DOI QR코드

DOI QR Code

Various MRI Findings of Toxocara canis Myelitis

개회충 척수염의 다양한 자기공명영상 소견

  • Sun Young Park (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Kyung Seok Park (Department of Neurology, Seoul National University Bundang Hospital) ;
  • Eugene Lee (Department of Neurology, Seoul National University Bundang Hospital) ;
  • Joon Woo Lee (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Yun Jung Bae (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Yusuhn Kang (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Joong Mo Ahn (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Heung Sik Kang (Department of Radiology, Seoul National University Bundang Hospital)
  • 박선영 (분당서울대학교병원 영상의학과) ;
  • 박경석 (분당서울대학교병원 신경과) ;
  • 이영준 (분당서울대학교병원 신경과) ;
  • 이준우 (분당서울대학교병원 영상의학과) ;
  • 배윤정 (분당서울대학교병원 영상의학과) ;
  • 강유선 (분당서울대학교병원 영상의학과) ;
  • 안중모 (분당서울대학교병원 영상의학과) ;
  • 강흥식 (분당서울대학교병원 영상의학과)
  • Received : 2019.03.05
  • Accepted : 2019.07.17
  • Published : 2020.01.01

Abstract

Purpose To describe magnetic resonance imaging (MRI) findings in 10 cases of Toxocara canis myelitis and to analyze these findings to aid in the diagnosis of this condition. Materials and Methods From June 2015 to March 2018, we retrospectively analyzed the electronic medical records and MR images of patients who were diagnosed with Toxocara canis myelitis. The analysis of the MR images was based on a discussion between an experienced spinal radiologist and a radiology resident. Results This study classified MRI findings into the following two types. Type 1 was defined as central and diffuse T2 high signal intensity on the axial plane, which was observed in 50% of all cases. All lesions showed avid enhancement, mostly in the posterolateral or posterior region (4 cases, 80%). Type 2 was defined as wedge-shaped or focal T2 high signal intensity in the posterolateral or posterior region and corresponded to the remaining 50% of the cases. In this case, the extent of the lesion was relatively small and contrast enhancement was observed in only one case. Conclusion This study revealed that various imaging findings could be observed in cases of Toxocara canis myelitis, and the findings were classified into two types.

목적 개회충 척수염의 자기공명영상 10예를 보고하고, 개회충 척수염 진단에 도움이 되는 다양한 영상 소견을 분석하고자 한다. 대상과 방법 2015년 6월부터 2018년 3월까지 본원에서 개회충 척수염으로 진단받은 환자들을 대상으로 의무기록과 촬영한 척추 자기공명영상 소견을 척추영상 전문의 1명과 영상의학과 전공의 1명이 후향적으로 분석하였다. 결과 본 연구는 개회충 척수염의 자기공명영상 소견을 다음 두 가지로 분류하였다. 먼저 type 1은 축상면에서 중심부, 미만성 T2 고신호강도가 보이는 경우로 50%가 해당되며 모든 환자에서 병변의 뚜렷한 조영증강이 있었으며 대부분의 경우(4예, 80%)에서 후외측 또는 후방의 결절성 조영증강을 보였다. Type 2는 후외측 혹은 후방에서 쐐기 모양 또는 국소적 T2 고신호강도의 병변이 보이는 경우로 분류하였으며, 50%에 해당한다. 이 경우 병변의 범위가 상대적으로 작았고 조영증강은 1예에서만 관찰되었다. 결론 개회충 척수염의 자기공명영상이 다양한 소견으로 나타날 수 있음을 확인하였고 이를 통해 개회충 척수염의 자기공명영상 소견을 2가지로 분류하여 제시하였다.

Keywords

References

  1. Finsterer J, Auer H. Neurotoxocarosis. Rev Inst Med Trop Sao Paulo 2007;49:279-287
  2. Eberhardt O, Bialek R, Nagele T, Dichgans J. Eosinophilic meningomyelitis in toxocariasis: case report and review of the literature. Clin Neurol Neurosurg 2005;107:432-438
  3. Jabbour RA, Kanj SS, Sawaya RA, Awar GN, Hourani MH, Atweh SF. Toxocara canis myelitis: clinical features, magnetic resonance imaging (MRI) findings, and treatment outcome in 17 patients. Medicine (Baltimore) 2011;90:337-343
  4. Lee IH, Kim ST, Oh DK, Kim HJ, Kim KH, Jeon P, et al. MRI findings of spinal visceral larva migrans of Toxocara canis. Eur J Radiol 2010;75:236-240
  5. Hiramatsu Y, Yoshimura M, Saigo R, Arata H, Okamoto Y, Matsuura E, et al. Toxocara canis myelitis involving the lumbosacral region: a case report. J Spinal Cord Med 2017;40:241-245
  6. Goffette S, Jeanjean AP, Duprez TP, Bigaignon G, Sindic CJ. Eosinophilic pleocytosis and myelitis related to Toxocara canis infection. Eur J Neurol 2000;7:703-706
  7. Umehara F, Ookatsu H, Hayashi D, Uchida A, Douchi Y, Kawabata H, et al. MRI studies of spinal visceral larva migrans syndrome. J Neurol Sci 2006;249:7-12
  8. Xinou E, Lefkopoulos A, Gelagoti M, Drevelegas A, Diakou A, Milonas I, et al. CT and MR imaging findings in cerebral toxocaral disease. AJNR Am J Neuroradiol 2003;24:714-718
  9. Ma G, Holland CV, Wang T, Hofmann A, Fan CK, Maizels RM, et al. Human toxocariasis. Lancet Infect Dis 2018;18:e14-e24
  10. Sheerin F, Collison K, Quaghebeur G. Magnetic resonance imaging of acute intramedullary myelopathy: radiological differential diagnosis for the on-call radiologist. Clin Radiol 2009;64:84-94
  11. Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 2015;85:177-189
  12. Jacob A, Weinshenker BG. An approach to the diagnosis of acute transverse myelitis. Semin Neurol 2008;28:105-120
  13. Kumar J, Kimm J. MR in Toxocara canis myelopathy. AJNR Am J Neuroradiol 1994;15:1918-1920