Imaging Features of Sellar Cysticercosis
Nicasio Arriada-Mendicoaa,
Miguel Angel Celis-Lópeza,
Jesús Higuera-Callejab and
Teresa Corona-Vázquezc
a Division of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
b Division of Neuroimaging, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
c Division of Medical Education, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
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FIG 1. Intrasellar NCC in a patient with chiasmatic syndrome and hypothyroidism.
A, Axial CT image shows a left hypoattenuated lesion of the sellar region displacing the pituitary
B, Reformatted sagittal CT image shows expansion of the sellar floor into the sphenoidal sinus by the cystic lesion.
C, Sagittal postcontrast T1-weighted image reveals a hypointense extraaxial cystic lesion that displaces the hypophysis laterally, with extrasellar extension and dorsal displacement of the third ventricle and optic chiasm.
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FIG 2. MR findings of NCC in other forms of sellar involvement.
A, Patient with a diagnosis of hydrocephalus, amaurosis, and severe hypothyroidism. Sagittal T1-weighted postcontrast MR image shows leptomeningeal enhancement of the parasellar region, the pineal gland, and prepontine cisterns.
B, Patient with a diagnosis of racemic NCC and symptoms of sellar involvement. Sagittal MR image shows a racemic, extraaxial lesion that displaces the parasellar structures with dorsal compression of the third ventricle, mesencephalic displacement, and hypophyseal compression.
C, Patient with a diagnosis of hydrocephalus, chiasmatic syndrome, and subclinical endocrine dysfunction. Sagittal T1-weighted MR image reveals a ventrally displaced infundibular stem and deformity of the fourth ventricle. ELISA findings for NCC in CSF were positive. Diagnosis was established by means of endoscopic extraction of multiple vesicles from the lateral and third ventricles.
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