Xiao Anqi, Zeng Hanjiang, Xiao Jiahe, Zhang Xiaoke, You Chao
Sichuan University, West China Hospital, Department of Neurosurgery, Chengdu, China.
Turk Neurosurg. 2017;27(3):386-394. doi: 10.5137/1019-5149.JTN.16209-15.0.
To investigate the imaging features of neurocysticercosis and to provide valuable information about the diagnosis and treatment for clinicians.
The data of 71 consecutive cases of neurocysticercosis, diagnosed by computed tomography (CT) and magnetic resonance imaging (MRI) between January 2009 and January 2014 in our institute were collected. Of all the cases, 57 patients met the recognized diagnostic criteria of neurocysticercosis. In this series, enzyme-linked immunosorbent assay (ELISA) examination and Cysticercosis IgG were positive in 55 cases and 3 cases, respectively. Among them, neurocysticercosis was confirmed surgically in 11 cases. Seven cases had CT examinations, including enhanced CT in one case. Fifty-four cases had MRI examinations, including contrast-enhanced MRI in 46 cases. Therapeutically, 32 patients received albendazole, while 25 patients received praziquantel. As a surgical treatment, 9 patients underwent lesionectomy, and 1 patient underwent lesionectomy plus shunt insertion for hydrocephalus.
Parenchymal cysticerci in 53 cases (92.9%), subarachnoidal cysticerci in 39 cases (68.4%), ventricular cysticerci in 13 cases (22.8%) and spinal cysticerci in 1 case were demonstrated on CT and MRI scans. In total, the intracranial cysticerci involving multiple locations simultaneously were found in 39 patients. Thirty-five cases had associated leptomeningitis, 10 cases had hydrocephalus. In 1 case, the cysticerci were located outside of the central nervous system.
The imaging findings of the cysticerci, including their location, numbers, cystic sizes, capsular thickness, densities and signals of the scolexes, as well as the peripheral edema, have distinct value in making possible timely diagnosis of neurocysticercosis for clinicians.
探讨神经囊尾蚴病的影像学特征,为临床医生的诊断和治疗提供有价值的信息。
收集我院2009年1月至2014年1月间经计算机断层扫描(CT)和磁共振成像(MRI)诊断的71例连续神经囊尾蚴病患者的数据。所有病例中,57例符合公认的神经囊尾蚴病诊断标准。在本系列中,酶联免疫吸附试验(ELISA)检查和囊尾蚴病IgG分别在55例和3例中呈阳性。其中,11例经手术确诊为神经囊尾蚴病。7例进行了CT检查,其中1例进行了增强CT检查。54例进行了MRI检查,其中46例进行了对比增强MRI检查。治疗方面,32例患者接受了阿苯达唑治疗,25例患者接受了吡喹酮治疗。作为手术治疗,9例患者接受了病灶切除术,1例患者接受了病灶切除术加脑积水分流术。
CT和MRI扫描显示53例(92.9%)为实质型囊尾蚴,39例(68.4%)为蛛网膜下腔型囊尾蚴,13例(22.8%)为脑室型囊尾蚴,1例为脊髓型囊尾蚴。总共39例患者同时发现颅内囊尾蚴累及多个部位。35例伴有软脑膜炎,10例伴有脑积水。1例中,囊尾蚴位于中枢神经系统外。
囊尾蚴的影像学表现,包括其位置、数量、囊肿大小、囊壁厚度、头节的密度和信号以及周围水肿,对临床医生及时诊断神经囊尾蚴病具有独特价值。