MRI of CNS parasitic diseases

Abstract

This article reviews MRI findings of parasitic diseases of the central nervous system (CNS), with emphasis on neurocysticercosis, which is by far the most common CNS parasitic infection worldwide. MRI findings of neurocysticercosis are various, depending on the location (parenchymal, cisternal, ventricular, and spinal forms), and temporal evolutional stages (vesicular, colloid vesicular, granular nodular, and nodular calcified stages) of the worm. Classical findings of each location and stage are presented. Characteristic MRI findings of cerebral toxoplasmosis frequently seen in patients with acquired immunodeficiency syndrome (AIDS), paragonimiasis, and sparganosis that have most commonly been reported in East Asia are also illustrated. MRI is superior to CT scan in the evaluation of most CNS parasitic infections and is nearly diagnostic, particularly in endemic areas. Contrast-enhanced study is essential not only for specific diagnosis of the disease, but also for assessment of the inflammatory activity.