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Intraspinal Paragonimiasis in Children: MRI Findings and Suggestions for Pathogenesis
AJNR. American Journal of Neuroradiology
|November 16, 2019
Summary
Intraspinal paragonimiasis, a rare condition, was studied using MR imaging in children. Findings reveal characteristic extradural thoracic masses connected to pleural lesions, aiding in understanding its pathogenesis.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Intraspinal paragonimiasis is a rare parasitic infection.
- Imaging findings for this condition are infrequently documented.
Purpose of the Study:
- To investigate the Magnetic Resonance (MR) imaging features of spinal paragonimiasis.
- To provide diagnostic imaging evidence for intraspinal paragonimiasis.
- To explore the pathogenesis of intraspinal paragonimiasis.
Main Methods:
- Retrospective analysis of clinical and imaging findings in 6 pediatric patients.
- Spinal MR imaging, including enhanced scans in 5 patients.
- Diagnosis confirmed by enzyme-linked immunosorbent assay and postoperative pathology.
Main Results:
- All cases showed extradural, fusiform/beanlike masses in the thoracic spine, connected to pleural lesions via intervertebral foramina.
- MR imaging revealed mixed signals (isointense on T1WI, hyperintense on T2WI), with 5/6 masses showing hemorrhagic foci.
- Enhanced scans demonstrated heterogeneous enhancement, adjacent meningeal thickening, and spinal cord compression/edema in most cases.
Conclusions:
- MR imaging is effective for detecting and characterizing spinal paragonimiasis.
- Key imaging features include extradural thoracic localization, connection to pleural lesions, and intralesional hemorrhage.
- Findings support larval migration from the chest through intervertebral foramina as the pathogenic route.
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