MRI Features of Intracranial Fungal Granuloma Taking Histopathology as the Gold Standard
Abstract
Objective: To explain the MRI features of intracranial fungal granuloma in patients with histopathology confirmed fungal infection.
Material and Methods: This descriptive case series study was conducted at the department of Radiology and Neurosurgery Lahore General Hospital, Lahore from June 2012 to June 2014, two years duration. 40 patients with histopathology confirmed intracranial fungal granuloma were included in this study. The mean ± SD was 33.76 ± 5.43 years. Out of total 40 patients 24 (60%) male and 16 (40%) female patients.
Study Design: Descriptive Case Series.
Duration: Two Years from June 2012 – June 2014.
Setting: Department of Radiology and Neurosurgery, Lahore General Hospital, Lahore.
Introduction: The diagnosis of intracranial fungal granulomas almost always remained a challenge both for neurosurgeons and radiologists because of their alter behavior and radiology. The diagnosis of these infections has increased in recent years because of increased awareness among clinicians about this pathology, better diagnostic tools and increase in the number of immunocompromised hosts (from any cause). Although mortality and morbidity from central nervous system (CNS) mycosis has improved over years; mortality often reaches 80 – 100% if the disease is not diagnosed properly and management initiated at the earliest. This study will help us to describe different radiological features (MRI) of this disease so that early detection and better management can be initiated on time.
Results: This study included 40 patients having histopathology confirmed diagnosis of intracranial fungal granuloma. The mean ± SD was 33.76 ± 5.43 years. Out of total 40 patients 24 (60%) male and 16 (40%) female patients. Thus the male to female ratio was 1.5: 1. Most of the patients were in their second and third decade of life. Out of total 40 cases, there were 36 (90%) patients had Aspergillus type and only 4 (10%) patients had Mucormycosis type of fungal infection.
Conclusion: These infections are hypo – iso intense on T2W MRI images with no or minimal enhancement in immunocompromised individuals. In immunocompetent individuals these infections form granuloma and usually show post gadolinium MRI enhancement.
Abbreviations: MRI (Magnetic Resonance Imaging), CNS (Central Nervous System).
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