Magalhães A C, Bacheschi L A, Caramelli P, Lo L S, de Menezes Neto J R, Shikanai-Yasuda M A, Magalhães A
Departamento de Radiologia, Hospital das Clínicas-Faculdade de Medicina, Universidade de São Paulo.
Rev Hosp Clin Fac Med Sao Paulo. 1993 Mar-Apr;48(2):94-7.
Paracoccidioidomycosis is a systemic mycosis, endemic in South and Central America, that affects the central nervous system in almost 10% of the cases. Neurological involvement includes to different clinical forms: meningeal and granulomatous form, also known as pseudotummoral form. Five patients with intracranial paracoccidioidomycosis were submitted to MR examination in a 1.5T system. All patients presented multiple round or lobulated lesions, hyperintense in T1-weighted images and predominantly hypointese in T2-weighted images. The lesions were distributed diffusely, with a slight predominance in the supratentorial compartment, although infratentorial lesions were also observed, mainly in the cerebellum. All lesions had ring or nodular contrast enhancement. Three patients were reexamined for treatment control, with disappearance of the lesions in two, with persistence of hypointense area in T2-weighted images. MR imaging proves to be a good method to evaluate the neurological involvement in paracoccidioidomycosis, mainly due to its high sensitivity for posterior fossa lesions. Further studies are needed to correlate the MR findings and the changes found in MR examination after treatment.
副球孢子菌病是一种系统性真菌病，在南美洲和中美洲流行，近10%的病例会累及中枢神经系统。神经受累包括不同的临床形式：脑膜和肉芽肿形式，也称为假肿瘤形式。5例颅内副球孢子菌病患者在1.5T系统中接受了MR检查。所有患者均表现为多发圆形或分叶状病变，在T1加权图像上呈高信号，在T2加权图像上主要呈低信号。病变呈弥漫性分布，幕上腔略占优势，尽管也观察到幕下病变，主要位于小脑。所有病变均有环形或结节状强化。3例患者因治疗控制进行了复查，其中2例病变消失，T2加权图像上低信号区持续存在。MR成像被证明是评估副球孢子菌病神经受累的一种好方法，主要是因为它对后颅窝病变具有高敏感性。需要进一步研究以关联MR表现与治疗后MR检查中发现的变化。
