Can diffusion-weighted imaging be used to differentiate brain abscess from other ring-enhancing brain lesions? A meta-analysis

Aim To explore the role of diffusion-weighted imaging (DWI) in the discrimination of brain abscess from other ring-enhancing brain lesions through meta-analysis. Materials and methods The PUMBED, OVID, and China National Knowledge Infrastructure (CNKI) databases, from January 1995 to March 2013, were searched for studies evaluating the diagnostic performance of DWI in the discrimination of brain abscess lesions. Using the data collected, pooled sensitivities and specificities across studies were determined, positive and negative likelihood ratios (LR) were calculated, and summary receiver operating characteristic (SROC) curves were constructed. Results A total of 11 studies fulfilled all of the inclusion criteria and were considered for the analysis. The pooled sensitivity values and pooled specificity values including 95% confidence intervals (CI) were 0.95 (0.87–0.98) and 0.94 (0.88–0.97). The pooled positive LR (95% CI) was 4.13(2.55–6.7); the pooled negative LR (95% CI) was 0.01 (0–1.7); and the area under the curve of the symmetric SROC was 0.98. Conclusions DWI has high sensitivity and specificity for the differentiation of brain abscess from other intracranial cystic mass lesions.