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Cerebral sparganosis: MR imaging versus CT features
1Department of Diagnostic Radiology, Seoul National University College of Medicine, Korea.
Abstract:
Fourteen magnetic resonance (MR) images of 11 patients with cerebral sparganosis were reviewed retrospectively and compared with 13 computed tomographic (CT) scans of 10 of the patients. All patients underwent both nonenhanced and contrast material-enhanced MR imaging. All white matter degenerations, which were slightly hypointense on T1-weighted images and were hyperintense on T2-weighted images, were seen as areas of low attenuation on CT scans. Better contrast between normal and degenerated brain tissues was seen at MR, and two lesions were seen that were missed at CT. The parasitic granuloma was isointense to brain parenchyma on images obtained with all pulse sequences. On two follow-up MR images, location or shape of the enhancing lesions changed, suggesting migration of the worm. A new finding of hyperintensity on T1-weighted images and hypointensity on T2-weighted images in subcortical areas probably due to petechial hemorrhages was demonstrated in eight patients only at MR. Small calcific foci, which were important diagnostic clues of cerebral sparganosis, were detected in four patients only at MR, while they were seen in eight patients at CT.
Insights
Magnetic resonance (MR) imaging offers superior visualization of cerebral sparganosis compared to computed tomography (CT). MR imaging detects subtle white matter changes, parasitic granulomas, and early signs of worm migration, improving diagnostic accuracy for this rare brain infection.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Cerebral sparganosis is a rare parasitic infection of the brain.
- Accurate diagnosis relies on advanced neuroimaging techniques.
- Distinguishing sparganosis from other brain pathologies can be challenging.
Purpose of the Study:
- To compare the diagnostic efficacy of magnetic resonance (MR) imaging versus computed tomography (CT) for cerebral sparganosis.
- To identify unique imaging features of cerebral sparganosis detectable by MR.
- To evaluate MR imaging's ability to detect disease progression and subtle diagnostic clues.
Main Methods:
- Retrospective review of 14 MR images from 11 patients with cerebral sparganosis.
- Comparison with 13 CT scans from 10 of the same patients.
- Analysis of both nonenhanced and contrast-enhanced MR imaging sequences.
Main Results:
- MR imaging provided better contrast between normal and degenerated brain tissues compared to CT.
- MR imaging detected two lesions missed by CT scans.
- Follow-up MR scans showed changes in enhancing lesions, suggesting parasite migration.
- MR imaging revealed subcortical petechial hemorrhages (hyperintense on T1, hypointense on T2) and small calcific foci not always seen on CT.
Conclusions:
- MR imaging is superior to CT in visualizing the extent and subtle findings of cerebral sparganosis.
- MR imaging can detect parasitic granulomas, white matter degeneration, potential worm migration, and associated hemorrhages.
- The detection of small calcific foci by MR imaging aids in diagnosing cerebral sparganosis.