Department of Radiology, Xiangya hospital, Central South University, Changsha, Hunan, 410008, China.
BMC Pediatr. 2012 Sep 24;12:155. doi: 10.1186/1471-2431-12-155.
Cerebral sparganosis in children is an extremely rare disease of central nervous system, and caused by a tapeworm larva from the genus of Spirometra. In this study, we discussed and summarized epidemiological, clinical and MR imaging characteristics of eighteen children with cerebral sparganosis for a better diagnosis and treatment of the disease.
Eighteen children with cerebral sparganosis verified by pathology, serological tests and MR presentations were retrospectively investigated, and the epidemiologic and clinical characteristics of the disease were studied.
Twenty-seven lesions were found in the eighteen children. Twelve lesions in twelve patients were solitary while the lesions in the rest six patients were multiple and asymmetrical. The positions of the lesions were: seven in frontal, eleven in parietal, four in temporal and two in occipital lobes, one in basal ganglia, one in cerebella hemisphere and one in pons. The lesions were presented as slight hypointensity on T1-weighted images but moderate hyperintensity on T2-weighted images with perilesional brain parenchyma edema. Enhanced MR scans by using Gadopentetic Acid Dimeglumine Salt were performed in the patients, and the images demonstrated abnormal enhancements with the patterns of a peripheral ring, or a tortuous beaded, or a serpiginous tubular shape. Follow-up MR scans were preformed for eight patients, and three out of the eight cases exposed migrations and changes in shapes of the lesion areas.
The MR presentations in our study in general were similar to those in previous studies. However serpiginous tubular and comma-shaped enhancements of lesions have not been previously reported. The enhanced MR imaging and follow-up MR scans with the positive results from serological tests are the most important methods for the clinical diagnosis of cerebral sparganosis in children.
儿童脑裂头蚴病是一种极为罕见的中枢神经系统寄生虫病，由裂头蚴属的绦虫幼虫引起。本研究通过讨论和总结 18 例儿童脑裂头蚴病的流行病学、临床和磁共振成像（MRI）特征，旨在提高对该病的诊断和治疗水平。
回顾性分析 18 例经病理、血清学检查和 MRI 证实的脑裂头蚴病患儿的临床资料，总结其流行病学和临床特征。
18 例患儿共发现 27 个病灶。12 例患儿的 12 个病灶为单发，其余 6 例患儿的病灶为多发且不对称，病变部位：额叶 7 个，顶叶 11 个，颞叶 4 个，枕叶 2 个，基底节区 1 个，小脑半球 1 个，脑桥 1 个。病灶 T1WI 呈稍低信号，T2WI 呈等或稍高信号，周围脑实质水肿。增强 MRI 扫描均采用钆喷酸葡胺，病灶呈异常强化，强化形式有：周边环状、迂曲串珠状或蜿蜒管状。8 例患儿进行了随访 MRI 扫描，其中 3 例病灶部位出现迁移和形态改变。
本研究中患儿的 MRI 表现与既往研究基本相似，但未见呈蜿蜒管状和逗号形强化的病灶。增强 MRI 成像和随访 MRI 扫描，结合血清学检查阳性结果，是儿童脑裂头蚴病的重要临床诊断方法。
