Kaur Khush Preet, Garg Ajay, Devaranjan Sebastian Leve Joseph, Bhatia Rohit, Singh Mamta Bhushan, Srivastava Achal, Tripathi Manjari, Padma M V
Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Neurol India. 2021 Mar-Apr;69(2):385-391. doi: 10.4103/0028-3886.314519.
Solitary cysticercus granuloma (SCG) appearing as a single ring-enhancing lesion (SREL) is the most frequently encountered imaging finding in patients of neurocysticercosis (NCC) in India and during follow-up, most of SCGs resolve with or without calcifications. Recurrent SCG have been rarely reported.
The aim of our study is to report the incidence of recurrent SCG in a cohort of patients with SCG and postulate the hypothesis.
This retrospective study included 278 patients with SCG meeting the criteria of NCC. Their medical records and imaging studies were analyzed.
Out of 278 patients, 119 patients with SCG meeting the criteria of NCC with follow-up imaging were included. 15 (12.61%) had recurrent NCC and 104 (87.4%) patients did not have any recurrence during a median follow-up of 14.23 months (range; 0.24 - 113.3) and 25.26 months (range; 3.09- 98.11) respectively. Out of 15 recurrent NCC cases, ten patients had documented imaging resolution or partial regression of previous lesion followed by occurrence of new SCG in the same location, three patients had change in morphology of lesion from solitary discrete REL to solitary conglomerate REL secondary to development of new cysticercus granuloma adjacent to old lesion patients had recurrent lesions adjacent to previous lesion and two patients had new SCG in different locations following regression of old SCGs.
Recurrent SCGs are not uncommon in NCC and recurrence is more likely to occur at the site of initial infection and therefore may be mistaken for persistent infection or other granulomatous lesions.
孤立性囊尾蚴肉芽肿（SCG）表现为单个环形强化病灶（SREL），是印度神经囊尾蚴病（NCC）患者最常见的影像学表现，在随访期间，大多数SCG无论有无钙化都会消退。复发性SCG鲜有报道。
我们研究的目的是报告一组SCG患者中复发性SCG的发生率并提出假设。
这项回顾性研究纳入了278例符合NCC标准的SCG患者。分析了他们的病历和影像学检查。
278例患者中，119例符合NCC标准且有随访影像学检查的SCG患者被纳入研究。15例（12.61%）出现复发性NCC，104例（87.4%）患者在中位随访期分别为14.23个月（范围：0.24 - 113.3）和25.26个月（范围：3.09 - 98.11）期间未出现任何复发。在15例复发性NCC病例中，10例患者有先前病灶影像学消退或部分缩小的记录，随后在同一部位出现新的SCG；3例患者病灶形态从孤立离散的REL变为孤立聚合的REL，这是由于旧病灶旁出现新的囊尾蚴肉芽肿；2例患者在先前病灶旁出现复发病灶；2例患者旧的SCG消退后在不同部位出现新的SCG。
复发性SCG在NCC中并不少见，复发更可能发生在初始感染部位，因此可能被误诊为持续性感染或其他肉芽肿性病变。
