Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Cerebral Sparganosis: The Differential Features between Live and Degenerated Worms on CT and MR Images

뇌 스파르가눔증: CT와 MR 영상에서 살아있는 유충과 죽은 유충의 감별점

  • Kim, Min-Sun (Department of Radiology, Eulji University Hospital) ;
  • Yu, In-Kyu (Department of Radiology, Eulji University Hospital) ;
  • Chang, Kee-Hyun (Department of Radiology and the Institute of Radiation Medicine, Seoul National University Hospital) ;
  • Han, Moon-Hee (Department of Radiology and the Institute of Radiation Medicine, Seoul National University Hospital) ;
  • Kim, Myung-Soon (Department of Radiology, Yonsei University, Wonju College of Medicine, Wonju Christian Hospital) ;
  • Lee, Byung-Hee (Department of Radiology, Eulji University Hospital) ;
  • Lee, Yun-Hee (Department of Radiology, Eulji University Hospital)
  • 김민선 (을지대학교 의과대학 을지대학병원 영상의학과) ;
  • 유인규 (을지대학교 의과대학 을지대학병원 영상의학과) ;
  • 장기현 (서울대학교 의과대학 서울대학교병원 영상의학과) ;
  • 한문희 (서울대학교 의과대학 서울대학교병원 영상의학과) ;
  • 김명순 (연세대학교 원주의과대학 원주기독병원 영상의학과) ;
  • 이병희 (을지대학교 의과대학 을지대학병원 영상의학과) ;
  • 이윤희 (을지대학교 의과대학 을지대학병원 영상의학과)
  • Received : 2009.01.30
  • Accepted : 2010.03.05
  • Published : 2010.07.01
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Abstract

Purpose: The purpose of this study is to describe the characteristic features of cerebral sparganosis with live worm on CT and MRI as compared with the characteristic CT and MRI features of degenerated cerebral worms. Materials and Methods: Twelve patients with surgically-proven live worms (the live group) and 13 patients with degenerated worms (the degenerated group) were included in this study. We retrospectively reviewed the CT scans of all the patients and the MR images of 19 patients. Results: The live group showed highly attenuated lesion (50-70 HUs for the CT number) on precontrast CT with surrounding enhancement extending to the cortical surface, a mass effect and change of the location and shape of the enhancing lesion on the follow-up images, whereas the degenerated group showed punctate calcification (more than 130 HUs) with surrounding enhancement and cerebromalacia in 77% of the subjects (p<.01). The highly attenuated lesion had an amorphous nodular or nodulotubular shape, and these lesions were slightly hyperintense on the T1-weighted MR images and hypointense on the T2-weighted MR images. Conclusion: In patients with cerebral sparganosis, live worm infection is highly suggested if there is a focal amorphous hyperattenuated lesion on the precontrast CT with a surrounding mass effect, irregular nodulotubular enhancement extending to the pial surface and change of the enhancing lesion on the follow-up images.

목적: 뇌 스파르가눔증 환자에서 살아있는 유충과 죽은 유충에 의한 특징적인 CT와 MRI 소견을 알아보고자 하였다. 대상과 방법: 수술로 확인된 살아있는 유충에 의한 뇌 스파르가눔증 환자 12명(live group)과 죽은 유충에 의한 환자 13명의 환자(degenerated group)를 대상으로 CT(25명)와 MR(19명) 소견을 후향적으로 조사하였다. 결과: Live group의 모든 환자에서 조영 전 CT에서 50-70HU의 약간 높은 감쇄 병변과 연막까지 퍼지는 조영증강 병변, 종괴 효과, 추적 검사 시 위치가 변하는 소견을 보였다. 반면에 degenerated group은 점상의 석회화 병변과 조영 증강, 뇌연화증의 소견을 77%에서 보였다 (p < .01). Live group의 CT에서 관찰되는 높은 감쇄 병변은 무정형 또는 관상의 결절이고 T1 강조 영상에서 고신호강도, T2 강조 영상에서 저신호강도의 소견을 보였다. 결론: 뇌 스파르가눔증 환자의 조영 전 CT에서 무정형의 고감쇄 결절이 보이고 종괴 효과, 연막까지 퍼지는 불규칙한 조영 증강, 추적 검사 시 위치와 모양이 바뀌는 소견을 보인다면 살아있는 유충을 강하게 시사한다.

Keywords

References

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