CT and MR characteristics of cerebral sparganosis
CT and MR characteristics of cerebral sparganosis
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DOI：
10.3174/ajnr.a0659
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发表时间：
2007-10-01
影响因子：
3.5
通讯作者：
Zhou, F.
中科院分区：
文献类型：
--
作者：
Song, T.;Wang, W.-S.;Zhou, F.
背景和目的：裂头蚴病是一种罕见的人体寄生虫感染，其病原菌为螺旋虫属幼虫。在过去，脑裂头蚴病的术前诊断一直非常困难。材料与方法：回顾分析25例经临床证实的脑裂头蚴病患者，男13例，女12例，年龄9~83岁。15例行MR检查，其中2例行CT扫描，8例行CT和MR扫描。重点评价CT和MR的影像表现。结果：所有患者均表现为脑白质水肿和变性。除1例外，其余均为单侧病变。22例患者有同侧脑室扩张。新发现是一个隧道征，长约4厘米，宽约0.8厘米，在增强后的冠状和矢状位MB图像上呈柱状或梭形(n=10)。13例呈珠状强化，2例CT表现为单环强化。在T2加权像上，管壁和管壁呈等信号或略高信号。CT有6例可见点状钙化，而MR仅有3例。4例患者在MR图像上可见出血。5例发现完整的白色、线状活虫。结论：MRI增强后最具特征的征象是隧道征。最常见的表现是珠状强化。除点状钙化外，MR在显示病变的范围和数目方面优于CT。结合临床资料和酶联免疫吸附试验，MRI可对脑裂头蚴病作出术前诊断。
Background and Purpose: Sparganosis is a rare parasitic infection in humans by a larval cestode of the genus Spirometra. Preoperative diagnosis of cerebral sparganosis in the past has been very difficult. Our objective was to evaluate the CT and MR features of cerebral sparganosis in order to make a definite diagnosis.Materials and Methods: We retrospectively reviewed 25 patients (13 male and 12 female; age range, 9-83 years) who proved to have cerebral sparganosis. Fifteen patients underwent MR imaging: 2 patients had CT scanning, and the remaining 8 had both CT and MR scanning. We focused on evaluating the imaging features on CT and MR.Results: All patients showed edema and degeneration of cerebral white matter. All but 1 had a unilateral lesion. Twenty-two patients had ipsilateral ventricular dilation. The new finding was a tunnel sign, approximately 4 cm in length and 0.8 cm in width, column or fusiform shaped on postcontrast coronal and sagittal MB images (n = 10). Thirteen patients showed bead-like enhancement, but solitary ring enhancement was common on the CT images (n = 2). The wall of the ring and tunnel appeared isointense or slightly hyperintense on T2-weighted images. Punctate calcifications were seen in 6 patients on CT images but only in 3 patients on the MR images. Hemorrhage was seen in 4 patients on the MR images. An intact whitish, stringlike, living worm was found (n = 5).Conclusion: The most characteristic finding was a tunnel sign on postcontrast MR images. The most common finding was bead-shaped enhancement. MR is superior to CT in demonstrating the extent and number of lesions, except punctate calcifications. Combined with clinical data and enzyme-linked immunosorbent assay, the preoperative diagnosis of cerebral sparganosis could be established on MR imaging.