Imaging Features of Neurocysticercosis: Analysis of 57 Consecutive Patients

To investigate the imaging features of neurocysticercosis and to provide valuable information about the diagnosis and treatment for clinicians.

The data of 71 consecutive cases of neurocysticercosis, diagnosed by computed tomography (CT) and magnetic resonance imaging (MRI) between January 2009 and January 2014 in our institute were collected. Of all the cases, 57 patients met the recognized diagnostic criteria of neurocysticercosis. In this series, enzyme-linked immunosorbent assay (ELISA) examination and Cysticercosis IgG were positive in 55 cases and 3 cases, respectively. Among them, neurocysticercosis was confirmed surgically in 11 cases. Seven cases had CT examinations, including enhanced CT in one case. Fifty-four cases had MRI examinations, including contrast-enhanced MRI in 46 cases. Therapeutically, 32 patients received albendazole, while 25 patients received praziquantel. As a surgical treatment, 9 patients underwent lesionectomy, and 1 patient underwent lesionectomy plus shunt insertion for hydrocephalus.

Parenchymal cysticerci in 53 cases (92.9%), subarachnoidal cysticerci in 39 cases (68.4%), ventricular cysticerci in 13 cases (22.8%) and spinal cysticerci in 1 case were demonstrated on CT and MRI scans. In total, the intracranial cysticerci involving multiple locations simultaneously were found in 39 patients. Thirty-five cases had associated leptomeningitis, 10 cases had hydrocephalus. In 1 case, the cysticerci were located outside of the central nervous system.

The imaging findings of the cysticerci, including their location, numbers, cystic sizes, capsular thickness, densities and signals of the scolexes, as well as the peripheral edema, have distinct value in making possible timely diagnosis of neurocysticercosis for clinicians.