Miaux Y, Ribaud P, Williams M, Guermazi A, Gluckman E, Brocheriou C, Laval-Jeantet M
Department of Radiology, Höpital Saint-Louis, Paris, France.
AJNR Am J Neuroradiol. 1995 Mar;16(3):555-62.
To assess the CT and MR appearance of cerebral aspergillosis in patients who have undergone bone marrow transplantation.
The imaging and clinical data of five patients with cerebral aspergillosis were reviewed retrospectively and compared with autopsy findings.
Lesions are often located in the basal ganglia and demonstrate an intermediate signal intensity within surrounding high-signal areas on long-repetition-time MR scans. The lesions were multiple in four of the five patients and more numerous on MR images than on CT scans. The lesions (which demonstrate no parenchymal enhancement) are consistent with acute infarcts as confirmed at autopsy. In the large lesions, there is early intravascular and meningeal enhancement, as expected in acute infarcts involving an appreciable portion of the territory of a cerebral artery.
The diagnosis of early cerebral infarction in a patient considered at risk for invasive aspergillosis, even without overt pulmonary disease, is an indication to institute aggressive antifungal therapy.
评估骨髓移植患者脑曲霉病的CT和MR表现。
回顾性分析5例脑曲霉病患者的影像学和临床资料，并与尸检结果进行比较。
病变常位于基底节区，在长重复时间MR扫描上，病变在周围高信号区内呈中等信号强度。5例患者中有4例病变为多发，且MR图像上的病变比CT扫描上更多。病变（无实质强化）与尸检证实的急性梗死相符。在大的病变中，可见早期血管内和脑膜强化，这与累及大脑动脉相当部分区域的急性梗死预期表现一致。
对于有侵袭性曲霉病风险的患者，即使没有明显的肺部疾病，早期脑梗死的诊断也是积极进行抗真菌治疗的指征。
