Brain magnetic resonance imaging findings in young patients with hepatosplenic schistosomiasis mansoni without overt symptoms

Abstract

The purpose of this study was to describe the brain magnetic resonance imaging (MRI) findings in young patients with hepatosplenic schistosomiasis mansoni without overt neurologic manifestations. This study included 34 young persons (age range = 9-25 years) with hepatosplenic schistosomiasis mansoni who had been previously treated. Patients were scanned on a 1.5-T system that included multiplanar pre-contrast and post-contrast sequences, and reports were completed by two radiologists after a consensus review. Twenty (58.8%) patients had MRI signal changes that were believed to be related to schistosomiasis mansoni. Twelve of the 20 patients had small focal hyperintensities on T2WI in the cerebral white matter, and eight patients had symmetric hyperintense basal ganglia on T1WI. There was a high frequency of brain MRI signal abnormalities in this series. Although not specific, these findings may be related to schistosomiasis.

Figure 1.

Magnetic resonance images of patient 18, a 15-year-old girl with hepatosplenic schistosomiasis without neurologic symptoms. Axial spin-echo T1WI demonstrate symmetrical and bilateral hyperintensity at the level of the globus pallidus (A), cerebral peduncles (B) and at the floor of the fourth ventricle (C) (arrows). Sagittal spin-echo T1WI (D) shows a white pituitary gland (small arrow).

Figure 2.

Magnetic resonance images of patient 14, a 15-year-old boy with schistosomiasis mansoni. Axial fluid attenuated inversion recovery (A) and TSE-T2WI (B) show small focal hyperintensities in the white matter of the left frontal lobe (small arrows).