Coexistent Neurocysticercosis and Japanese B Encephalitis: MR Imaging Correlation
Paramjeet Singha,
Naveen Kalraa,
Radha Kanta Rathoa,
Sridhar Shankara,
Niranjan Khandelwala and
Sudha Suria
a From the Departments of Radiodiagnosis and Imaging (P.S., N.K., S.Sh., N.K., S.Su.) and Virology (R.R.), Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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FIG 1. Images of a 16-year-old man with serologically positive JE and single coexistent NCC.
A, T2-weighted turbo fluid-attenuated inversion recovery axial section shows bilateral asymmetric thalamic hyperintensity (left more than right) with left globus pallidus involvement.
B, T2-weighted turbo spin-echo coronal section shows the degenerating cyst in the left frontal region superficially in close association with the leptomeninges with associated edema.
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FIG 2. Images of a 13-year-old boy with a solitary cyst and JE.
A, T2-weighted turbo spin-echo axial section of the brain shows more extensive right thalamic hyperintensity on the same side as the cyst inciting edema. The encephalitic changes in the temporal cortex also lateralize to the same side.
B, T1-weighted contrast-enhanced axial section shows the enhancement of the wall of the cyst. The thalamic lesions appear hypointense and show no hemorrhage.
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FIG 3. Images of a 50-year-old man with JE and positive serology.
A, T2-weighted turbo spin-echo axial section reveals two cysticercus cysts in the right temporal lobe with thalamic lesion lateralization on the same side. The hyperintensity associated with the cysts (representing edema) involves the right temporal lobe extensively and merges with the thalamic signal changes of JE.
B, T2-weighted turbo spin-echo axial section reveals the second cysticercus cyst in the right temporal lobe.
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FIG 4. Images of an 8-year-old boy with JE and two cysticercus cysts.
A, T2-weighted turbo spin-echo coronal section of the brain reveals predominant signal changes in the left thalamus.
B, T2-weighted turbo spin-echo coronal section shows degenerating cyst with edema in the left frontal cortex, which correlates with the side of dominant JE lesion.
C, T2-weighted turbo spin-echo axial section shows the other cyst on the contralateral side in granular nodular stage with no inflammation in the surrounding brain.
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