脑囊虫病的MRI诊断价值

目的 分析脑囊虫病的MRI影像特点,探讨脑囊虫病的MRI诊断价值.方法 回顾性分析2011年1月～2012年12月98例脑囊虫病的MRI表现特点.结果 脑实质型77例,脑室型5例,脑膜型4例,混合型12例,主要MRI特点:脑实质型活动期表现为多发圆形或类圆形大小一致的囊腔,大小2～8 mm;囊腔T1WI呈低信号,内可见偏心或居中的等或较高信号头节影,T2WI呈高信号;慢性期,囊虫呈点状钙化,MRI显示不敏感,T1WI及T2WI呈低信号.脑室型表现为脑室非对称性扩大,脑室内可见结节影,第四脑室多见,第三脑室次之,常伴有梗阻性脑积水.脑膜型表现各脑池或脑沟不规则增宽,内可见小圆形长T1长T2信号,大小不一,可呈簇状,常见不到头节.混合型表现为上述两种或两种以上类型表现同时存在,多为脑实质型和脑室型混合.结论 脑囊虫病MRI表现具有特征性,MRI对确定脑囊虫病部位、数目具有很高的诊断价值.     

脑积水型脑囊虫病的外科手术治疗研究

目的:探讨脑积水型脑囊虫病的外科手术治疗方法及疗效。方法:经手术病理证实的脑积水型脑囊虫病73例,回顾分析其治疗过程。结果:对诊断明确的73例脑积水型脑囊虫病患者实施了脑室或脑池囊虫摘除术,术后进行抗脑囊虫病治疗,其中13例脑积水症状改善效果不佳,二次行脑室-腹腔分流术,手术均获成功,术后均未出现新的神经损害症状,脑室恢复正常。结论:脑积水型脑囊虫病一旦诊断明确,应积极手术切除脑囊虫,解除梗阻性脑积水术后再进行抗囊虫治疗,必要时再行脑室腹腔分流手术,临床效果明确安全。     

Outcome of short-term antiepileptic treatment in patients with solitary cerebral cysticercus granuloma

OBJECTIVES: The duration of antiepileptic drug (AED) therapy in cases of solitary cerebral cysticercus granuloma (SCCG) presents a major dilemma and the efficacy of short-term (6 months) vs long-term (2 years) AED therapy has been studied. MATERIALS AND METHODS: Prospective randomized study of short-term vs long-term AED treatment with SCCG has been undertaken. A total of 206 subjects with new onset seizures with SCCG were randomized into two groups: group A (98 patients) were treated for 6 months and group B (108 patients) were treated for 2 years with AED therapy. The patients were evaluated periodically during and at least 18 months after the tapering of drugs. RESULTS: Partial seizures with or without secondary generalization has been found to be the commonest manifestation occurring in 80.6% of patients with SCCG. In group A 66.3% and in group B 57.4% patients showed complete resolution of computerized tomographic lesion and rest had punctated residual calcification. Statistically, no significant difference in the recurrence of seizures was found in two groups with disappearance of lesion but the difference between calcified residua and complete resolution subset was significant. In patients having residual calcification, 42.2% in group A and 21.7% in group B had recurrence of seizures and the difference was statistically significant (Z = 1.97, P < 0.05). CONCLUSIONS: The study revealed that SCCG with epilepsy is a benign self-limiting disease. A longer duration of therapy is not warranted in patients having total resolution of lesion. Calcified lesion was found to be the most common cause of recurrence of seizures. Higher recurrence rate was observed in short-term therapy in patients having calcified lesions and may require long-term AED treatment.     

The immune response in Taenia solium cysticercosis: protection and injury

This article reviews current knowledge on the innate and acquired immune responses in human Taenia solium neurocysticercosis, highlighting the conditions that appear to be favourable for the survival or destruction of the parasite and for the benefit or injury to its host.     

脑囊虫病杀虫治疗后并发脑疝死亡1例

本文报道1例脑囊虫病死亡病例。该患者为弥漫型脑囊虫病,在杀虫治疗后并发脑疝而死亡。该类型脑囊虫病较严重,治疗时绝不能按常规公斤体重用药,而应先给予杀虫缓和的阿苯达唑或中药治疗,待囊尾蚴活力降低后,再以吡喹酮迅速杀虫,治疗同时加用甘露醇和激素以脱水、抗过敏。     

Cysticercosis of the cerebellopontine angle cistern mimicking epidermoid inclusion cyst

We report a case of a cystic lesion in the left cerebellopontine (CP) angle cistern. The magnetic resonance (MR) imaging features closely resembled an epidermoid inclusion cyst, and was interpreted as such. However, at surgery and on histopathological examination the lesion was found to be a cysticercus cyst. It may be impossible to distinguish between the two by imaging. The MR imaging findings of cysticercosis, epidermoid and other common differentials are discussed.     

MRI在脑实质型脑囊虫病诊断中的价值

目的 探讨MRI在脑实质型脑囊虫病诊断中的价值。方法 回顾性分析32例经临床、病理证实和MRI诊断的脑实质型囊虫病患者。全部病例在常规T1WI,T2WI扫描后均加扫了FLAIR序列,其中29例行增强扫描。分析其各期MRI征象及病理基础。结果 活虫期6例,退变死亡期20例(早期11例,晚期9例),非活动期2例,混杂期4例。MRI发现头节,是诊断脑实质型囊虫病的可靠依据,而MRI上"白靶征","多环、分层征"是脑实质型囊虫病的典型征象。结论 MRI多种序列的联合应用对脑实质型脑囊虫病可以给予定性、定位、定量诊断,同时MRI的准确分期为临床治疗方案的选择提供了有力帮助。     

Control of Taenia saginata by post-mortem examination of carcasses

Background

A study to curb transmission cycle of a zoonotic Taenia cestodiasis between humans and cattle is presented.

Objective

To evaluate the reliability of meat inspection procedure in detecting carcasses of cattle with T. saginata cysticercosis.

Methods

A total of 55 cattle divided into two groups of artificially (n =30) and naturally (n = 25) infested animals were utilized. Total dissection method was used as a gold standard of validity.

Results

Meat inspection insensitively revealed cysticerci in 12 carcasses in each group compared with 24 and 23 carcasses revealed by total dissection in natural and artificial infestations, respectively. Sites of oncosphere invasion showed great variations with the two groups of cattle. In the predilection sites, most cysticerci were found in the heart, Triceps brachii, tongue and head muscles in that order. However, non-predilection sites (neck and back, hind limbs, chest, pelvic and lumbar regions, lungs and liver) considerably harboured high numbers of cysticerci. Observations indicated that except for the dead, degenerate or calcified cysticerci a careless meat inspector will most likely miss out quite a number of viable cysticerci, which blend the pinkish-red colour of the meat and be passed on for human consumption, becoming the source of bovine cysticercosis.

Conclusions

The results confirmed that in spite of the time and efforts taken by meat inspectors looking for cysticerci at specified predilection sites of carcasses, this method is insensitive and inaccurate. To effectively improve meat inspection procedures, there is need to increase the area and number of predilection sites observed during inspection and vary them according to the nature of the animals, their husbandry history and the target human population for consumption. In addition, other control approaches such as vaccination, chemotherapy and immunodiagnosis should be developed and implemented to complement meat inspection procedures.     

人体包虫病与囊虫病血清学鉴别诊断ELISA方法的建立

本文设计及建立了将常规ELISA与数学公式相结合以鉴别诊断人体包虫病与囊虫病的血清学方法(DD—ELISA)。两病总正确鉴别诊断率达83.12％,尤其是将包虫病对囊虫抗原呈100％的交叉反应率降到18.18％,假阳性率显著降低。该方法简便、效佳、适用于临床诊断及流行病学调查。     

应用酶联免疫吸附试验检测猪囊虫病特异抗体的研究

用猪囊虫粗抗原、B 抗原、等电聚焦技术分离的抗原组份和特异单克隆抗体亲和层析抗原,以ELSA间接法检测猪囊虫病血清抗体,结果特异性均不理想。应用单克隆抗体分析查明,在某些囊虫抗原分子上既有特异性抗原位点,又有非特异性位点。用特异单克隆抗体以ELISA抑制法检测猪囊虫病血清抗体,结果完全消除了假阳性反应,病猪血清检出率为86.41％(89/103)。