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Unique Linear and Nodular MR Enhancement Pattern in Schistosomiasis of the Central Nervous System

Report of Three Patients

¹ Department of Radiology, Massachusetts General Hospital, 55 Fruit St., Gray Building 2nd Floor, Boston, MA 02114.
² Present address: Department of Radiology, New York—Presbyterian Hospital, NewYork Weill Cornell Medical Center, 520 E. 70th St., Starr Pavilion—Starr 630, New York, NY 10021.

OBJECTIVE. The purpose of this paper is to describe the unique MR imaging appearance of schistosomiasis of the central nervous system (CNS).

CONCLUSION. Contrast-enhanced T1-weighted MR images in all three patients with CNS schistosomiasis revealed a central linear enhancement surrounded by multiple enhancing punctate nodules, forming an "arborized" appearance. Pathologically, this enhancement pattern correlated with a host granulomatous response to Schistosoma species ova. Although the pattern is not present in all cases of CNS schistosomiasis, when it is observed, a diagnosis of CNS schistosomiasis should be considered.

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