NECROTIZING FASCIITIS - CT CHARACTERISTICS

PURPOSE: To establish computed tomographic (CT) criteria for the diagn osis of necrotizing fasciitis. MATERIALS AND METHODS: Twenty CT scans in 20 patients with pathologically proved necrotizing fasciitis were r eviewed retrospectively for fascial thickening, fat infiltration, foca l fluid collection, soft-tissue gas, muscle involvement, and intra-abd ominal extension; the findings were correlated with clinical factors, including associated illnesses, disease site, treatment, and outcome. RESULTS: Average patient age was 57.8 years; there were 13 men and sev en women. Four patients (20%) died. Asymmetric fascial thickening and fat stranding were seen in 16 patients (80%). Gas tracking along fasci al planes was present in 11 patients (55%), and abscesses were found i n seven patients (35%). Infection sites were scrotum (n = 6), a lower extremity (n = 4), perineum (n = 4), neck (n = 2), back (n = 2), arm ( n = 1), and abdomen (n = 1). Underlying illness (n = 17) was diabetes in 10 patients (50%), alcoholism in three (15%), chronic renal failure in two (10%), and drug abuse in two (10%). CONCLUSION: CT criteria of asymmetric fascial thickening and gas are valuable in assessing suspe cted necrotizing fasciitis. CT also can provide information on coexist ent deep collections.