Cysticercosis MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Computerized tomography (CT) is superior to magnetic resonance imaging (MRI) for demonstrating small calcifications. However, MRI shows cysts in some locations (cerebral convexity, ventricular ependyma) better than CT, is more sensitive than CT to demonstrate surrounding edema and may show internal changes indicating the death of cysticerci.

In recent years, the use of CT and MRI has permitted identification of neurocysticercosis cases with a benign course that would not have been detected previously.

Cysticercosis MRI findings

• MRI bis superior to CT in showing the scolices within the cysts, cysts in CSF spaces and the edema surrounding the lesions.

Both of CT and MRI show:

1. Vesicular lesions: Well demarcated ring enhancing lesions without surrounding edema and inflammation. Scolices appear as hyperdense eccentric nodule within the cyst.
2. Colloidal and granular lesions: Ill defined lesions surrounded by brain edema and inflammation.
3. In advanced cases, images may show diffuse brain edema, encephalitis, obstruction of the ventricles and midline shift.

Sagittal and FLAIR MRI brain sowing intraventricular cyst complicated with hydrocephalus

Sagital FLAIR MRI brain - Case courtesy of Dr Gagandeep Choudhary, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/10847">rID: 10847</a>	Sagital T2 MRI brain - Case courtesy of Dr Gagandeep Choudhary, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/10847">rID: 10847</a>

Degenerating cyst causing edema and inflammation in the surrounding area - Patient presented with epileptic episodes

Sagittal T1 MRI brain - Case courtesy of Dr Chris O'Donnell, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/29040">rID: 29040</a>	Axial FLAIR MRI brain - Case courtesy of Dr Chris O'Donnell, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/29040">rID: 29040</a>	Coronal T2 MRI brain - Case courtesy of Dr Chris O'Donnell, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/29040">rID: 29040</a>

Multiple ring-enhancing lesions with central dots in the posterior fossa - Patient was treated for hydrocephalus of unknown origin but continued to have symptoms even after shunt drainage.

Axial T1+C MRI brain - Case courtesy of Dr G Balachandran, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/10411">rID: 10411</a>

References

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