Magnetic Resonance Spectroscopy and Magnetic Resonance Imaging Characteristics of Cerebral Sparganosis: A Case Report

摘要

We report a case of a 63-year-old man with cerebral sparganosis due to infection with a sparganum larva and discuss the characteristic magnetic resonance imaging and magnetic resonance spectroscopy features of cerebral sparganosis. A 63-year-old man, who lived in a rural community, presented to our center for numbness and paresthesia on his right limbs, and a mass lesion on his left parietal lobe, initially suspected to be vascular malformations by local clinicans. He consulted to our service for a definite diagnosis. He underwent a cranial magnetic resonance imaging on admission, which revealed a mass lesion with prominent perifocal oedema in the left parietal lobe. The lesion was presented as slight hypointensity on T1-weighted images but slight hyperintensity on T2-weighted images, and demonstrated abnormal enhancement with the pattern of a peripheral ring shape on enhanced magnetic resonance scans. Further tests, magnetic resonance spectroscopy and enzyme-linked immunosorbent assay for parasites were performed. A single-voxel magnetic resonance spectroscopy showed a dramatically increased choline level and no significantly decreased N-acetylaspartate level in this lesion. The result of enzyme-linked immunosorbent assay was strongly positive for anti-sparganum antibody in blood. With these findings the patient was finally diagnosed with cerebral sparganosis. Following treatment, the patient's neurological deficits markedly improved. A peripheral ring shape enhancement was characteristic of cerebral sparganosis on enhanced magnetic resonance scans. The result of magnetic resonance spectroscopy was thought to be a new finding according to the literature, however, more cases should be studied to confirm the result.