Follow-Up MR Imaging for Cerebral Sparganosis

Letters to the Editor Letters to the Editor

Published online before print October 25, 2012, doi: 10.3174/ajnr.A3391
AJNR 2012 33: E131

S. Wiwanitkita
aWiwanitkit House
Bangkok, Thailand

V. Wiwanitkitb
bJoseph Ayobabalola University
Nigeria, Africa

The recent article on follow-up MR imaging for cerebral sparganosis is interesting.1 Li et al noted, “Migration is a notable feature of cerebral sparganosis.” This finding is quite interesting. Due to its basic nature, sparganosis is usually a chronic localized disease. According to a large series from Thailand, no observation of cerebral migration was noted.2 The “tunnel” sign is a new finding that was recently reported, but there has been no confirmation on pathology.3 The question is whether the cases are actual sparganosis with confirmed pathology or whether there is any additional co-occurrence of another migrating cerebral parasitic disease such as gnathostomiasis.

References

  1. Li YX, Ramsahye H, Yin B, et al. Migration: a notable feature of cerebral sparganosis on follow-up MR imaging. AJNR Am J Neuroradiol 2012 Aug 2. [Epub ahead of print] » Search Google Scholar
  2. Wiwanitkit V. A review of human sparganosis in Thailand. Int J Infect Dis2005;9:312–16 » CrossRef » Medline
  3. Song T, Wang WS, Zhou BR, et al. CT and MR characteristics of cerebral sparganosis. AJNR Am J Neuroradiol 2007;28:1700–05 » Abstract/FREE Full Text

Reply

Published online before print October 25, 2012, doi: 10.3174/ajnr.A3413
AJNR 2012 33: E132

Y.X. Lia
aRadiology Department
Huashan Hospital
Fudan University
Shanghai, China

In our study, 8 out of 14 patients were diagnosed by histopathology (3 from surgical resection and 5 from stereotactic biopsy). The diagnosis was proved by an ELISA test for sparganosis in 6 patients. IgG results were positive in both serum and CSF in 5 patients and positive in serum in 1 patient.

The ELISA tests for other parasitic disease including gnathostomiasis, angiostrongyliasis, toxoplasmosis, trichinosis, hydatidosis, schistosomiasis, clonorchiasis, paragonimiasis, and cysticercosis were all negative in our patients. Gnathostomiasis is endemic in Thailand but rare in China. Therefore, the possibility of co-occurrence of other migrating cerebral parasitic disease is very low.

Follow-Up MR Imaging for Cerebral Sparganosis