,
         
    4. Penetration of brain abscess by systemically administered antibiotics , Black P;Graybill R;Charache P. , J Neurosurg / v.38,pp.705-709,
    5. Neuroimaging of cerebral abscess , Zimmerman RD;Weingarten K , Neuroimag Clin N Am / v.1,pp.1-16,
    6. Youmans I. , Neurological Surgery. (3rd ed.) Philadelphia: Saunders / v.,pp.3722-3735,
    7. The computed tomographic appearances of intra- and extracerebral abscesses , Blaquiere RM , Br J Radiol / v.56,pp.171-181,
    8. 뇌옹양의 자기공명영상소견. , 박만수;서대철;김상준 , 대한방사선의학회지 / v.31,pp.211-216,
    9. 뇌농양의 자기공명영상 소견 , 김성문;장기현;한문희;김상준;차상훈 , 대한방사선의학회지 / v.28,pp.513-518,
         
    10. MR imaging of brain abscesses , Haimes AB;Zimmerman RD;Morgello S;Weingarten K;Becker RD;Jennis R , AJR / v.152,pp.1073-2085,
    11. Experimental brain abscesses in the rabbit , Falconer MA;McFarian A;Russel DS , Br J Surg / v.30,pp.245-260,
    12. Infectious Disease. In Lee SH, Rao KCVG, Zimmerman RA. , Sze G;Lee SH , Cranial MRI and CT. (3rd ed.) / v.,pp.539-588,
    13. The magnetic resonance imaging of infections and inflammatory disease , Zimmerman RD;Sze G , Radiol Clin North Am / v.26,pp.839-859,
    14. Computed tomography as a guide in the diagnosis and follow-up of brain abscesses , Whelan MA;Hilal SK , Radiology / v.135,pp.663-671,
    15. 뇌농양의 자기공명영상 및 CT소견 : 농양벽두께와 신호강도를 중심으로. , 한태일;최우석;송미진;류경남;오주형;윤엽 , 대한방사선의학회지 / v.30,pp.993-997,
         
    16. Experimental brain abscess evolution : computed tomographic and neuropathologic correltatoin , Enzmann DR;Brit RH;Yeager AS , Radiology / v.133,pp.113-122,
    17. Decadron in treatment of cerebral abscess , Quartey GRC;Johnston JA;Rozdisky B , J Neurosurg / v.45,pp.301-310,
    18. Evolution of cerebral abscess : correlation of clinical features with computed tomography. , Zimmerman RD;Bilaniuk LT;Shipkin PM(et al.) , Neurology / v.27,pp.14-19,
    19. Nonspecificity of ring enhancement in "medically cured" brain abscess , Dobkin JF;Healton EB;Dickinson T;Brust JCM , Neurology / v.34,pp.139-144,
  • 이 논문을 인용한 문헌 (2)

    1. 1997. "Usefulness of MR Imaging in the Staging of Brain Abscess : Comparison between Experimental Models and Clinical Cases" 대한방사선의학회지 = Journal of the Korean Radiological Society, 37(6): 975~984     
    2. 1998. "Differential Diagnosis of and Brain Tumor and Brain Abscess : The Usefulness of Dynamic MR Imaging" 대한방사선의학회지 = Journal of the Korean Radiological Society, 39(3): 455~460     

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    1. 1992 "횡문근융해증의 골스캔" 大韓核醫學會誌 = Korean journal of nuclear medicine 26 (1): 106~110    
    2. 1992 "비장동맥에 선택적으로 투여한 Interleukin-2와 $^{99m}Tc-Phytate$ 혼합물의 생체내 분포" 大韓核醫學會誌 = Korean journal of nuclear medicine 26 (1): 124~126    
    3. 1994 "뇌종양에서의 역동적 자기공명영상의 유용성" 대한방사선의학회지 = Journal of the Korean Radiological Society 30 (4): 605~611    
    4. 1994 "내시경 담낭절제술에 발생한 담도손상의 간담도스캔" 大韓核醫學會誌 = Korean journal of nuclear medicine 28 (1): 141~144    
    5. 1995 "$^{99m}Tc-MAG_3$ 제거지수를 이용한 이식신장의 기능평가" 大韓核醫學會誌 = Korean journal of nuclear medicine 29 (1): 79~83    
    6. 1998 "역동적 자기공명영상을 이용한 뇌종양과 뇌농양의 감별진단" 대한방사선의학회지 = Journal of the Korean Radiological Society 39 (3): 455~460    
    7. 2002 "소아 단순 흉부 X-선 사진의 판독 - 정상 및 폐렴 소견을 중심으로 -" 소아과 = Journal of the Korean pediatric society 45 (11): 1311~1316    
    8. 2002 "재발한 급성 혼합형 백혈병에 동반된 골수괴사 1례의 MRI 소견" 소아과 = Journal of the Korean pediatric society 45 (2): 256~260    
    9. 2003 "선천성 양측성 신경모세포종의 치료경험 1례" 소아과 = Journal of the Korean pediatric society 46 (12): 1279~1282    
    10. 2003 "소아 종양 환아의 중추 신경계 합병증" 소아과 = Journal of the Korean pediatric society 46 (11): 1112~1117    

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