Zhang Jin Song, Huan Yi, Sun Li Jun, Zhang Guang Yun, Ge Ya Li, Zhao Hai Tao
Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China.
J Magn Reson Imaging. 2006 Apr;23(4):569-73. doi: 10.1002/jmri.20546.
We retrospectively reviewed the MR images of the brains of six children (age = 5-13 years) who had cerebral paragonimiasis in the early active stage. Diagnosis was based on a positive antibody test enzyme-linked immunosorbent assay (ELISA) for paragonimiasis in serum. The most common finding (in five patients) was irregular hemorrhage of various degrees. Moreover, in three cases some multiple irregular lesions with surrounding edema appeared to be conglomerated and aggregated. The rare appearance (in one patient) was a "tunnel sign," which showed the migrating track of the adult worm. In one patient with abscess and minimal hemorrhage, diffusion-weighted imaging (DWI) showed a heterogeneous high signal of lesions. Other findings included slight (one patient) or marked (one patient) irregular contrast enhancement, and large edematous areas surrounding small centers of hemorrhage (two patients). MR findings of conglomerated lesions with hemorrhage or tunnel sign may help to establish the diagnosis of active-stage cerebral paragonimiasis.
我们回顾性地分析了6例处于脑肺吸虫病早期活动阶段儿童（年龄5 - 13岁）的脑部磁共振成像（MR）。诊断依据血清中肺吸虫病酶联免疫吸附试验（ELISA）抗体检测呈阳性。最常见的表现（5例患者）为不同程度的不规则出血。此外，3例出现一些伴有周围水肿的多发不规则病灶，似有聚集融合。罕见表现（1例患者）为“隧道征”，显示成虫的移行轨迹。1例有脓肿及少量出血的患者，扩散加权成像（DWI）显示病灶呈不均匀高信号。其他表现包括轻度（1例患者）或明显（1例患者）的不规则强化，以及围绕小出血灶的大片水肿区（2例患者）。伴有出血的融合病灶或隧道征的MR表现可能有助于脑肺吸虫病活动期的诊断。
