MR and other imaging methods in the investigation of mycetomas

Purpose: To report features of mycetomas (actino- and eumycetoma infection) , which belong to the so-called rare bone infections, as evaluated by MR an d other imaging methods and to assess chemotherapy treatment. Material and Methods: Twenty patients (average age 57 years) were diagnosed by different modalities. Analyses of 57 plain films, 31 three-phase bone s cans, 28 CT and 35 MR examinations were performed. The MR protocol included T1-weighting without and with contrast, T2-weighted, proton density and fa t suppressing sequences. Results: Signs of chronic osteomyelitis were seen in plain films of 10 pati ents (50%). but the healing process was difficult to assess. Bone scintigra phy was positive in 12 patients (60%). In 14 patients (70%), CT could demon strate bone lesions, but the healing process was difficult to estimate in 4 patients. MR imaging provided accurate diagnostic information in 15 cases (75%). In 16 patients (80%), small lesions could be identified due to grain s, which seemed to differentiate mycetoma from other infections and tumorou s lesions. MR examination gave definitive answer about the healing process in 18 cases (90%). Conclusion: MR investigation was superior to the other imaging techniques i n the evaluation of mycetoma and the assessment of therapy.