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Optical Clearing of the Mouse Central Nervous System Using Passive CLARITY
Published on: June 30, 2016
Paracoccidioidomycosis of the Central Nervous System: CT and MR Imaging Findings
M Rosa Júnior1, A C Amorim2, I V Baldon2
1From the Departments of Neuroradiology (M.R.J.).
Background And Purpose:
Paracoccidioidomycosis is a fungal infection mainly caused by the thermodimorphic fungus Paracoccidioides. The purpose of our study was to demonstrate the neuroimaging findings from 24 patients with CNS paracoccidioidomycosis.
Materials And Methods:
We performed a retrospective analysis focusing on the radiologic characteristics of CNS paracoccidioidomycosis. The 24 selected patients underwent MR imaging and/or CT, and the diagnosis was made by the presence of typical neuroimaging features, combined with fungus isolation, a serologic test, or the presence of disseminated disease.
Results:
Headache was the most common neurologic symptom, while the pseudotumoral form was the most common pattern. The number of lesions ranged from 1 to 11, with most localized on the frontal lobe with >2-cm lesions. CT showed mainly hypoattenuating lesions, whereas MR imaging demonstrated mainly hyposignal lesions on T1WI and T2WI. Furthermore, ring enhancement was present in most patients. The "dual rim sign" on SWI occurred in 100% of our patients with lesions of >2 cm.
Conclusions:
The diagnosis of CNS paracoccidioidomycosis is difficult. Nevertheless, imaging examinations can play an important role in the diagnosis and evaluation of the disease.
Insights
Neuroimaging reveals key findings in central nervous system (CNS) paracoccidioidomycosis. This fungal infection diagnosis is challenging, but characteristic imaging patterns aid in identification and evaluation.
Area of Science:
- Mycology
- Infectious Diseases
- Neurology
Background:
- Paracoccidioidomycosis is a fungal infection caused by *Paracoccidioides*.
- Central nervous system (CNS) involvement presents diagnostic challenges.
Purpose of the Study:
- To demonstrate neuroimaging findings in patients with CNS paracoccidioidomycosis.
- To highlight the role of imaging in diagnosing and evaluating this infection.
Main Methods:
- Retrospective analysis of 24 patients with CNS paracoccidioidomycosis.
- Review of MR imaging and/or CT scans.
- Diagnosis confirmed by neuroimaging features, fungus isolation, serology, or disseminated disease.
Main Results:
- Headache was the most common symptom; pseudotumoral form was the most frequent pattern.
- Lesions were often multiple, frontal lobe-located, and >2 cm.
- CT showed hypoattenuating lesions; MR imaging showed T1WI/T2WI hyposignal.
- Ring enhancement was common; the "dual rim sign" on SWI was present in 100% of patients with >2 cm lesions.
Conclusions:
- Diagnosing CNS paracoccidioidomycosis is difficult.
- Imaging examinations are crucial for diagnosis and evaluation.
- Characteristic neuroimaging findings can guide the diagnostic process.
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