Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710, Republic of Korea.
Eur J Radiol. 2010 Aug;75(2):236-40. doi: 10.1016/j.ejrad.2009.04.024. Epub 2009 May 17.
The purpose of this study is to investigate the MRI findings of visceral larva migrans (VLS) of Toxocara canis in spinal cord.
We retrospectively reviewed spinal MRI findings in eight patients with serologically proven Toxocara canis between 2005 and 2008. We evaluated the location, length, extent and migration of the lesion, MR signal intensity (SI), enhancement pattern, and swelling of the spinal cord. We evaluated clinical features including presenting symptoms and signs and treatment response.
Total 8 patients (M=8; age range 36-79 years) were included. The lesions were located in the cervical or thoracic spinal cord in all patients. All lesions showed high SI and minimal or mild swelling of involved spinal cord on T2WI and focal nodular enhancement on posterior or posterolateral segment of spinal cord. The length of involved lesion was relatively short in most patients. There was a migration of lesion in one patient. In spite of albendazole or steroid treatment, neurological symptoms or signs were not significantly improved in all patients.
Although all lesions show non-specific imaging findings like non-tumorous myelopathy mimicking transverse myelitis, single lesion, focal nodular enhancement on posterior or posterolateral segment of spinal cord, relatively short segmental involvement and migration of lesion may be characteristic findings of spinal VLM of Toxocara canis. In addition, the reluctant response to the treatment may be characteristic of spinal VLM of Toxocara canis.
本研究旨在探讨犬弓首蛔虫内脏幼虫移行症(VLS)在脊髓中的 MRI 表现。
我们回顾性分析了 2005 年至 2008 年间 8 例经血清学证实的犬弓首蛔虫感染患者的脊髓 MRI 表现。我们评估了病变的位置、长度、范围和迁移、MR 信号强度(SI)、增强模式和脊髓肿胀情况。我们评估了临床特征,包括症状和体征以及治疗反应。
共纳入 8 例患者(M=8;年龄 36-79 岁)。所有患者病变均位于颈段或胸段脊髓。所有病变在 T2WI 上均呈高信号,受累脊髓轻度或轻度肿胀,脊髓后或后外侧段呈局灶性结节样强化。大多数患者受累病变长度相对较短。1 例患者病变有迁移。尽管使用阿苯达唑或类固醇治疗,但所有患者的神经症状或体征均无明显改善。
尽管所有病变均表现出非特异性的影像学表现,如类似于横断性脊髓炎的非肿瘤性脊髓病,但单发病变、脊髓后或后外侧段局灶性结节样强化、受累节段相对较短以及病变迁移可能是犬弓首蛔虫脊髓 VLS 的特征性表现。此外,对治疗的反应不敏感可能是犬弓首蛔虫脊髓 VLS 的特征性表现。