Imaging characteristics of central nervous system aspergillosis / 中华神经科杂志

ABSTRACT

Objective:To explore the imaging manifestations of central nervous system aspergillosis (CNSAG).Methods:The cranial imaging changes of five CNSAG patients admitted to the First Medical Center of People′s Liberation Army General Hospital from 2013 to 2019 were analyzed and their imaging characteristics were summarized.Results:There were four males and one female with the minimum age of 20 years old and maximum age of 59 years old. Among the five cases, two cases mainly occurred in the cavernous sinus and three cases in the cerebral parenchyma. Long T 1-weighted and long T 2-weighted signals were observed in all the lesions of the cerebral parenchyma, while equal or short T 1-weighted, equal or long T 2-weighted signals were observed in the lesions of the cavernous sinus. Magnetic resonance imaging (MRI) of the brain of all cases showed multiple ring enhancement, which could form serrate or lace-like arrangement along the periphery of the lesion and gather together to form "honeycomb" enhancement characteristics. The degree of peripheral enhancement was more obvious, and the scope of enhancement increased after the disease was aggravated. High diffusion weighted imaging (DWI) signal can be seen in the ring enhanced focus, which is the MRI feature of abscess, and high DWI signal can be seen at the edge of the enhanced ring. Susceptibility weighted imaging showed low bleeding signal, no characteristic changes in the spectrum, and decreased perfusion in the central area. Computer tomography scan showed normal or equal density mass lesions, obvious edema or complicated infarction showed irregular low-density shadow, and bleeding showed high-density shadow. Conclusion:MRI showed mixed signal and circular enhancement, computer tomography showed normal or isodense mass lesions, or irregular low-density shadow, and bleeding signs could be found in CNSAG.