Arun G Karthat, Soumya Regi, Habie Thomas, Katti B Sara, P Beula Subashini, Rajan Sundaresan, Regi Thomas
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引用次数: 0
Abstract
Objective: Apparent diffusion coefficient (ADC) value helps in differentiating infections from neoplasms on magnetic resonance imaging (MRI). We investigate the diffusion-weighted images in skull base osteomyelitis (SBO) to evaluate if ADC values can differentiate fungal and bacterial SBO and to analyse the microbiology of all SBO patients.
Design: Retrospective observational study.
Setting: Quaternary care referral centre.
Participants: A retrospective review of 142 patients diagnosed and treated for SBO patients from January 2010 to May 2023 was done.
Main outcome measure: Chi-square or Fisher's exact test was used to compare ADC values of bacterial and fungal SBO.
Results: The most common pathogens isolated were Pseudomonas (42.2%), Aspergillus (30.98%), and S. aureus (23.94%). The average ADC value of affected soft tissues among patients was 1.13 ± 0.26 × 10-3 mm2/s compared to the average ADC value of normal soft tissue, 1.34 ± 0.31 × 10-3 mm2/s. There was no statistical significance when comparing the average ADC values of bacterial and fungal SBO patients (p value = 0.142).
Conclusion: This study suggests that though infection due to Pseudomonas was the commonest, it was detected only in 42.2% of patients. More than half of the cases had organisms other than Pseudomonas, demanding the clinician to obtain deeper biopsies early in the course of the disease for microbiological analysis. DWI does not help differentiate bacterial and fungal SBO, again emphasising the need for deeper tissue biopsies in all these patients to assist in the early identification of the pathogen.
期刊介绍：
Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with:
current otorhinolaryngological practice
audiology, otology, balance, rhinology, larynx, voice and paediatric ORL
head and neck oncology
head and neck plastic and reconstructive surgery
continuing medical education and ORL training
The emphasis is on high quality new work in the clinical field and on fresh, original research.
Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject.
• Negative/null results
In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.
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