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MRI findings of eosinophilic myelomeningoencephalitis due to Angiostrongylus cantonensis.
Clin Radiol. 2005 Feb; 60(2):242-50.CR

Abstract

AIM

To study the imaging characteristics of eosinophilic myelomeningoencephalitis due to Angiostrongylus cantonensis using magnetic resonance imaging (MRI).

MATERIALS AND METHODS

Seventeen MRI examinations of the brain and spinal cord in five patients with angiostrongyliasis cantonensis of the central nervous system were performed. The final diagnosis was based on typical clinical symptoms, results of blood and cerebrospinal fluid (CSF) tests, and the presence of nematode larvae in the CSF. The sequential MRI follow-up examinations were carried out at a different stage for every patient from 1 to 28 weeks after the onset of symptoms. The features of the lesions in the brain, spinal cord, meninges and nerve roots on MRI were studied, moreover, the development of the lesions was analysed on follow-up MRI.

RESULTS

Abnormalities were demonstrated on MRI in all five cases. They included three cases of meningoencephalitis, one case of encephalitis and one myelomeningitis. The locations and appearances of the lesions were as follows: (1) brain involvement in four cases (including cerebrum in four, cerebellum in two and brain stem in three), and spinal cord involvement in one case. These lesions were diffuse or scattered and appeared as similar or slightly reduced signal intensity on T1-weighted images (T1WI), high signal intensity on T2-weighted images (T2WI) and turbo fluid attenuated inversion recovery pulse sequence (FLAIR) images. After administration of gadolinium chelate (Gd-DTPA), multiple round or oval enhancing nodules, with diameters ranging from 3 to 10 mm, were seen on T1WI, a few lesions appeared as stick-shaped enhancement whose longest measurement was 14 mm. Diffuse or local oedema around the lesion could be seen. (2) Meningeal involvement in four cases, a case of ependymal involvement and a case of nerve root involvement were among them. These lesions appeared as linear or nodular enhancement of the leptomeninges and ependyma, as well as nerve root enhancement. (3) There was a mild ventricular enlargement in two cases. On follow-up MRI lesions were most severe from the 5th week to the 8th week and it took at least 4-8 weeks (1-2 months) for a lesion to resolve completely, the resolution of larger lesion needed more than 22 weeks.

CONCLUSION

Multiple enhancing nodules in the brain and linear enhancement in the leptomeninges were the main features; stick-shaped enhancement was the characteristic sign of the disease on Gd-DTPA enhanced-T1 weighted images.

Authors+Show Affiliations

Department of Radiology, Beijing Friendship Hospital affiliate of Capital University of Medical Sciences, 95 Yong-An Road, Beijing 100050, China. erhujin@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15664579

Citation

Jin, E, et al. "MRI Findings of Eosinophilic Myelomeningoencephalitis Due to Angiostrongylus Cantonensis." Clinical Radiology, vol. 60, no. 2, 2005, pp. 242-50.
Jin E, Ma D, Liang Y, et al. MRI findings of eosinophilic myelomeningoencephalitis due to Angiostrongylus cantonensis. Clin Radiol. 2005;60(2):242-50.
Jin, E., Ma, D., Liang, Y., Ji, A., & Gan, S. (2005). MRI findings of eosinophilic myelomeningoencephalitis due to Angiostrongylus cantonensis. Clinical Radiology, 60(2), 242-50.
Jin E, et al. MRI Findings of Eosinophilic Myelomeningoencephalitis Due to Angiostrongylus Cantonensis. Clin Radiol. 2005;60(2):242-50. PubMed PMID: 15664579.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - MRI findings of eosinophilic myelomeningoencephalitis due to Angiostrongylus cantonensis. AU - Jin,E, AU - Ma,D, AU - Liang,Y, AU - Ji,A, AU - Gan,S, PY - 2004/02/15/received PY - 2004/04/26/revised PY - 2004/05/04/accepted PY - 2005/1/25/pubmed PY - 2005/3/9/medline PY - 2005/1/25/entrez SP - 242 EP - 50 JF - Clinical radiology JO - Clin Radiol VL - 60 IS - 2 N2 - AIM: To study the imaging characteristics of eosinophilic myelomeningoencephalitis due to Angiostrongylus cantonensis using magnetic resonance imaging (MRI). MATERIALS AND METHODS: Seventeen MRI examinations of the brain and spinal cord in five patients with angiostrongyliasis cantonensis of the central nervous system were performed. The final diagnosis was based on typical clinical symptoms, results of blood and cerebrospinal fluid (CSF) tests, and the presence of nematode larvae in the CSF. The sequential MRI follow-up examinations were carried out at a different stage for every patient from 1 to 28 weeks after the onset of symptoms. The features of the lesions in the brain, spinal cord, meninges and nerve roots on MRI were studied, moreover, the development of the lesions was analysed on follow-up MRI. RESULTS: Abnormalities were demonstrated on MRI in all five cases. They included three cases of meningoencephalitis, one case of encephalitis and one myelomeningitis. The locations and appearances of the lesions were as follows: (1) brain involvement in four cases (including cerebrum in four, cerebellum in two and brain stem in three), and spinal cord involvement in one case. These lesions were diffuse or scattered and appeared as similar or slightly reduced signal intensity on T1-weighted images (T1WI), high signal intensity on T2-weighted images (T2WI) and turbo fluid attenuated inversion recovery pulse sequence (FLAIR) images. After administration of gadolinium chelate (Gd-DTPA), multiple round or oval enhancing nodules, with diameters ranging from 3 to 10 mm, were seen on T1WI, a few lesions appeared as stick-shaped enhancement whose longest measurement was 14 mm. Diffuse or local oedema around the lesion could be seen. (2) Meningeal involvement in four cases, a case of ependymal involvement and a case of nerve root involvement were among them. These lesions appeared as linear or nodular enhancement of the leptomeninges and ependyma, as well as nerve root enhancement. (3) There was a mild ventricular enlargement in two cases. On follow-up MRI lesions were most severe from the 5th week to the 8th week and it took at least 4-8 weeks (1-2 months) for a lesion to resolve completely, the resolution of larger lesion needed more than 22 weeks. CONCLUSION: Multiple enhancing nodules in the brain and linear enhancement in the leptomeninges were the main features; stick-shaped enhancement was the characteristic sign of the disease on Gd-DTPA enhanced-T1 weighted images. SN - 0009-9260 UR - https://www.unboundmedicine.com/medline/citation/15664579/MRI_findings_of_eosinophilic_myelomeningoencephalitis_due_to_Angiostrongylus_cantonensis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0009926004001941 DB - PRIME DP - Unbound Medicine ER -