[Paracoccidioidomycosis of the central nervous system: study of 5 cases by magnetic resonance].

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.