脑囊虫病影像诊断

Case Discussion,By Head Group2013-5-9,History,Female,48YSudden onset;headache, nausea and vomit for 10 years; aggravation for 1 dayCSF culture(),2013-1-2,2013-1-15,2013-1-22,Diagnosis,Cerebral Cysticercosis,epidemiology,most commonly in the whole body cysticercosis(80)most commonly in cerebral parasitic diseasemore prevalent in the countryPathogen: the cysticercus of armed tapeworm,classification,ParenchymalVentricular(the third or fourth)MeningealMixed,periodization,Subclinical stageActive stageDegeneration and death stageCalcification stageMixed stage,Imaging,Active stagesmall excentric spotty shadow of the mural cysticercus scolexlow signals on T1WI,high signals onT2WIcapsular liquid : higher than CSF on FLAIRunremarkable peripheral edema,Degeneration and death stagescolex disappearanceenlarged capsular cavityremarkable peripheral edema“white/black target sign”“multi-ring sign”“delanminated sign”,Calcification stagelower signals on T1WI and T2WIperipheral edema disappearance,Mixed stage,Enhanced scanning:ringlike enhancement,DDX,Intracranial tuberculosisMetastatic encephalomaBrain abscess,intracranial tuberculosis,Children and youthClassification tuberculous meningitis tuberculoma tuberculous brain abscess,IMAging,Tuberculous meningitis hydrocephalus distention of subarachnoid spaces abnormal meningeal and cistern enhancement,Tuberculoma space-occupying effect hydrocephalus calcification “target sign” ringlike or eggshell-like enhancement,Metastatic encephaloma,Primary leision(lung,braest,melanoma)MultipleSupratentorial(80)，subtentorial(20)Cortex-medullary junctions,Imaging,Isointensity on T1WIIso- or mildly hypointensity on T2WI“small nodule and big edema” signnecrosis and cystic degenerationobvious nodular or ringlike enhancement,Brain abscess,Supratentorial(temporal lobe)Pathogen:MRSA,streptococcus,pneumococcusPeriodization acute encephalitis stage suppuration stage capsule formation stage,acute encephalitis stage low signal on T1WI,high signal on T2WIsuppuration and capsule formation stage the wall: complete,smooth,thin,homogeneous circular enhancement “dark belt” sign,immunological examinations,CAg: activity of neurocysticercosisIgG4:therapy effectIHA/ELISA:supplementary indicator,treatment,Medical treatment : active stage albendazole+praziquantelSurgical operation : degeneration and death stage&granulomatous stage cysticercosis enucleation decompressive craniectomy ventriculoperitoneal shunt,Conclusion,Making a correct diagnosis should be based on epidemiology, patient history, clinical manifestations, neuroimaging and laboratory examination,carring out a comprehensive analysis. Some n