Diagnostic And Staging Value Of Conventional MR Sequences&DWI In Neurocysticercosis

Objective：1、Analyze the detection sensitivity of neurocysticercosis lesion in conventional MRIsequences: T1-FLAIR, FSE-T2WI, T2-FLAIR, EPI-DWI, EPI-T2WI and enhancedFSE-T1WI.2、Study the value of EPI-DWI sequence in diagnosis, staging and treatment ofcerebral cysticercosis in parenchyma level.Materials and Methods：45cases (28male cases,17female cases, average age at31.1±10.7) of cerebralcysticercosis patients with clinical diagnoses and complete medical image data werereviewed and studied. Diagnosis methods include: experimental anti-cystucercosistreatment, enzyme-linked immune reaction test, and pathology. Among them,experimental anti-cystucercosis treatment was effective to33cases, while7caseswere positive in enzyme-linked immune reaction test and5cases were confirmed bysurgical pathology. GE1.5T-HDe superconducting magnetic resonance scanner wasapplied during plain scan and enhanced scan for cerebra. Plain scan sequence includesaxial T1-FLAIR, FSE-T2WI, T2-FLAIR, EPI-DWI and EPI-T2WI, and enhancedscan sequence includes axial, sagittal and coronal T1WI.The author had counted the lesions that detected in each sequence, calculated andcompared the detection rate of neurocysticercosis lesions in axial MR scan andenhanced scan sequences. The lesions were grouped into typical and atypical imagingfindings based on the staging criteria concluded by Wenfang Li (The typical weredivided into vesicular stage, colloidal vesicular stage, granular nodular stage, andnodular calcification stage). The author had measured ADC values of cysticercosislesions in different periods, compared the results with normal brain parenchyma andCSF， and had conducted a statistic analysis towards those differentials. Thecharacteristics of ADC pseudo-color and eADC pseudo-color images of neurocysticercosis in different stages were studied. The absorption rate of atypicallesions post treatment was computed.Results：1、279lesions were detected by CE-T1WI; the detection rate was significantly higherthan other sequences（2=144.06，P<0.01）.253lesions were detected by T2FLAIR;the detection rate was higher than T2WI (221lesions)（2=20.83，P＜0.01）.EPI-T2WI (215lesions) and T2WI (221lesions) of neurocysticercosis lesiondetection rate were not very different; the detection rate of DWI were the lowest.2、In the typical group, cyst wall ADC value of colloidal vesicular stage is statisticallyhigher than water-like vesicular stage (t=-2.19，p=0.03), meanwhile, cyst fluid ADCof water-like vesicular stage and colloidal vesicular stage were higher than granularnodular stage (t=13.94，p＜0.01）; the cyst fluid ADC value is statistically lower thanCSF (t=-15.08，p＜0.01）. ADC value of cephalomere and peripheral swelling werewithout statistical significance. In atypical group, the ADC value of cyst wall and cystfluid was similar with water-like vesicular stage, without statistical significance.3、ADC pseudo-color and eADC pseudo-color images of neurocysticercosis atdifferent levels had revealed differentials: water-like vesicular had revealed acontinued and regular pseudo-color band while colloidal vesicular was irregular anddisproportioned. Granular nodular stage had revealed a discontinued anddisproportioned pseudo-color band. Calcified lesions were not shown.4、72lesions were detected in33cases, and57lesions were absorbed after2-3timesanti-worms treatments.Conclusion：1、The detection rate of neurocysticercosis lesion was different by different MRIsequences. CET1WI was able to increase the detection rate significantly.2、MRI was able to reveal pathological changes of neurocysticercosis lesion atparenchyma level. ADC value, ADC pseudo-color, and eADC pseudo-color wereconductive to lesion staging. MR findings of atypical lesion were similar with water-like vesicular lesion, and79.17%lesions were completely absorbed aftertreatment. Timely treatment the lesions can be completely disappear.