Imaging characteristics of cerebral sparganosis with live worms.

BACKGROUND AND PURPOSE: The purpose of this study was to analyze the computed tomography (CT) and magnetic resonance imaging (MRI) features of cerebral sparganosis to improve the accuracy of diagnosing cerebral sparganosis with medical imaging modalities.

MATERIALS AND METHODS: This was a retrospective study of CT and MRI features of 12 patients with cerebral sparganosis. A comparative analysis between imaging findings, and intraoperative and postoperative pathological findings was performed.

RESULTS: A total of 20 lesions were observed in 12 patients with 5 patients having a solitary lesion. CT and MRI imaging showed worm-body sign in 5 patients (41.7%), tunnel-sign in 5 patients (41.7%), migration sign in 7 patients (58.3%), worm-shaped enhancement in 4 patients (33.3%), bead-shaped or ring-shaped enhancement in 5 patients (41.7%), irregular or nodular enhancement in 3 patients (25%), meningeal enhancement in 2 patients (16.6%), intracranial hemorrhage in 2 patients (16.6%), brain parenchymal edema in 10 patients (83.3%), cerebral white matter degeneration in 11 patients (91.7%), negative mass effect in 10 patients (83.3%), and punctuate calcification in 3 patients (25%). Among the 4 patients with live worm, CT and MRI showed worm-body sign in 3 patients (75%), tunnel-sign in 3 patients (75%), migration sign in 3 patients (75%), and worm-shaped enhancement in 2 patients (50%).

CONCLUSION: Cerebral sparganosis with live worm exhibits several distinguishing imaging characteristics, which reflect the pathological changes and can improve the diagnosis of cerebral sparganosis.