Diffusion-weighted imaging of cerebritis

Area of Science:

• Neuroradiology
• Infectious Diseases
• Neuroimaging

Background:

• Restricted diffusion on diffusion-weighted imaging (DWI) is a hallmark of pyogenic brain abscess.
• DWI characteristics of cerebral infections before capsule formation are less understood.
• Distinguishing early-stage infections from other brain masses is clinically important.

Observation:

• A case of fungal cerebritis presented with restricted water diffusion.
• The diffusion-weighted imaging findings were similar to those typically seen in pyogenic brain abscess.
• Diffusion coefficient measurements fell within the reported range for pyogenic abscess.

Findings:

• Fungal cerebritis, an early-stage cerebral infection, can exhibit markedly restricted water diffusion.
• This restricted diffusion is comparable to that observed in established pyogenic brain abscesses.
• The diffusion characteristics challenge the assumption that restricted diffusion solely indicates pyogenic etiology.

Implications:

• Cerebritis should be included in the differential diagnosis for ill-defined focal brain masses with restricted diffusion.
• This expands the understanding of DWI findings in cerebral infections.
• Accurate diagnosis of early cerebral infections is vital for timely and appropriate treatment.