Cha S H, Chang K H, Cho S Y, Han M H, Kong Y, Suh D C, Choi C G, Kang H K, Kim M S
Department of Diagnostic Radiology, Seoul National University Hospital, Korea.
AJR Am J Roentgenol. 1994 Jan;162(1):141-5. doi: 10.2214/ajr.162.1.8273653.
Diagnosis of cerebral paragonimiasis in its early active stage is important because curative chemotherapy is possible. Accordingly, this study was undertaken to evaluate the CT and MR features of early active cerebral paragonimiasis.
We retrospectively reviewed the CT scans (n = 29) and MR images (n = 7) of the brain in 20 patients between 7 and 59 years old who had cerebral paragonimiasis in the early active stage. The diagnosis was based on a positive antibody test by enzyme-linked immunosorbent assay (ELISA) for paragonimiasis in serum and CSF. The diagnosis was confirmed surgically in seven patients.
The most common and characteristic imaging finding was a conglomerate of ringlike enhancing lesions (grape-cluster appearance) with surrounding edema in one cerebral hemisphere in 11 patients (55%). Other nonspecific findings included a solitary ringlike lesion (n = 4) or irregular enhancing lesions (n = 2), localized hemorrhage with (n = 3) or without (n = 2) enhancing lesions, and a poorly defined non-hemorrhagic, nonenhancing lesion (n = 1).
CT and MR findings of clustered ring-enhancing lesions, seen in approximately half of the cases of early cerebral paragonimiasis, are suggestive of cerebral paragonimiasis.
脑型肺吸虫病早期活动期的诊断很重要，因为此时进行根治性化疗是可行的。因此，本研究旨在评估早期活动期脑型肺吸虫病的CT和MR特征。
我们回顾性分析了20例年龄在7至59岁之间的早期活动期脑型肺吸虫病患者的脑部CT扫描（n = 29）和MR图像（n = 7）。诊断基于血清和脑脊液中肺吸虫病酶联免疫吸附试验（ELISA）抗体检测呈阳性。7例患者经手术确诊。
最常见且具有特征性的影像学表现是11例患者（55%）一侧脑半球出现由环形强化病灶组成的团块（葡萄串样外观）并伴有周围水肿。其他非特异性表现包括单个环形病灶（n = 4）或不规则强化病灶（n = 2）、伴有（n = 3）或不伴有（n = 2）强化病灶的局限性出血，以及边界不清的非出血性、无强化病灶（n = 1）。
在大约一半的早期脑型肺吸虫病病例中可见的成簇环形强化病灶的CT和MR表现提示脑型肺吸虫病。
