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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(07): 765-766
DOI: 10.1055/s-0042-1755214
Images in Neurology

High-resolution vessel wall imaging in human neurocysticercosis with leptomeningitis

Imagens de alta resolução das paredes dos vasos na neurocisticercose humana, com leptomeningite
Luiz Fernando Monte Borella 
1   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Radiologia, Campinas SP, Brazil
,
Dafny Soares Leitao 
2   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Infectologia, Campinas SP, Brazil
,
Eduardo de Oliveira Narvaez 
3   Hospital Beneficência Portuguesa de São Paulo, Departamento de Radiologia, São Paulo SP, Brazil
,
Marcelo de Carvalho Ramos 
2   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Infectologia, Campinas SP, Brazil
,
Fabiano Reis 
1   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Radiologia, Campinas SP, Brazil
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The high-resolution vessel wall imaging (HR-VWI) is a millimetric technique that demonstrates vessel wall inflammation, which can occur simultaneously with leptomeningitis. Encephalic infarction may be observed in less than 50% of the cases.[1] [2] [3]

A 42-year-old man with neurocysticercosis, presented headache and visual blurring. Magnetic resonance imaging (MRI) and HR-VWI scans were performed, as demonstrated in [Figures 1] and [2], respectively. The findings contribute to the pathophysiology of the disease, by demonstrating concentric and irregular wall enhancement (vasculitis). The degree of vessel involvement correlates with the severity of disease stage,[1] and was demonstrated in other infections, such as syphilis,[4] and tuberculosis,[1] [5] but not in neurocysticercosis.

Zoom Image
Figure 1 Axial Fast Imaging Employing Steady-state Acquisition (FIESTA) images (A and B): cystic lesions in the subarachnoid space. Axial T1 post-contrast (C and D): a nodular lesion with peripheral contrast enhancement in the left calcarine region (arrow) and leptomeningeal enhancement (arrowhead). The MIP axial TOF MRA and DWI images (E and F) showed no significant abnormalities. Abbreviations: DWI, Diffusion-weighted imaging; MIP, Maximum Intensity Projection; MRA, Magnetic Resonance Angiography; TOF, Time-Of-Flight.
Zoom Image
Figure 2 Axial HR-VWI pre (A) and post-contrast (B) demonstrate smooth enhancement in both M1 middle cerebral arteries.

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Conflict of Interest

The authors have no conflict of interests to declare.

Authors' Contributions

LFMB: conceptualization, data curation, investigation, writing-original draft; DSL: conceptualization, data curation, investigation; EON: conceptualization, visualization, writing-review & editing; MCR, FR: conceptualization, formal analysis, project administration, visualization, writing-review & editing.


  • References

  • 1 Choudhary N, Vyas S, Modi M. et al. MR vessel wall imaging in tubercular meningitis. Neuroradiology 2021; 63 (10) 1627-1634
    CrossrefPubMedGoogle Scholar
  • 2 Pacheco FT, Cruz Junior LCHD, Padilha IG. et al. Current uses of intracranial vessel wall imaging for clinical practice: a high-resolution MR technique recently available. Arq Neuropsiquiatr 2020; 78 (10) 642-650
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Mont'Alverne Filho FE, Machado LdosR, Lucato LT, Leite CC. The role of 3D volumetric MR sequences in diagnosing intraventricular neurocysticercosis: preliminar results. Arq Neuropsiquiatr 2011; 69 (01) 74-78
    CrossrefPubMedGoogle Scholar
  • 4 Feitoza LM, Stucchi RSB, Reis F. Neurosyphilis vasculitis manifesting as ischemic stroke. Rev Soc Bras Med Trop 2020; 53: e20190546
    CrossrefPubMedGoogle Scholar
  • 5 Feitoza LM, Jarry VM, Ramos MC, Reis F. High-Resolution Vessel Wall MRI as a Complementary Investigation for CNS Tuberculosis. Can J Neurol Sci 2021; 48 (05) 717-718
    CrossrefPubMedGoogle Scholar

Address for correspondence

Luiz Fernando Monte Borella

Publication History

Received: 17 January 2022

Accepted: 07 March 2022

Article published online:
29 September 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Choudhary N, Vyas S, Modi M. et al. MR vessel wall imaging in tubercular meningitis. Neuroradiology 2021; 63 (10) 1627-1634
    CrossrefPubMedGoogle Scholar
  • 2 Pacheco FT, Cruz Junior LCHD, Padilha IG. et al. Current uses of intracranial vessel wall imaging for clinical practice: a high-resolution MR technique recently available. Arq Neuropsiquiatr 2020; 78 (10) 642-650
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Mont'Alverne Filho FE, Machado LdosR, Lucato LT, Leite CC. The role of 3D volumetric MR sequences in diagnosing intraventricular neurocysticercosis: preliminar results. Arq Neuropsiquiatr 2011; 69 (01) 74-78
    CrossrefPubMedGoogle Scholar
  • 4 Feitoza LM, Stucchi RSB, Reis F. Neurosyphilis vasculitis manifesting as ischemic stroke. Rev Soc Bras Med Trop 2020; 53: e20190546
    CrossrefPubMedGoogle Scholar
  • 5 Feitoza LM, Jarry VM, Ramos MC, Reis F. High-Resolution Vessel Wall MRI as a Complementary Investigation for CNS Tuberculosis. Can J Neurol Sci 2021; 48 (05) 717-718
    CrossrefPubMedGoogle Scholar

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Zoom Image
Figure 1 Axial Fast Imaging Employing Steady-state Acquisition (FIESTA) images (A and B): cystic lesions in the subarachnoid space. Axial T1 post-contrast (C and D): a nodular lesion with peripheral contrast enhancement in the left calcarine region (arrow) and leptomeningeal enhancement (arrowhead). The MIP axial TOF MRA and DWI images (E and F) showed no significant abnormalities. Abbreviations: DWI, Diffusion-weighted imaging; MIP, Maximum Intensity Projection; MRA, Magnetic Resonance Angiography; TOF, Time-Of-Flight.
Zoom Image
Figure 2 Axial HR-VWI pre (A) and post-contrast (B) demonstrate smooth enhancement in both M1 middle cerebral arteries.