DEEP FASCIAL HYPERINTENSITY IN SOFT-TISSUE ABNORMALITIES AS REVEALED BY T2-WEIGHTED MR-IMAGING

OBJECTIVE. The purpose of this study was to determine whether recently described criteria, including hyperintense TZ-weighted signal or othe r abnormalities revealed by MR imaging within deep fascial planes, are specific for necrotizing soft-tissue infections. MATERIALS AND METHOD S. We reviewed 22 MR imaging examinations that revealed abnormally hig h signal intensity within deep fascial planes on T2-weighted images. T wenty-one of the patients had clinical diagnoses other than necrotizin g soft-tissue infection, including nonnecrotizing cellulitis (n=4), ab scess without evidence of necrotizing fasciitis (n=5), and cellulitis with accompanying vascular thrombosis (n=2), MR imaging was performed using T1-weighted spin-echo (range of TRs/range of TEs, 300-800/9-30) and fat-saturated T2-weighted fast spin-echo (3000-5000/76-108) sequen ces, Gadolinium-enhanced T1-weighted spin-echo MR images with fat satu ration were obtained for 14 patients. Two reviewers, unaware of clinic al diagnoses, evaluated each study for abnormalities in superficial an d deep soft tissues and submitted a consensus diagnosis. RESULTS. Usin g only the described MR imaging criteria, we interpreted all cases as necrotizing cellulitis, including the cases of 21 patients who had non necrotizing conditions. CONCLUSION. Hyperintense T2-weighted signal wi thin deep fascial planes and muscle, with or without contrast enhancem ent, is not specific for necrotizing soft-tissue infection. A variety of conditions exhibited similar findings and were indistinguishable fr om necrotizing soft-tissue infection.