Differentiating Intracranial Aspergillosis from a High Grade Glioma Using MRI and MR Spectroscopic Imaging

We compare the MRI (magnetic resonance imaging) and MRSI (MR spectroscopic imaging) findings in a patient with intracerebral aspergillosis to those typically seen in an infiltrating high-grade glioma (HGG). We demonstrate paramagnetic areas of T2-hypointensity due to the pathologic deposition of iron and other paramagnetic elements seen in intracerebral aspergillosis. We also demonstrate the diffusion-weighted imaging (DWI) findings and discuss how MR spectroscopy can be useful in differentiating an aspergilloma from a high-grade glioma.