Characteristic magnetic resonance enhancement pattern in cerebral schistosomiasis.

OBJECTIVE: To describe the characteristic magnetic resonance imaging (MRI) appearance of cerebral schistosomiasis.

METHODS: Twenty-five patients whose diagnosis of central nervous system (CNS) schistosomiasis had been pathologically (n = 8) and clinically (n = 17) confirmed were randomly selected. MRI was performed on a Signal 1. 5T MRI scanner before and after the intravenous administration of gadopentetate dimeglumine constrast medium. We reviewed the MRI studies obtained at the time of initial presentation, as well as follow-up studies obtained during and after medical treatment.

RESULTS: Immunological tests in 15 patients indicated schistosomiasis haematobium. Contrast-enhanced T1-weighted images in 22 cases showed central linear enhancement surrounded by multiple enhancing punctate nodules, which appeared "arborized". Through operation and pathological examination, 8 cases had the granuloma formation of schistosomal eggs extensive surrounded by inflammation and venous congestion. And 17 cases were treated with praziquantel and corticosteroid therapy. And they were followed up for 2 months by taking MRI, which turned out to be complete resolution of the enhancing structure and edema. At follow-up, all the patients' initial symptoms also resolved.

CONCLUSION: The specified MRI enhancement pattern of cerebral schistosomiasis is common in most cases of CNS schistosomiasis, so it should be taken account into the diagnosis of cerebral schistosomiasis.