%0 Journal Article %T Cerebral mucormycosis: neuroimaging findings and histopathological correlation %+ Hôpital de Hautepierre [Strasbourg] %+ Centre hospitalier de Haguenau %+ Service des Maladies Infectieuses et Tropicales [CHU Strasbourg] %+ Laboratoire de Parasitologie et de Mycologie Médicale [Strasbourg] %+ Département de neuroradiologie interventionnelle et fonctionnelle [Fondation A.-de-Rothschild, Paris] %+ Service de Radiologie et IRM [CHU Lyon] %+ Neuroépidémiologie Tropicale (NET) %+ Service de Radiologie et Imagerie Médicale [CHU Limoges] %+ Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale (U1215 Inserm - UB) %+ Département de Neuro-Radiologie [Bordeaux] (DNR - Bordeaux) %+ Lille Neurosciences & Cognition - U 1172 (LilNCog) %+ Departement de Neuroradiologie [Lille] %+ Service de Radiologie (TOURS - Radio) %+ Service d’Hématologie, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France %+ Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube) %+ Département de Radiologie [CHU Hautepierre, Strasbourg] %A Lersy, François %A Royer-Leblond, Julie %A Lhermitte, Benoit %A Chammas, Agathe %A Schneider, Francis %A Hansmann, Yves %A Lefebvre, Nicolas %A Denis, Julie %A Sabou, Marcela %A Lafitte, François %A Cotton, François %A Boncoeur-Martel, Marie-Paule %A Tourdias, Thomas %A Pruvo, Jean-Pierre %A Cottier, Jean-Philippe %A Herbrecht, Raoul %A Kremer, Stéphane %< avec comité de lecture %@ 0340-5354 %J Journal of Neurology %I Springer Verlag %8 2021-07-08 %D 2021 %R 10.1007/s00415-021-10701-8 %K Cerebral mucormycosis %K Fungal %K Invasive fungal infections %K MRI %K Mucormycosis %Z Life Sciences [q-bio]/Santé publique et épidémiologieJournal articles %X Introduction: Mucormycosis are infections caused by molds of the order Mucorales. These opportunistic infections are rare, difficult to diagnose, and have a poor prognosis. We aimed to describe common radiographic patterns that may help to diagnose cerebral mucormycosis and search for histopathological correlations with imaging data. Methods: We studied the radiological findings (CT and MRI) of 18 patients with cerebral mucormycosis and four patients' histopathological findings. Results: All patients were immunocompromised and/or diabetic. The type of lesions depended on the infection's dissemination pathway. Hematogenous dissemination lesions were most frequently abscesses (59 lesions), cortical, cortical-subcortical, or in the basal ganglia, with a halo aspect on DWI for lesions larger than 1.6 cm. Only seven lesions were enhanced after contrast injection, with different presentations depending on patients' immune status. Ischemia and hemorrhagic areas were also seen. Vascular lesions were represented by stenosis and thrombosis. Direct posterior extension lesions were bi-fronto basal hypodensities on CT and restricted diffusion without enhancement on MRI. A particular extension, perineural spread, was seen along the trigeminal nerve. Histopathological analysis found endovascular lesions with destruction of vessel walls by Mucorales, microbleeds around vessels, as well as acute and chronic inflammation. Conclusions: MRI is the critical exam for cerebral mucormycosis. Weak ring enhancement and reduced halo diffusion suggest the diagnosis of fungal infections. Involvement of the frontal lobes should raise suspicion of mucormycosis (along with aspergillosis). The perineural spread can be considered a more specific extension pathway of mucormycosis. %G English %L hal-03407674 %U https://unilim.hal.science/hal-03407674 %~ UNILIM %~ HCL %~ CNRS %~ INRIA %~ ENGEES %~ NET %~ UNIV-STRASBG %~ SANTE_PUB_INSERM %~ GEIST %~ INSA-STRASBOURG %~ TESTBORDEAUX %~ INC-CNRS %~ AGREENIUM %~ SITE-ALSACE %~ UNIV-LILLE %~ INRIA-AUT %~ INSA-GROUPE %~ EPIMACT %~ OMEGAHEALTH %~ MAGENDIE %~ LABCIS