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Role of magnetic resonance spectroscopy and susceptibility weighted imaging in cerebral alveolar echinococcosis.

Yang G, Zhang Q, Tang G, Xu H, Yang Z, Guo J, Liang L, Qi Y - Iran J Parasitol (2015 Jan-Mar)

Bottom Line: We retrospectively analyzed 10 clinical-identified CAE cases MR performance, and summarized the MRS and SWI performance of CAE.The 10 cases of CAE all had the history of primary HAE, among who 6 cases had single lesion (60%), while the rest 4 cases had multiple lesions (40%); and 4 cases were concomitant with lung metastases.MRI performance: T2WI lesions were coal-like low-signal shadow, with multiple small vesicles inside the lesions; MRS performance: NAA, Cho and Cr significantly reduced, an abnormally high and steep crest was found at 1.4 ppm; the phase diagram and strength diagram of SWI showed isointensity.

View Article: PubMed Central - PubMed

Affiliation: Dept. of Radiology (MRI), Qinghai Provincial People's Hospital, Xining, China.

ABSTRACT

Background: To analyze the characteristic performance of magnetic resonance spectroscopy (MRS) and susceptibility weighted imaging (SWI) in cerebral alveolar echinococcosis (CAE).

Methods: We retrospectively analyzed 10 clinical-identified CAE cases MR performance, and summarized the MRS and SWI performance of CAE.

Results: The 10 cases of CAE all had the history of primary HAE, among who 6 cases had single lesion (60%), while the rest 4 cases had multiple lesions (40%); and 4 cases were concomitant with lung metastases. MRI performance: T2WI lesions were coal-like low-signal shadow, with multiple small vesicles inside the lesions; MRS performance: NAA, Cho and Cr significantly reduced, an abnormally high and steep crest was found at 1.4 ppm; the phase diagram and strength diagram of SWI showed isointensity.

Conclusion: The MRS and SWI of CAE could provide important supplemental information for the diagnosis of CAE, especially the abnormally high and steep crest at 1.4 ppm provide the reliable image basis for the diagnosis and differential diagnosis of CAE.

No MeSH data available.


Related in: MedlinePlus

Displayed the traditional, MRS and SWI imaging appearance of CAE on the left occipital lobe in 3.0T SkyraMRIA.T2WI mass mainly appeared as low signal, within spotted high signal inside, and the lesion edge could see high signal vesicles shadow, with obvious position-occupation effect and the perifocal edema; B. T1WI mass showed a slightly higher signal, the boundary was less clear, and the small vesicles was unclear; C. Blackwater sequence showed that lesions had a clear boundary, mixed with signal shadow, while the peripheral edema was obvious; D. DWI showed that the lesions appeared as mixed but slightly high signal, within which the spotted high signal could be seen; E. ADC image was ill-defined isointensity, within which spotted lower signal could be seen; F and G were the SWI phase diagram and intensity diagram, respectively, the lesions appeared as slabby isointensity shadow, the intensity graph showed multiple small blood vessels shadows around; H and I contrast-enhanced T1WI showed that apparent, irregular ring enhancement appeared around the lesions; J. in PRESS sequence with 135ms echo time of 1HMR spectroscopy, the low signal center of the lesion was focused on the 1cm3 interest region, which exhibited the abnormal steep peak at 1.4ppm, while NAA, Cho and Cr significantly reduced; K. in PRESS sequence with 30ms echo time, the interest region of the lesion exhibited abnormal steep peak at 1.4 ppm, while NAA, Cho and Cr all significantly reduced.
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Figure 1: Displayed the traditional, MRS and SWI imaging appearance of CAE on the left occipital lobe in 3.0T SkyraMRIA.T2WI mass mainly appeared as low signal, within spotted high signal inside, and the lesion edge could see high signal vesicles shadow, with obvious position-occupation effect and the perifocal edema; B. T1WI mass showed a slightly higher signal, the boundary was less clear, and the small vesicles was unclear; C. Blackwater sequence showed that lesions had a clear boundary, mixed with signal shadow, while the peripheral edema was obvious; D. DWI showed that the lesions appeared as mixed but slightly high signal, within which the spotted high signal could be seen; E. ADC image was ill-defined isointensity, within which spotted lower signal could be seen; F and G were the SWI phase diagram and intensity diagram, respectively, the lesions appeared as slabby isointensity shadow, the intensity graph showed multiple small blood vessels shadows around; H and I contrast-enhanced T1WI showed that apparent, irregular ring enhancement appeared around the lesions; J. in PRESS sequence with 135ms echo time of 1HMR spectroscopy, the low signal center of the lesion was focused on the 1cm3 interest region, which exhibited the abnormal steep peak at 1.4ppm, while NAA, Cho and Cr significantly reduced; K. in PRESS sequence with 30ms echo time, the interest region of the lesion exhibited abnormal steep peak at 1.4 ppm, while NAA, Cho and Cr all significantly reduced.

Mentions: Eight cases appeared as slight T1WI hypointensity, and 2 cases appeared as mixed signal; all the cases showed low T2IW signal, with "coal-like" changes; the main T2flair sequence all appeared as isointensity, mixed with stippled high signal shadow inside, the mass boundary was clear, surrounded by flaky edema, with significant position-occupation effect (Fig. 1 A ∼ D). The multiple aggregated vesicles, with about 1 ∼ 10 mm in diameter, could be seen in all cases. T1WI was low intensity signal, T2 IW was high intensity signal; DWI all appeared as slightly higher intensity signals with clear boundaries, ADC appeared as the isointensity signal shadow, with stippled low signal shadow inside, while the peripheral edema appeared as the high signal shadow (Fig. 1E); SWI phase diagram and intensity diagram appeared as slabby isointensity (Fig. 1F ∼ G), and the scope was slightly larger than T2WI, and the borders were more clearer, without significant vascular shadows peripherally. In the single voxel MRS, an abnormally high and steep peak approximately at 1.4 ppm could be seen, and NAA, CHO and Cr significantly reduced (Fig. 1 J-K); 10 cases all appeared the enhanced irregular ring-shaped enhancement, and the enhancement was obvious (Fig. 1 H-I).


Role of magnetic resonance spectroscopy and susceptibility weighted imaging in cerebral alveolar echinococcosis.

Yang G, Zhang Q, Tang G, Xu H, Yang Z, Guo J, Liang L, Qi Y - Iran J Parasitol (2015 Jan-Mar)

Displayed the traditional, MRS and SWI imaging appearance of CAE on the left occipital lobe in 3.0T SkyraMRIA.T2WI mass mainly appeared as low signal, within spotted high signal inside, and the lesion edge could see high signal vesicles shadow, with obvious position-occupation effect and the perifocal edema; B. T1WI mass showed a slightly higher signal, the boundary was less clear, and the small vesicles was unclear; C. Blackwater sequence showed that lesions had a clear boundary, mixed with signal shadow, while the peripheral edema was obvious; D. DWI showed that the lesions appeared as mixed but slightly high signal, within which the spotted high signal could be seen; E. ADC image was ill-defined isointensity, within which spotted lower signal could be seen; F and G were the SWI phase diagram and intensity diagram, respectively, the lesions appeared as slabby isointensity shadow, the intensity graph showed multiple small blood vessels shadows around; H and I contrast-enhanced T1WI showed that apparent, irregular ring enhancement appeared around the lesions; J. in PRESS sequence with 135ms echo time of 1HMR spectroscopy, the low signal center of the lesion was focused on the 1cm3 interest region, which exhibited the abnormal steep peak at 1.4ppm, while NAA, Cho and Cr significantly reduced; K. in PRESS sequence with 30ms echo time, the interest region of the lesion exhibited abnormal steep peak at 1.4 ppm, while NAA, Cho and Cr all significantly reduced.
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Related In: Results  -  Collection

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Figure 1: Displayed the traditional, MRS and SWI imaging appearance of CAE on the left occipital lobe in 3.0T SkyraMRIA.T2WI mass mainly appeared as low signal, within spotted high signal inside, and the lesion edge could see high signal vesicles shadow, with obvious position-occupation effect and the perifocal edema; B. T1WI mass showed a slightly higher signal, the boundary was less clear, and the small vesicles was unclear; C. Blackwater sequence showed that lesions had a clear boundary, mixed with signal shadow, while the peripheral edema was obvious; D. DWI showed that the lesions appeared as mixed but slightly high signal, within which the spotted high signal could be seen; E. ADC image was ill-defined isointensity, within which spotted lower signal could be seen; F and G were the SWI phase diagram and intensity diagram, respectively, the lesions appeared as slabby isointensity shadow, the intensity graph showed multiple small blood vessels shadows around; H and I contrast-enhanced T1WI showed that apparent, irregular ring enhancement appeared around the lesions; J. in PRESS sequence with 135ms echo time of 1HMR spectroscopy, the low signal center of the lesion was focused on the 1cm3 interest region, which exhibited the abnormal steep peak at 1.4ppm, while NAA, Cho and Cr significantly reduced; K. in PRESS sequence with 30ms echo time, the interest region of the lesion exhibited abnormal steep peak at 1.4 ppm, while NAA, Cho and Cr all significantly reduced.
Mentions: Eight cases appeared as slight T1WI hypointensity, and 2 cases appeared as mixed signal; all the cases showed low T2IW signal, with "coal-like" changes; the main T2flair sequence all appeared as isointensity, mixed with stippled high signal shadow inside, the mass boundary was clear, surrounded by flaky edema, with significant position-occupation effect (Fig. 1 A ∼ D). The multiple aggregated vesicles, with about 1 ∼ 10 mm in diameter, could be seen in all cases. T1WI was low intensity signal, T2 IW was high intensity signal; DWI all appeared as slightly higher intensity signals with clear boundaries, ADC appeared as the isointensity signal shadow, with stippled low signal shadow inside, while the peripheral edema appeared as the high signal shadow (Fig. 1E); SWI phase diagram and intensity diagram appeared as slabby isointensity (Fig. 1F ∼ G), and the scope was slightly larger than T2WI, and the borders were more clearer, without significant vascular shadows peripherally. In the single voxel MRS, an abnormally high and steep peak approximately at 1.4 ppm could be seen, and NAA, CHO and Cr significantly reduced (Fig. 1 J-K); 10 cases all appeared the enhanced irregular ring-shaped enhancement, and the enhancement was obvious (Fig. 1 H-I).

Bottom Line: We retrospectively analyzed 10 clinical-identified CAE cases MR performance, and summarized the MRS and SWI performance of CAE.The 10 cases of CAE all had the history of primary HAE, among who 6 cases had single lesion (60%), while the rest 4 cases had multiple lesions (40%); and 4 cases were concomitant with lung metastases.MRI performance: T2WI lesions were coal-like low-signal shadow, with multiple small vesicles inside the lesions; MRS performance: NAA, Cho and Cr significantly reduced, an abnormally high and steep crest was found at 1.4 ppm; the phase diagram and strength diagram of SWI showed isointensity.

View Article: PubMed Central - PubMed

Affiliation: Dept. of Radiology (MRI), Qinghai Provincial People's Hospital, Xining, China.

ABSTRACT

Background: To analyze the characteristic performance of magnetic resonance spectroscopy (MRS) and susceptibility weighted imaging (SWI) in cerebral alveolar echinococcosis (CAE).

Methods: We retrospectively analyzed 10 clinical-identified CAE cases MR performance, and summarized the MRS and SWI performance of CAE.

Results: The 10 cases of CAE all had the history of primary HAE, among who 6 cases had single lesion (60%), while the rest 4 cases had multiple lesions (40%); and 4 cases were concomitant with lung metastases. MRI performance: T2WI lesions were coal-like low-signal shadow, with multiple small vesicles inside the lesions; MRS performance: NAA, Cho and Cr significantly reduced, an abnormally high and steep crest was found at 1.4 ppm; the phase diagram and strength diagram of SWI showed isointensity.

Conclusion: The MRS and SWI of CAE could provide important supplemental information for the diagnosis of CAE, especially the abnormally high and steep crest at 1.4 ppm provide the reliable image basis for the diagnosis and differential diagnosis of CAE.

No MeSH data available.


Related in: MedlinePlus