Nalini Atchayaram, de Souza Aaron, Saini Jitender, Thennarasu Kandavel
Department of Neurology, National Institute of Mental Health and Neurosciences; Bangalore, India -
Department of Neurology, National Institute of Mental Health and Neurosciences; Bangalore, India.
Neuroradiol J. 2014 Jun;27(3):339-49. doi: 10.15274/NRJ-2014-10054. Epub 2014 Jun 17.
We describe the evolution of quantitative T2 relaxometry values on serial MRI in patients with a solitary cerebral cysticercal lesion (SCCL), and determine whether albendazole therapy affects T2 relaxation (T2R) values. Patients with new-onset seizures and MRI-confirmed SCCL were randomized to treatment with albendazole and antiepileptics ("treatment group") or antiepileptics only ("controls"). Serial MRI including T2 relaxometry was performed at baseline, three, six, 12, and 24 months. Of 123 patients recruited, 81 had more than three MRI scans (treatment group: 37; controls: 44; 58 patients had five scans). The lesion wall at baseline showed a mean T2R value of 152.3 ms, centre 474.9 and perilesional parenchyma 338.5 ms. These were significantly higher than those from normal parenchyma (114 ms). Over time, most sharply in the initial three months, T2R values fell but even at 24 months, they remained above those from normal parenchyma. A slight increase in T2R values from the lesion centre at six months was thought to represent the initiation of gliosis. In the treatment group, T2R values approached normal at 24 months, while controls had persistently higher T2R values. The decline in T2R values at six months was more prominent in the treatment group. T2R values at baseline and at three months differed significantly depending on the stage of the lesion, being higher in stage 2 SCCL. T2R values from SCCL declined over 24 months, being significantly higher in earlier stages of degeneration. A mild increase after six months may be due to the initiation of gliosis. T2R values appear to decline faster in patients who receive albendazole.
我们描述了孤立性脑囊尾蚴病病变（SCCL）患者在系列磁共振成像（MRI）上定量T2弛豫测量值的演变情况，并确定阿苯达唑治疗是否会影响T2弛豫（T2R）值。新发癫痫且MRI确诊为SCCL的患者被随机分为接受阿苯达唑和抗癫痫药物治疗组（“治疗组”）或仅接受抗癫痫药物治疗组（“对照组”）。在基线、3个月、6个月、12个月和24个月时进行包括T2弛豫测量的系列MRI检查。在招募的123例患者中，81例进行了超过3次MRI扫描（治疗组：37例；对照组：44例；58例患者进行了5次扫描）。基线时病变壁的平均T2R值为152.3毫秒，中心为474.9毫秒，病变周围实质为338.5毫秒。这些值显著高于正常实质的值（114毫秒）。随着时间推移，尤其是在最初3个月内，T2R值下降，但即使在24个月时，它们仍高于正常实质的值。6个月时病变中心T2R值略有增加被认为代表胶质增生的开始。在治疗组中，24个月时T2R值接近正常，而对照组的T2R值持续较高。治疗组6个月时T2R值的下降更为显著。基线和3个月时的T2R值因病变阶段而异，在2期SCCL中更高。SCCL的T2R值在24个月内下降，在退变早期显著更高。6个月后轻度增加可能是由于胶质增生的开始。接受阿苯达唑治疗的患者T2R值似乎下降得更快。
