BACKGROUND AND PURPOSE: Systemic invasive aspergillosis involves the brain
through hematogenous dissemination. A retrospective review of 18 patients w
ith aspergillosis involving the brain was performed in order to present ima
ging findings and thereby broaden the understanding of the distribution and
imaging characteristics of brain Aspergillus infection and to facilitate i
ts early diagnosis.
METHODS: The neuroimaging studies of 17 biopsy- or autopsy-proved cases and
one clinically diagnosed case were examined retrospectively by two neurora
diologists, The studies were evaluated for anatomic distribution of lesions
, signal characteristics of lesions, enhancement, hemorrhage, and progressi
on on serial studies (when performed), Medical records, biopsy reports, and
autopsy findings were reviewed.
RESULTS: Thirteen of 18 patients had involvement of the basal nuclei and/or
thalami, Nine of the 10 patients with lesions at the corticomedullary junc
tion also had lesions in the basal nuclei or thalami, Callosal lesions were
seen in seven patients, Progression of lesion number and size was seen in
all 11 patients in whom serial studies had been performed, Enhancement was
minimal or absent in most cases, There was gross hemorrhage in eight of the
18, and definite ring-enhancement in three.
CONCLUSION: Among our cases, lesions in perforating artery territories were
more common than those at the corticomedullary junction, Ring enhancement
and gross hemorrhage may be present, but are not necessary for the prospect
ive diagnosis.