全身磁共振成像在评估播散性神经囊尾蚴病患者对阿苯达唑治疗反应中的价值：一项前瞻性随访研究

Value of whole-body MRI for the assessment of response to albendazole in disseminated neurocysticercosis: a prospective follow-up study.

作者信息

Wangda Kinzang, Kumar Neeraj, Garg Ravindra Kumar, Malhotra Hardeep Singh, Rizvi Imran, Uniyal Ravi, Pandey Shweta, Malhotra Kiran Preet, Verma Rajesh, Sharma Praveen Kumar, Parihar Anit, Jain Amita

机构信息

Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India.

Department of Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226010, India.

出版信息

Trans R Soc Trop Med Hyg. 2023 Apr 3;117(4):271-278. doi: 10.1093/trstmh/trac097.

DOI:10.1093/trstmh/trac097

PMID:36259415

Abstract

BACKGROUND

Disseminated neurocysticercosis is defined as simultaneous involvement of the brain (≥3 cysts) and at least one additional body site/organ. We aimed to identify disseminated cystic lesions in other body parts and investigate the effect of albendazole.

METHODS

We enrolled patients with multiple (≥3) neurocysticercosis brain lesions. Whole-body MRI (short tau inversion recovery coronal sequences) was performed to assess the number of lesions in the brain and other body parts at baseline and 3 months after albendazole therapy.

RESULTS

We screened 35 patients with multiple brain neurocysticercosis. In 13 patients, whole-body MRI demonstrated disseminated neurocysticercosis lesions. Ten patients were treated with albendazole. We excluded three patients. Brain MRI showed a mean lesion count of 163.6±193.8. Whole-body MRI (excluding the brain) showed a mean lesion count of 629.9±486.1. After albendazole therapy, the lesion load of the brain reduced significantly (163.6±193.8 to 99±178.3; p=0.008). Similarly, whole-body MRI showed a significant reduction in extracerebral neurocysticercosis lesion load (629.9±486.1 to 183.4±301.9; p=0.005). Three patients had complete resolution, five patients showed ≥50% reduction and two patients had <50% reduction in extracerebral lesion load.

CONCLUSION

Whole-body MRI should routinely be performed in multiple neurocysticercosis lesions of the brain. Albendazole treatment leads to a remarkable reduction in neurocysticercosis lesions throughout the body.

摘要

背景

播散性神经囊尾蚴病定义为脑（≥3个囊肿）和至少一个其他身体部位/器官同时受累。我们旨在识别其他身体部位的播散性囊肿性病变，并研究阿苯达唑的疗效。

方法

我们纳入了患有多个（≥3个）神经囊尾蚴病脑病变的患者。在基线时以及阿苯达唑治疗3个月后，进行全身MRI（短tau反转恢复冠状序列）以评估脑和其他身体部位的病变数量。

结果

我们筛查了35例患有多个脑神经囊尾蚴病的患者。在13例患者中，全身MRI显示有播散性神经囊尾蚴病病变。10例患者接受了阿苯达唑治疗。我们排除了3例患者。脑MRI显示平均病变数为163.6±193.8。全身MRI（不包括脑）显示平均病变数为629.9±486.1。阿苯达唑治疗后，脑内病变负荷显著降低（从163.6±193.8降至99±178.3；p=0.008）。同样，全身MRI显示脑外神经囊尾蚴病病变负荷显著降低（从629.9±486.1降至183.4±301.9；p=0.005）。3例患者病变完全消退，5例患者脑外病变负荷降低≥50%，2例患者脑外病变负荷降低<50%。