Ununsual manifestations of neurocysticercosis in MR imaging: analysis of 172 cases

PURPOSE: The typical manifestations of neurocysticercosis are described widely in the literature. The purpose of this study is to demonstrate the uncommon presentations of different forms of neurocysticercosis in MR imaging. METHOD: A retrospective analysis of 172 cases of neurocysticercosis in MR studies was carried out over a period of 13 years. One hundred and four males and 68 females with a mean age of 32 ± 3.7 years were studied. The studies were performed on 1.5 T GE MR units and T1 was used before and after gadolinium injection, T2 and gradient-echo (T2*) sequences. RESULTS: The authors divided the unusual manifestations of neurocysticercosis into: intraventricular, subarachnoid, spinal, orbital, intraparenchymatous, and reactivation of previously calcified lesions. The results obtained were: intraparenchymatous 95 cases (55.23%); intraventricular 27 cases (15.69%); subarachnoid 20 cases (11.63%); spinal 6 cases (3.49%); orbital 1 case (0.58%); reactivated lesion 1 case (0.58%); association of intraventricular and intraparenchymatous 12 cases (6.98%); association of subarachnoid and intraparenchymatous 6 cases (3.49%); association of subarachnoid and intraventricular, 4 cases (2.32%). CONCLUSION: MR imaging is a sensitive and specific method in the analysis of different forms of unusual manifestations of neurocysticercosis, which should appear in the differential diagnosis of parenchymal, ventricular, spinal, cisternal, and orbital lesions. OBJETIVO: as manifestações típicas da neurocisticercose já são bem conhecidas. O papel deste estudo foi demonstrar os aspectos incomuns da neurocisticercose na ressonância magnética. MÉTODO: foram analisados 172 casos de ressonância magnética de neurocisticercose na Med Imagem num período de 13 (treze) anos em aparelhos GE de 1.5T Signa (Horizon, LX e CVI). Dos casos analisados, foram diversas as formas de apresentação, incluindo intraventricular, intraespinhal, cisternal, orbital, formas atípicas parenquimatosas (simulando tumores), forma miliar e evolução não usual (reativação). CONCLUSÃO: A ressonância magnética é método sensível e específico na avaliação das numerosas formas de apresentação atípica da neurocisticercose, as quais devem constar no diagnóstico diferencial de lesões intraventriculares, cisternais, orbitárias e parenquimatosas.