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神经囊虫病:放射-病理相关性。

Neurocysticercosis: radiologic-pathologic correlation.

机构信息

PET-CT Unit, CT Scanner del Sur, Grupo CT Scanner, Rafael Checa 3, Mexico City, Mexico.

出版信息

Radiographics. 2010 Oct;30(6):1705-19. doi: 10.1148/rg.306105522.

Abstract

Neurocysticercosis is a neurologic parasitic disease caused by the encysted larva of the tapeworm Taenia solium and is the most important parasitic disease of the human central nervous system. It is the most common cause of acquired epilepsy in endemic settings and constitutes a public health challenge for most of the developing world. Nowadays, however, as a result of globalization, neurocysticercosis is being seen more frequently in developed countries as well. Neurocysticercosis is acquired through fecal-oral contamination, and the disease course is complex, with two intermediate hosts (ie, pigs and humans) and a definitive host (humans). Traditionally, it has been classified into active and nonactive forms according to disease location. Radiologists must be aware of its imaging appearance, which is quite variable, as is the differential diagnosis. Imaging findings depend on several factors, including the stage of the life cycle of T solium at presentation; the number and location (ie, subarachnoid, cisternal, or intraventricular) of parasites; and associated complications such as vascular involvement (ie, arteritis with or without infarction), inflammatory response (ie, edema, gliosis, or arachnoiditis), and, in ventricular forms, degree of obstruction. Thus, the diagnostic approach, management, and prognosis for neurocysticercosis differ widely depending on the type of infection.

摘要

脑囊尾蚴病是一种由带绦虫囊尾蚴引起的神经系统寄生虫病,是人类中枢神经系统最重要的寄生虫病。它是流行地区获得性癫痫的最常见原因,也是大多数发展中国家的公共卫生挑战。然而,由于全球化的影响,如今在发达国家也越来越多地发现脑囊尾蚴病。脑囊尾蚴病通过粪-口污染获得,疾病过程复杂,有两个中间宿主(即猪和人)和一个终末宿主(人)。传统上,根据病变部位将其分为活动期和非活动期。放射科医生必须了解其影像学表现,因为它具有很大的变异性,鉴别诊断也很复杂。影像学表现取决于多种因素,包括猪带绦虫生命周期在就诊时所处的阶段;寄生虫的数量和位置(即蛛网膜下腔、脑池或脑室);以及血管受累(即动脉炎伴或不伴梗死)、炎症反应(即水肿、胶质增生或蛛网膜炎)等相关并发症,在脑室形式中,还取决于阻塞程度。因此,根据感染类型,脑囊尾蚴病的诊断方法、治疗和预后差异很大。

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