Roentgen Findings in Cerebral Paragonimiasis

Abstract

Roentgen findings in 62 patients with cerebral paragonimiasis are reviewed. The most common finding in skull radiographs was the intracranial calcification seen in almost half the cases. This calcification has features which mimic those of the various intracranial diseases. However, Type IV intracranial calcification, consisting of multiple round or oval cystic calcifications presenting a "soap-bubble" appearance, is diagnostic of cerebral paragonimiasis. In half the cases, the intracranial calcification was seen in the posterior temporal and parietal and the occipital areas. In cases with signs and symptoms of "tumor," angiography is imperative for localization of the lesion. Absence of vascular staining and of abnormal vessels differentiates cerebral paragonimiasis from brain tumors. Pneumoencephalography gives the most valuable diagnostic information. The most common pneumoencephalographic finding is bilateral sub-cortical atrophy, somewhat more marked on the side of lesion. A filling defect of the ventricle due to the granuloma or cyst was seen in a few cases. The most characteristic chest x-ray finding in pulmonary paragonimiasis is the cystic-nodular lesion. The differential diagnoses are also discussed.