Annals of Indian Academy of Neurology
ORIGINAL ARTICLE
Year
: 2019  |  Volume : 22  |  Issue : 1  |  Page : 67--72

Conglomerate ring-enhancing lesions are common in solitary neurocysticercosis and do not always suggest neurotuberculosis


Ajay Garg1, Khush Preet Kaur1, Leve Joseph Devaranjan Sebastian1, Shailesh B Gaikwad1, Rohit Bhatia2, Mamta Bhushan Singh2, Achal Srivastava2, Ravindra Mohan Pandey3 
1 Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India
2 Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
3 Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Prof. Ajay Garg
Room No: 17, Neurosciences Centre, Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi
India

Background and Purpose: Differentiating between neurocysticercosis (NCC) and neurotuberculosis has serious therapeutic implications and this distinction relies heavily on neuroimaging. Few case reports discuss the conglomeration of ring-enhancing lesions (RELs) in patients with solitary NCC. The aim of our study is to describe the imaging findings of conglomerate RELs in a cohort of patients with solitary NCC, emphasizing the frequency of conglomeration. Materials and Methods: This retrospective study included 100 patients with solitary NCC. Two neuroradiologists analyzed contrast-enhanced computed tomography (CT) images regarding morphology, enhancement pattern, location, number of lesions, and degree of perilesional edema. The solitary lesions were classified as solitary discrete RELs (SD-RELs) when a well-defined lesion was seen and solitary conglomerate RELs (SC-RELs) when two or more ring lesions or ring/rings plus disc lesions were present contiguously. Follow-up CT scans were evaluated for the resolution of lesions and surrounding edema. Results: Out of 100 patients, 42 were SD-RELs and 58 were SC-RELs. No statistically significant difference was found between both groups in terms of age of presentation, clinical presentation, lesion size and location, and degree of perilesional edema. Larger lesions (>10 mm) were more likely to show scolex and were associated with greater degree of edema in both subgroups. During follow-up, 13 patients had new lesions (SD-RELs-5, SC-RELs-8). In SD-RELs, follow-up lesions were in the same location in four patients and new location in one; and in SC-RELs, lesions were in the same location in seven and in new location in one case. Conclusion: Conglomeration of RELs is a common finding in patients with solitary NCC.


How to cite this article:
Garg A, Kaur KP, Devaranjan Sebastian LJ, Gaikwad SB, Bhatia R, Singh MB, Srivastava A, Pandey RM. Conglomerate ring-enhancing lesions are common in solitary neurocysticercosis and do not always suggest neurotuberculosis.Ann Indian Acad Neurol 2019;22:67-72


How to cite this URL:
Garg A, Kaur KP, Devaranjan Sebastian LJ, Gaikwad SB, Bhatia R, Singh MB, Srivastava A, Pandey RM. Conglomerate ring-enhancing lesions are common in solitary neurocysticercosis and do not always suggest neurotuberculosis. Ann Indian Acad Neurol [serial online] 2019 [cited 2021 Sep 28 ];22:67-72
Available from: https://www.annalsofian.org/article.asp?issn=0972-2327;year=2019;volume=22;issue=1;spage=67;epage=72;aulast=Garg;type=0