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Characteristic CT and MR imaging findings of cerebral paragonimiasis.
J Neuroradiol. 2016 Jun; 43(3):200-6.JN

Abstract

BACKGROUND AND PURPOSE

The early diagnosis of cerebral paragonimiasis (CP) is essential for a good prognosis. We seek to provide references for early diagnosis by analyzing the imaging characteristics of cerebral paragonimiasis.

MATERIALS AND METHODS

Images of 27 patients with CP (22 males and 5 females; median age 20.3 years; range: 4 to 47 years) were retrospectively evaluated. All patients underwent head computed tomography (CT) scans; 22 patients underwent conventional magnetic resonance imaging (MRI) sequences, including contrast-enhanced MRI for 20 patients and diffusion-weighted-imaging (DWI) for 1 patient. The diagnosis was confirmed based on a positive antibody test using enzyme-linked immunosorbent assay (ELISA) for paragonimiasis in the serum.

RESULTS

The most common imaging findings of CP were isodense or hypodense lesions combined with extensive hypodense areas of perilesional edema on CT scans and a large mass composed of multiple ring-shaped lesions with surrounding edema on MRI images. The conglomeration of multiple ring-shaped lesions (n=11 patients), "tunnel signs" (n=12 patients) and worm-eaten signs (n=5 patients) were characteristic of most CP images. In 14 patients, contrast-enhanced MRI showed varying degrees of contrast enhancement combined with adjacent meningeal enhancement (n=10).

CONCLUSIONS

A large mass comprising multiple ring-shaped lesions of different sizes, "tunnel signs" and worm-eaten signs with surrounding edema are the most characteristic features of CP. Extensive invasions of the adjacent meninges and ventricular wall (19 patients), multiple intracerebral lesions, bilateral hemispheric involvement, and lesion migration are other noteworthy imaging characteristics.

Authors+Show Affiliations

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China. Electronic address: xiayong163@tom.com.Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China.Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China.Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China. Electronic address: Jchenhx@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27261801

Citation

Xia, Yong, et al. "Characteristic CT and MR Imaging Findings of Cerebral Paragonimiasis." Journal of Neuroradiology = Journal De Neuroradiologie, vol. 43, no. 3, 2016, pp. 200-6.
Xia Y, Chen J, Ju Y, et al. Characteristic CT and MR imaging findings of cerebral paragonimiasis. J Neuroradiol. 2016;43(3):200-6.
Xia, Y., Chen, J., Ju, Y., & You, C. (2016). Characteristic CT and MR imaging findings of cerebral paragonimiasis. Journal of Neuroradiology = Journal De Neuroradiologie, 43(3), 200-6. https://doi.org/10.1016/j.neurad.2014.10.006
Xia Y, et al. Characteristic CT and MR Imaging Findings of Cerebral Paragonimiasis. J Neuroradiol. 2016;43(3):200-6. PubMed PMID: 27261801.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristic CT and MR imaging findings of cerebral paragonimiasis. AU - Xia,Yong, AU - Chen,Jing, AU - Ju,Yan, AU - You,Chao, Y1 - 2014/11/26/ PY - 2014/07/30/received PY - 2014/10/05/revised PY - 2014/10/29/accepted PY - 2016/6/5/entrez PY - 2016/6/5/pubmed PY - 2017/3/9/medline KW - Cerebral paragonimiasis KW - Imaging KW - Infection KW - Paragonimus SP - 200 EP - 6 JF - Journal of neuroradiology = Journal de neuroradiologie JO - J Neuroradiol VL - 43 IS - 3 N2 - BACKGROUND AND PURPOSE: The early diagnosis of cerebral paragonimiasis (CP) is essential for a good prognosis. We seek to provide references for early diagnosis by analyzing the imaging characteristics of cerebral paragonimiasis. MATERIALS AND METHODS: Images of 27 patients with CP (22 males and 5 females; median age 20.3 years; range: 4 to 47 years) were retrospectively evaluated. All patients underwent head computed tomography (CT) scans; 22 patients underwent conventional magnetic resonance imaging (MRI) sequences, including contrast-enhanced MRI for 20 patients and diffusion-weighted-imaging (DWI) for 1 patient. The diagnosis was confirmed based on a positive antibody test using enzyme-linked immunosorbent assay (ELISA) for paragonimiasis in the serum. RESULTS: The most common imaging findings of CP were isodense or hypodense lesions combined with extensive hypodense areas of perilesional edema on CT scans and a large mass composed of multiple ring-shaped lesions with surrounding edema on MRI images. The conglomeration of multiple ring-shaped lesions (n=11 patients), "tunnel signs" (n=12 patients) and worm-eaten signs (n=5 patients) were characteristic of most CP images. In 14 patients, contrast-enhanced MRI showed varying degrees of contrast enhancement combined with adjacent meningeal enhancement (n=10). CONCLUSIONS: A large mass comprising multiple ring-shaped lesions of different sizes, "tunnel signs" and worm-eaten signs with surrounding edema are the most characteristic features of CP. Extensive invasions of the adjacent meninges and ventricular wall (19 patients), multiple intracerebral lesions, bilateral hemispheric involvement, and lesion migration are other noteworthy imaging characteristics. SN - 0150-9861 UR - https://www.unboundmedicine.com/medline/citation/27261801/Characteristic_CT_and_MR_imaging_findings_of_cerebral_paragonimiasis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0150-9861(14)00254-5 DB - PRIME DP - Unbound Medicine ER -