Utility of Magnetic Resonance Imaging for Differentiating Necrotizing Fasciitis from Severe Cellulitis : A Magnetic Resonance Indicator for Necrotizing Fasciitis (MRINEC) Algorithm
We developed a new magnetic resonance indicator for necrotizing fasciitis (MRINEC) algorithm for differentiating necrotizing fasciitis (NF) from severe cellulitis (SC). All adults with suspected NF between 2010 and 2018 in a tertiary hospital in South Korea were enrolled. Sixty-one patients were diagnosed with NF and 28 with SC. Among them, 34 with NF and 15 with SC underwent magnetic resonance imaging (MRI). The MRINEC algorithm, a two-step decision tree including T2 hyperintensity of intermuscular deep fascia and diffuse T2 hyperintensity of deep peripheral fascia, diagnosed NF with 94% sensitivity (95% confidence interval (CI), 80-99%) and 60% specificity (95% CI, 32-84%). The algorithm accurately diagnosed all 15 NF patients with a high (≥8) laboratory risk indicator for necrotizing fasciitis (LRINEC) score. Among the five patients with an intermediate (6-7) LRINEC score, sensitivity and specificity were 100% (95% CI, 78-100%) and 0% (95% CI, 0-84%), respectively. Finally, among the 29 patients with a low (≤5) LRINEC score, the algorithm had a sensitivity and specificity of 88% (95% CI, 62-98%) and 69% (95% CI, 39-91%), respectively. The MRINEC algorithm may be a useful adjuvant method for diagnosing NF, especially when NF is suspected in patients with a low LRINEC score.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
Journal of clinical medicine - 9(2020), 9 vom: 21. Sept. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kim, Min-Chul [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Revised 30.10.2020 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/jcm9093040 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM315381779 |
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| 245 | 1 | 0 | |a Utility of Magnetic Resonance Imaging for Differentiating Necrotizing Fasciitis from Severe Cellulitis |b A Magnetic Resonance Indicator for Necrotizing Fasciitis (MRINEC) Algorithm |
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| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a We developed a new magnetic resonance indicator for necrotizing fasciitis (MRINEC) algorithm for differentiating necrotizing fasciitis (NF) from severe cellulitis (SC). All adults with suspected NF between 2010 and 2018 in a tertiary hospital in South Korea were enrolled. Sixty-one patients were diagnosed with NF and 28 with SC. Among them, 34 with NF and 15 with SC underwent magnetic resonance imaging (MRI). The MRINEC algorithm, a two-step decision tree including T2 hyperintensity of intermuscular deep fascia and diffuse T2 hyperintensity of deep peripheral fascia, diagnosed NF with 94% sensitivity (95% confidence interval (CI), 80-99%) and 60% specificity (95% CI, 32-84%). The algorithm accurately diagnosed all 15 NF patients with a high (≥8) laboratory risk indicator for necrotizing fasciitis (LRINEC) score. Among the five patients with an intermediate (6-7) LRINEC score, sensitivity and specificity were 100% (95% CI, 78-100%) and 0% (95% CI, 0-84%), respectively. Finally, among the 29 patients with a low (≤5) LRINEC score, the algorithm had a sensitivity and specificity of 88% (95% CI, 62-98%) and 69% (95% CI, 39-91%), respectively. The MRINEC algorithm may be a useful adjuvant method for diagnosing NF, especially when NF is suspected in patients with a low LRINEC score | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a LRINEC score | |
| 650 | 4 | |a MRINEC algorithm | |
| 650 | 4 | |a magnetic resonance imaging | |
| 650 | 4 | |a necrotizing fasciitis | |
| 650 | 4 | |a nonnecrotizing soft tissue infection | |
| 700 | 1 | |a Kim, Sujin |e verfasserin |4 aut | |
| 700 | 1 | |a Cho, Eun Been |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Guen Young |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Seong-Ho |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Seon Ok |e verfasserin |4 aut | |
| 700 | 1 | |a Chung, Jin-Won |e verfasserin |4 aut | |
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