Review of neuroimaging findings of intracranial angioinvasive fungal infections.

Autor: Acharya J; David Geffen School of Medicine, University of California, Los Angeles, Department of Diagnostic Radiology, Los Angeles, CA 90095, United States of America., Zamary AR; Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA 91101, United States of America. Electronic address: anthony.r.zamary@kp.org., Alach A; Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA 91101, United States of America., Kang J; Kaiser Permanente Los Angeles Medical Center, Department of Diagnostic Radiology, Los Angeles, CA 90027, United States of America., Rajamohan AG; Kaiser Permanente Los Angeles Medical Center, Department of Diagnostic Radiology, Los Angeles, CA 90027, United States of America., Mamlouk MD; Kaiser Permanente Santa Clara Medical Center, Department of Diagnostic Radiology, Santa Clara, CA 95051, United States of America; University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA 94143, United States of America., Torres F; Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA 91101, United States of America; Kaiser Permanente Los Angeles Medical Center, Department of Diagnostic Radiology, Los Angeles, CA 90027, United States of America.
Jazyk: angličtina
Zdroj: Clinical imaging [Clin Imaging] 2024 Nov; Vol. 115, pp. 110306. Date of Electronic Publication: 2024 Sep 24.
DOI: 10.1016/j.clinimag.2024.110306
Abstrakt: With increasing use of broad-spectrum antibiotics, advances in organ and stem-cell transplant therapy, and the continued diabetes mellitus II epidemic, as well as other risk factors, reports of fungal infections of the CNS have been increasing. The most lethal subset is the angioinvasive fungal infection. Aspergillus fumigatus, Mucor, and Fusarium tend to affect immunocompromised individuals depending on their risk factors. Exserohilum rostratum and Cladophialaphora species tend to infect immunocompetent individuals. Early diagnosis and treatment are imperative for improved outcomes and reduced morbidity and mortality. Clinical presentation is often nonspecific, while neuroimaging can be helpful for accurate diagnosis. CT of the head and/or the maxillofacial structures is the primary imaging modality. Once the infection begins to proliferate, areas of vasogenic and cytotoxic edema, with regional mass effect and shift of the midline structures may be seen. These findings, however, are often nonspecific and may also be seen in underlying neoplasm, inflammatory processes, and other intracranial infections. Characteristic findings on T1, T2, diffusion-weighted imaging (DWI), and gradient echo sequences (GRE) may help to further narrow the differential diagnoses. We present a review of neuroimaging findings that will aid the neuroradiologist in distinguishing intracranial angioinvasive fungal infections and lead to improved patient outcomes.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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