An imaging diagnosis of cerebral paragonimiasis: CT and MR findings and correlation with ELISA antibody test.
10.3348/jkrs.1993.29.3.345
- Author:
Kee Hyun CHANG
;
Sang Hoon CHA
;
Moon Hee HAN
;
Hong Dae KIM
;
Seung Yull CHO
;
Yoon KONG
;
Hyung Keun KANG
;
Myung Soon KIM
- Publication Type:Original Article
- MeSH:
Cerebrum;
Diagnosis*;
Encephalomalacia;
Enzyme-Linked Immunosorbent Assay*;
Hemorrhage;
Humans;
Paragonimiasis*;
Praziquantel;
Retrospective Studies;
Tomography, X-Ray Computed
- From:Journal of the Korean Radiological Society
1993;29(3):345-354
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
To evaluate the CT and MR findings of cerebral paragonimiasis (PW) and to assess the diagnostic value of the specific antibody test by enzyme-linked immunosorbent assay (ELISA) for PW, 55 CT scans and 13 MR images of 57 patients with cerebral PW were reviewed retrospectively, and correlated with the serum/CSF antibody levels. We divided the into three groups, early active(n=21), chronic(n=32), and combined stage (n=4), on the basis of CT/MR findings. In the group of early active stage the most common and characteristic findings was multiple, conglomerated, ring-like enhancing lesions in the unilateral cerebral hemisphere, which was seen in 52% on CT and 44% on MR. Other non-specific findings included a solitary ring-like or irregular enhancing lesions, ill-defined low density lesions without enhancement, localized hemorrhage with or without enhancing lesions. In the group of chronic stage there were multiple calcifications of various shapes, most commonly 1-2cm sized round shape, and associated encephalomalacia. MR was superior to CT in detecting hemorrhage and in characterizing the central contents of ring-shaped calcifications, while it was inferior to CT in identifying small calcifications. Antibody levels of serum and CSF were positive in 86% and 82% in early active group, and in 48% and 31% in chronic sgage respectively. The positive rate was significantly different between the two groups (P=0.001). CT/MR findings were characteristic in only approximately half the cases in early active cerebral PW which can be cured by traziquantel therapy. Therefore, antibody test by ELISA is recommended as a complementary tool, particularly in patients with non-specific imaging findings.
