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.
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.
Figure 2. Axial HR-VWI pre (A) and post-contrast (B) demonstrate smooth enhancement in both M1 middle cerebral arteries.
References
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