Imaging characteristics of brain abscess in children with congenital heart disease

BACKGROUND: Brain abscess is a rare disease in childhood requiring prompt medical and/or surgical treatment. The objective was to discuss the head computed tomography and magnetic resonance imaging characteristics of children with brain abscess in congenital heart disease (CHD) group compared with the group without CHD, further comprehend the imaging findings, and assess the severity of brain abscess in children with CHD. MATERIALS AND METHODS: The radiological features of brain abscess in children hospitalized in Shanghai Children's Medical Center between September 2014 and September 2021 were retrospectively reviewed. RESULTS: Forty-four children (14 females, 30 males), with a median age of 8.6 years (range 2–15 years), were enrolled in this study. CHD was found in 22 cases. Twenty-one of these 22 patients were with cyanotic CHD. The remaining 22 cases were without CHD. Among the 22 patients with CHD, superficial abscesses of 2–5 cm in diameter are the main imaging findings, which was the same as in children without CHD. In our study, brain abscesses of CHD are usually single, while other brain abscesses are usually multiple in children without CHD. There was statistically significant difference in the number of abscesses between the group with CHD and the group without CHD (χ2 = 6.3, P = 0.04). Compared with no CHD children, the nearest distance from the ventricular wall to the margin of brain abscess in children with CHD is often <7 mm. CONCLUSIONS: Brain abscesses in children with CHD have some special imaging characteristics. Superficial abscesses of 2–5 cm in diameter are the main imaging findings. Brain abscesses of CHD are usually single, while other brain abscesses are usually multiple in children without CHD. Compared with no CHD children, the nearest distance from the ventricular wall to the margin of brain abscess in children with CHD is shorter.