Cysticercosis MRI

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

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.

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

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.^[1]
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

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

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.

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