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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.

View larger version (95K): [in a new window]   Fig. 1A. —41-year-old woman with spinal schistosomiasis. Sagittal T2-weighted MR image shows diffuse signal prolongation and expansion of distal spinal cord and conus (arrow).

View larger version (97K): [in a new window]   Fig. 1B. —41-year-old woman with spinal schistosomiasis. Sagittal contrast-enhanced T1-weighted MR image shows central linear enhancement surrounded by multiple punctate enhancing nodules (arrows) that form masslike structure.

View larger version (161K): [in a new window]   Fig. 2A. —30-year-old man with cerebral schistosomiasis. Axial T2-weighted MR image shows vasogenic edema and mass effect involving left temporal lobe.

View larger version (137K): [in a new window]   Fig. 2B. —30-year-old man with cerebral schistosomiasis. Axial contrast-enhanced T1-weighted MR image shows multiple areas of central linear enhancement surrounded by enhancing punctate nodules (arrows).

View larger version (162K): [in a new window]   Fig. 2C. —30-year-old man with cerebral schistosomiasis. Coronal contrast-enhanced T1-weighted MR image confirms linear and nodular enhancement pattern in different imaging plane.

View larger version (122K): [in a new window]   Fig. 3A. —32-year-old man with cerebral schistosomiasis. Axial contrast-enhanced T1-weighted MR image shows punctate multinodular enhancement pattern surrounding central linear enhancement.

View larger version (156K): [in a new window]   Fig. 3B. —32-year-old man with cerebral schistosomiasis. Sagittal contrast-enhanced T1-weighted MR image confirms linear (arrow) and nodular enhancement pattern in different imaging plane.

View larger version (149K): [in a new window]   Fig. 3C. —32-year-old man with cerebral schistosomiasis. Axial T2-weighted MR image shows hyperintense mass (arrow) with surrounding vasogenic edema involving right parietal lobe.

View larger version (172K): [in a new window]   Fig. 3D. —32-year-old man with cerebral schistosomiasis. Photomicrograph of histopathologic section shows granuloma formation (arrows) with surrounding inflammation. (H and E, x250)

View larger version (153K): [in a new window]   Fig. 3E. —32-year-old man with cerebral schistosomiasis. Photomicrograph of frozen histopathologic section shows ovum of Schistosoma mansoni. Note characteristic broad lateral spine (arrow). (H and E, x300)

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