Objective   To explore the value of dynamic susceptibility contrast MR (DSC-MR) perfusion-weighted imaging in differential diagnosis of brain abscess from necrotic or cystic metastatic brain tumor and high-grade glioma.     Methods   A total of 47 patients (20 patients with abscess and 27 patients with necrotic or cystic metastatic brain tumor and high-grade glioma) confirmed histologically were examined before operation using conventional MRI and DSC-MR perfusion-weighted imaging. The time-signal intensity curves and CBV artificial color mapping were analyzed. The mean maximum rrCBV values of the abscess walls and the bodies of necrotic or cystic metastatic brain tumor and high-grade glioma were measured and calculated.     Results   Difference was found in the time-signal intensity curves of brain abscess from those of necrotic or cystic metastatic brain tumor and high-grade glioma. Difference was also found in the CBV artificial color mapping in 16 (16/20) cases of brain abscess from all 27 cases of necrotic or cystic metastatic brain tumor and high-grade glioma. The mean maximum rrCBV value in the walls of the abscess (2.55±0.92) was lower than that in the bodies of the necrotic or cystic metastatic brain tumor and high-grade glioma [(4.32±1.09)

P0.01].     Conclusion    DSC-MR perfusion-weighted imaging can reveal the differences and it is of significant clinical value in preoperative differential diagnosis of brain abscess from necrotic or cystic metastatic brain tumor and high-grade glioma.