MR imaging of neurocysticercosis

Magnetic resonance (MR) was performed in 50 patients with neurocysticercosis. Comparison was made with other neuroradiological imaging modalities including CT, myelography, CT ventriculography, and CT myelocisternography. Eighteen patients were found to have intraventricular cysts. In several patients, these were multiple and 22 intraventricular cysts were discovered. Although 4 of the 22 ventricular cysts were missed by MR, T1-weighted images can play a significant role in the early detection of intraventricular cysticercosis cysts, showing the cyst wall (9 of 22), a high intensity mural nodule (6 of 22), and increased signal intensity of the cyst fluid (5 of 22). Cisternal cysts (14 cysts in 10 patients) could be identified; they appear similar to intraventricular cysts, but mural nodules are infrequently seen (1 of 14). Twenty-nine patients had 69 parenchymal cysts. An attempt was made to assess the viability of these parenchymal lesions by matching the CT and MR findings with the Escobar pathologic staging system. Neuroimaging findings seemed compatible with early parenchymal lesions in the vesicular stage in 11 instances. Findings in cases with later stage cysts tend to support the concept that a dying larva provokes pronounced inflammatory reaction in the adjacent brain. Computed tomography remains the superior modality for depicting parenchymal calcifications within dead larvae. A case of a spinal cysticercosis cyst demonstrated with MR (in a patient with extensive intracranial cisternal cysts and a fourth ventricular cyst) is described.     

眼内囊虫病的影像学诊断

目的探讨眼内囊虫病的影像学表现。方法回顾分析3例经手术病理证实的眼内囊虫的US,CT,MRI表现,并复习相关文献。结果3例眼内囊虫病的US,CT,MRI均表现为眶内占位,其中,1例发生在左侧眼球后并波及眼肌肿胀,2例发生在右眼玻璃体内。临床病程较长,囊虫免疫试验阳性,手术病理均显示囊虫头节。结论眼内囊虫病是一种少见部位的感染性疾病,影像学表现对其诊断可提供重要依据。     

Optic nerve cysticercosis: imaging findings

We present the imaging findings of retrobulbar optic nerve cysticercosis in a 50-year-old woman with a 6-month history of vision loss. Contrast-enhanced CT revealed an approximately 7-mm ring-enhancing cyst with a mural nodule located in the anterior portion of the left optic nerve. A contrast-enhanced MR imaging study revealed a cystic lesion with peripheral enhancement of the mural nodule. Sonography showed a cystic mass with a focal area of increased echogenicity corresponding to the mural nodule.     

脑囊虫病72例MRI表现分析

目的　重点逐灶分析大宗脑囊虫病MRI表现 ,并初步探讨脑囊虫病的诊断标准。方法　回顾性阅读已确诊的脑囊虫病例的MRI片 ,并于横断面、矢状面、冠状面的立体结构上对全部病灶进行定位、定数及MRI解剖分析。结果　脑囊虫病以涉及脑实质最为常见 (97 2 % ) ,且绝大多数寄生于双侧大脑半球皮髓质交界处 (83 1% ) ,95 7%的病人系多发病灶。脑实质囊虫病MRI表现有 9种之多。同一患者同时出现 2种或 2种以上表现者占 5 4 3 %。对其头节、囊泡、周边水肿、钙化状态等征象 ,MRI都有其特征性表现 ,一般诊断不难。脑室内及蛛网膜下腔囊虫病表现为小圆形活囊虫灶及葡萄丛状 2种 ,以T1加权显示病灶较好。脑囊虫病MRI表现复杂多样 ,其主要取决于囊虫感染的不同阶段及部位。结论　脑囊虫病MRI表现复杂多样MRI可予以定性、定位、定量诊断以及明确其病理阶段     

脑囊虫病的CT诊断(附60例报告)

目的：探讨脑囊虫病的CT表现及诊断价值。方法：回顾分析60例临床资料完整，并经实验室检查或临床随访证实的脑囊虫病的CT表现。结果：本组60例中，脑实质型39例；脑室型5例，并有不同程度的脑积水表现；脑膜型11例；混合型5例，各具不同的脑囊虫病CT表现。结论：CT诊断脑囊虫病，特别是发生钙化的脑囊虫病具有优势，结合病史及实验室检查一般可做出准确诊断。     

脑囊虫病的CT诊断（附120例分析）

目的：评价和探讨脑囊虫病的CT诊断价值。方法：对临床确诊和120例脑囊虫病的CT表现及分型特点进行分析比较。结果：脑实质型71例,脑室型10例,脑膜型8例,混合型31例。结论：脑囊虫病CT扫描具有特征性表现,CT是诊断本病的主要影像学检查方法。     

Cysticercosis of the brain shown by magnetic resonance imaging

Fifteen patients in whom the diagnosis of cysticercosis of the brain was suggested by computed tomography (CT) were further studied with magnetic resonance imaging (MRI). Besides lesions in the substance of the hemispheres, cysts were found adjacent to and within the ventricles, the brainstem, cerebellum and subarachnoid space. Magnetic resonance imaging showed brain involvement out of proportion to what was shown by CT. The eccentrically placed mural nodule within a cyst, the pathognomonic lesion of cysticercosis, was seen in all cases with MRI. The various stages of development of the cysticercus larva were seen in one individual. An attempt is made to illustrate the various stages of development by means of MR images, and a possible pathological explanation is offered. The authors believe that MRI provides diagnostic information in this disease and dispenses with the need for enhanced CT examination.     

眶内囊虫病的影像学诊断

目的 总结眶内囊虫病的影像学表现，评价Ｂ超、ＣＴ和ＭＲＩ对其诊断的优势与限度。方法 将６例眶内囊虫病者的Ｂ超、ＣＴ和ＭＲ影像学表现与手术病理结果进行对照分析。结果 眶内囊虫病在眶内形成肉芽肿。Ｂ超见肿块内有低回声液性暗区（囊泡）和点状强回声头节，并可见特异性虫体蠕动；ＣＴ可见点状高密度头节和低密度囊泡影，ＣＴ对头节的显示率较Ｂ超高；ＭＲＩ对头节显示不清，仅可见囊光，但对眶内囊虫病累及范围和程度的显     

CT鉴别脑内囊虫性小脓肿与结核瘤

作者分析了３０例囊虫性小脓肿，２５例结核瘤的ＣＴ征像，将其鉴别诊断总结为以下几点ＣＴ平扫：１．病灶部位，囊虫性小脓肿以两侧顶叶发病最多，而结核瘤可发生于脑组织任何部位。２．病灶数目，囊虫性小脓肿均为单发病灶，而结核瘤的病灶则以多发为主。对多发病灶要考虑结核瘤的诊断。ＣＴ增强扫描：１、增强灶数目，囊虫性小脓肿为单发的结节、环状增强灶。而大多数结核瘤呈多发的结节、环状增强灶。结节样增强灶可融合成不规则团块状、环状增强灶可融合成“梅花样”，“串珠样”为结核瘤的主要ＣＴ特征。２、增强灶中心ＣＴ值，囊虫性小脓肿组均值为１８Ｈｕ，结核瘤组均值为４１Ｈｕ，（ｔ＝２．７８２Ｐ＜０．０１）。对增强灶中心ＣＴ值较高的病灶要考虑结核瘤的诊断。     

脑囊虫病MRI诊断

目的:探讨脑囊虫病的MR分型与分期标准。材料和方法:本组190例,男性119例,女性71例;平均年龄33岁。全部检查均在0.3T永磁体磁共振仪上进行,平扫222次;GD-DTPA增强98次。根据脑囊虫可以独立寄生的部位将其分为脑实质型、脑室型和蛛网膜下腔型,二型以上并存为混合型。依据脑囊虫在体内的病理过程将其分为存活期、退变死亡期和修复期。又根据修复期的不同表现将此期分为肉芽肿形成亚期(ⅢA期)、结节钙化亚期(ⅢB期)和斑痕形成亚期(ⅢC期),两期以上并存为混合期。结果:脑实质型160例(84.2％),脑室型13例(6.8％)和蛛网膜下腔型3例(1.6％),混合型14例(7.4％);各型中存活期24例(12.6％),退变死亡期66例(34.7％)和修复期55例(29.0％)(其中ⅢA期19例;ⅢB期21例;ⅢA B期10例;ⅢC期5例),混合期45例(23.7％)。结论:MR对脑囊虫病的分型与分期有可靠的诊断价值,正确的分型与分期可有效地指导临床治疗工作。     

In vivo single-voxel proton MR spectroscopy in intracranial cystic masses.

PURPOSEOur objective was to evaluate the proton MR spectroscopic pattern of the cystic contents of various intracranial masses and to report characteristic spectral patterns that may be helpful in the differential diagnosis of these lesions.METHODSWe evaluated 40 proton MR spectra obtained from cystic contents of various intracranial cystic masses in 39 patients, including gliomas (n = 14), metastases (n = 3), abscesses (n = 8), cysticercosis (n = 4), epidermoids (n = 3), and others (n = 7). Proton MR spectroscopy was performed on a 1.5-T MR unit using a point-resolved spectroscopic sequence with a 2 x 2 x 2 cm3 volume of interest. Assignment of the resonance peaks was based on previous studies.RESULTSAdequate proton MR spectroscopic data were obtained in 35 cases (88%). In most gliomas and metastases, only a lactate resonance was observed. There was a trend toward a higher lactate peak in high-grade gliomas. A few tumors, including malignant gliomas and metastases, showed lipid signal combined with lactate signal. In abscesses, there were various combinations of lactate, acetate, succinate, amino acids (including valine, alanine, and/or leucine), and/or unassigned resonances. In cysticercosis, resonances of lactate, succinate, alanine, acetate, and/or unassigned resonances were observed. Three epidermoid cysts showed only lactate signal. There were no identifiable resonances from the arachnoid and porencephalic cysts.CONCLUSIONOnly lactate is commonly observed in a variety of intracranial cystic masses, except for abscess and cysticercosis, in which resonances of acetate, succinate, amino acids, and/or unassigned metabolites can be seen in addition to a lactate peak.     

Mobile myelographic filling defects: spinal cysticercosis

Summary Cysticercosis usually affects the brain and is easily demonstrated by CT. Spinal cysticercosis is much rarer and is usually diagnosed only at surgery. Myelographic demonstration of multiple rounded filling defects, some of which were mobile, allowed diagnosis of spinal extramedullary cysticercosis in an unsuspected case. The literature on spinal cysticercosis is briefly reviewed. Diagnosis is important in view of the recent development of medical treatment.     

Criteria for the diagnosis of epilepsy caused by cerebral cysticercosis in a population of recruits

Epidemiological and clinical characteristics as well as characteristic of paraclinical findings in epilepsia caused by cerebral cysticercosis in recruit population have been studied. The experimental group consisted of 50 recruits with epilepsia caused by cerebral cysticercosis and the control group consisted of 28 recruits with symptomatic epilepsia of other etiology. By correlation of all the results obtained the criteria for diagnosis of epilepsia caused by cerebral cysticercosis have been defined. The results were graded as reliable, probable and suspected. For diagnosis of epilepsia caused by cerebral cysticercosis the decisive factors have been the results of tests of indirect immunofluorescence to cysticercosis (IIF) and computerized tomography (CT) of the brain. Finally, some clinical signs and paraclinical findings have been grouped on the basis of which it can be established a reliable, probable or suspected diagnosis of the disease.     

Pulmonary and cardiac cysticercosis: helical CT findings

The authors aim to report the chest CT findings of a patient with disseminated cysticercosis, emphasising the pulmonary and cardiac features. The main finding consisted of multiple pulmonary, cardiac and chest wall nodules. The present case demonstrates that cysticercosis should be considered in the differential diagnosis of multiple pulmonary nodules, mainly in those patients with similar lesions in the cardiac muscle and/or in the chest wall.     

Cerebral cysticercosis. Diagnostic value of x-ray computed tomography. Apropos of 117 cases

117 cases of cerebral cysticercosis in La Réunion are reported. Different CT features are related and situated with the evolutive state of the parasite. CT scan provided accurate diagnostic information except in some intraventricular or subarachnoid location where NMR study seems already to be superior.     

隐源性单发小型脑脓肿CT诊断与临床分析（附30例报告）

本文报告经手术病理和临床证实的３０例隐源性单发小型脑脓肿，重点分析讨论了其ＣＴ表现特征及在定性诊断和临床上的意义，同时也对本病与脑胶质瘤、转移瘤、结核瘤和单发瘤实质型脑囊虫病的鉴别诊断进行了讨论。     

Renal cancer staging: Comparison of contrast-enhanced CT and gadolinium-enhanced fat-suppressed spin-echo and gradient-echo MR imaging

Fifty-three consecutive patients with 61 solid or complex non-fat-containing renal masses compatible with renal cancer were examined with contrast-enhanced computed tomography (CT) and magnetic resonance (MR) imaging with pre- and postcontrast FLASH (fast low-angle shot) and fat-suppressed spin-echo sequences. CT and MR imaging were performed within a 1-month interval. CT and MR images were prospectively interpreted. Tumor detection and staging were determined in all patients. CT and MR imaging enabled detection of 54 and 58 of 61 renal tumors, respectively. CT and MR imaging showed 34 and 35 of 38 histologically proved renal tumors, respectively, in 31 patients. Tumor size on CT and MR images demonstrated good correlation and correlated well with the size of pathologic specimens of 34 of 38 resected tumors detected with CT and MR imaging (r =.99). Of the 31 tumors in 31 patients who underwent surgical resection, 24 were correctly staged with CT and 29 with MR imaging. CT and MR imaging both enabled correct staging of four of five additional tumors with biopsy proof of tumor stage. A moderate difference in staging was observed between CT and MR imaging (P =.05). CT showed 13 and MR imaging 15 of 15 tumor thrombi. CT and MR imaging both showed 11 of 11 cases of adenopathy. The results suggest that MR imaging is moderately better than CT for the detection and staging of renal cancer.     

Comparison of MR imaging and CT in patients with intracranial aneurysm clips

CT and MR imaging of the brain were performed without complications in 16 patients who had undergone surgery for a ruptured aneurysm with the use of nonferromagnetic Yasargil 316 or Sugita Elgiloy clips. MR was performed on a 0.3-T Fonar beta-3000M imaging system. The artifacts caused by the clips were smaller on MR than on CT, and, therefore, anatomic structures such as the brainstem and temporal lobes were better visualized on MR. Brain-tissue lesions corresponding to the frontotemporal surgical approach were seen with MR in seven patients and with CT in six. In three patients temporal-lobe lesions seen on MR were not seen on CT because of beam-hardening artifacts. Lesions unrelated to the region of surgery were seen with MR in nine patients and with CT in five. In conclusion, MR was safe and superior to CT both in demonstrating anatomic details and in detecting tissue lesions in patients with aneurysm clips.     

Intracranial vascular malformations: MR and CT imaging

Twenty-four patients with 29 cerebrovascular malformations were evaluated with a combination of computed tomography (CT), angiography, and magnetic resonance (MR) imaging. Characteristics of the malformations on MR images were reviewed retrospectively, and a comparative evaluation of MR and CT images was made. Of 14 angiographically evident malformations, 13 intra-axial lesions were detected on both CT and MR images, and one dural malformation gave false-negative results on both modalities. The appearance of parenchymal lesions on MR images closely mirrored characteristic CT findings. Calcific foci were difficult to separate from vessels on both images. Clot was more easily identified on MR images. In the detection of 15 angiographically occult malformations, CT proved more sensitive when focal calcification was the only evidence of their presence. MR study failed to detect two small supratentorial lesions evidenced by faint calcifications on CT scans. In two patients, MR images showed small hemorrhages not detectable by CT, and MR provided strong evidence for the diagnosis of hematoma for 12 lesions. Angiographically evident malformations have a highly characteristic appearance on MR images. MR may be more sensitive than CT in the detection of small hemorrhagic foci associated with cryptic arteriovenous malformations and may add specificity in the diagnosis of occult malformations in some cases, but MR is less sensitive than CT for the detection of small calcified malformations.     

Computed tomography in intracranial cysticercosis

The computed tomography (CT) scans and other radiographic studies of 23 patients with cerebral cysticercosis were reviewed. Parenchymal calcifications, the most common finding, are somewhat better seen on CT scans than on skull films. Ventricular cysts may be suspected by disproportionate enlargement of the involved ventricle. Cysts in subarachnoid cisterns are best detected by performing both CT and pneumoencephalography. Contrast enhancement was not seen with cisternal or ventricular cysts but may be with parenchymal cysticercus lesions.