Natural history of solitary cerebral cysticercosis on serial magnetic resonance imaging and the effect of albendazole therapy on its evolution
Natural history of solitary cerebral cysticercosis on serial magnetic resonance imaging and the effect of albendazole therapy on its evolution
复制标题
DOI：
10.1016/j.jns.2009.09.018
复制
发表时间：
2010-01-15
影响因子：
4.4
通讯作者：
Thennarasu, K.
中科院分区：
文献类型：
--
作者：
de Souza, A.;Nalini, A.;Thennarasu, K.
目的：描述连续MRI上孤立性脑囊尾蚴病变（SCCL）的影像学特征的演变，并研究阿苯达唑治疗的效果。设计：随机对照前瞻性试验。方法和材料：123例新发癫痫发作和SCCL在对比MRI上的患者随机接受阿苯达唑治疗，并随访5次连续MRI。结果：81例患者（M - 41，F - 40）的平均年龄为19.6 ± 11.7岁，接受了4或5次连续MRI。对356例MRI进行了分析。在第一次MRI研究中，61.9%的患者在造影后T1序列中观察到Scolex，并且从下一次扫描开始可见性显著下降。囊肿内容物最初呈T1低信号，T2高信号，30.8%的囊肿内容物在FLAIR上倒置，随后扫描显示T2低信号。囊壁特征从最初的T2低信号到后来的高信号边缘发生了显着变化。初次扫描显示98.5%的患者出现病灶周围水肿，第二次扫描后症状消失。约17.5%的患者在随访扫描中显示轻微的病灶周围T2高信号。增强模式从环状到盘状，再到无增强。最初69.7%的病变处于胶泡状阶段。病变通过囊肿变性的后续阶段：这个过程所需的时间进行了描述。影像学特征，无论是在第一次和随后的扫描，阿苯达唑和control groups.Conclusions之间没有差异：SCCL的演变遵循一个可预测的序列对应于前面描述的形态学阶段，需要一年多的时间才能完成。随着退变的进展，对比增强降低，但一些钙化病变继续增强。阿苯达唑治疗可以加速病变周围炎症的消退，但既不影响囊尾蚴的形态，也不影响囊尾蚴的变性和随后的愈合过程。(C)2009 Elsevier B. V.保留所有权利。
Aim: To describe the evolution of imaging characteristics of solitary cerebral cysticercal lesions (SCCL) on serial MRI, and to study the effect of treatment with albendazole.Design: Randomised controlled prospective trial.Methods and material: 123 patients with new-onset seizures and SCCL on contrast MRI were randomised to treatment with albendazole and followed with up to five serial MRIs.Results: 81 patients (M - 41, F - 40) with mean age of 19.6 +/- 11.7 years and 4 or 5 serial MRI were included in the analysis. Analysis was performed oil 356 MRI's. Scolex was seen in 61.9% of patients in postcontrast T1 sequence in the first MRI Study, and there was a significant drop in visibility from the next scan onwards. Cyst contents were initially T1-hypointense and T2-hyperintense with inversion on FLAIR in 30.8% and later scans showed T2-hypointensity. Cyst wall characteristics changed significantly from initially T2-hypointensity to later hyperintense rim. Initial scan revealed perilesional oedema in 98.5%, which is resolved by the second scan. Around 17.5% showed subtle perilesional T2-hyperintensity in follow-up scans. Enhancement pattern changed significantly from ring to disc, and later to non-enhancement. Initially, 69.7% lesions were in colloid-vesicular stage. Lesions moved through subsequent stages of cyst degeneration: time needed for this process is described. Imaging characteristics, both on the first and on subsequent scans, did not differ between albendazole and control groups.Conclusions: Evolution of SCCL follows a predictable sequence corresponding to morphologic stages described earlier, taking over a year to complete. Contrast enhancement decreases as degeneration progresses, but some calcific lesions continue to enhance. Albendazole therapy may hasten resolution of inflammation around the lesion but affects neither the morphology of the cysticercus nor the process of degeneration and subsequent healing. (C) 2009 Elsevier B.V. All rights reserved.