Yuxin Li MD, PhD, Presenter: Nothing to Disclose

Haleena Ramsahye MD, Abstract Co-Author: Nothing to Disclose

Bo Yin MD, Abstract Co-Author: Nothing to Disclose

Daoying Geng, Abstract Co-Author: Nothing to Disclose

To reveal the migration of cerebral sparganosis and describe its characteristics.

The serial MRI studies (≥3 times and ≥1 year)of 13 patients with cerebral sparganosis were retrospectively reviewed. The diagnosis was based on clinical data (A history of risky behavior; positive result of ELISA for sparganosis-specific antibody in serum and CSF;and distinct CT and MR findings), and confirmed by histopathological specimens in six patients (three from surgical resection, three from stereotactic biopsy). The various characteristics of the migration were evaluated using MRI.

Inflammatory granulomas were found in all 13 patients on baseline MRI, and other abnormalities with white matter degeneration and gray matter atrophy were observed in nine patients. On total of 48 follow-up MRI scans，15 migrated active lesions were found in 13 patients, among whom two patients showed two successive lesions. The migration appeared at 6-18months after the baseline MRI. One appeared after the resection of primary lesion, two after biopsy, 11 after pharmaceutical treatment of sparganum larvae, one without any intervention. Nearly all migrations (13/15) were ipsilateral from one lobe to the adjacent one (n=5) , white matter to gray matter or conversely in the same lobe(n=4), from basal ganglia to cortex (n=2) , basal ganglia to cerebellum (n=1)and cerebellum to pons (n=1). Two contralateral migrations were observed from one side of the thalamus to the other side. The migrated active lesions showed the typical “tunnel” sign or “bead”-like enhancement after Gd-DTPA contrast injection. Definite route of migrations showing hyperintensity on FLAIR images(n=1) and “bead”-like enhancement(n=2) were found in 3 cases only.

Migration of cerebral sparganosis can be revealed by MRI studies. It could probably appear if no living worm was taken out by surgical resection or biopsy, even after pharmaceutical treatment .Therefore, a follow-up MRI is necessary.

The serial MRI can detect the migration of sparganum and this exam is recommended for patients with cerebral sparganosis even after pharmaceutical treatment and surgical resection.

Li, Y, Ramsahye, H, Yin, B, Geng, D, Migration: A Notable Hallmark of Cerebral Sparganosis Revealed on Serial MRI.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11013511.html