[SP2-2F-3] Enigma behind calcified neurocysticercosis: Can we predict calcification?
[Introduction] Calcification is a risk factor for persistent seizure in children with Neurocysticercosis (NCC). Process of calcification in parenchymal NCC is poorly understood. This study was conducted to investigate the frequency, timing and factors associated with calcification in children with single lesion parenchymal NCC.
[Methodology] In a prospective observational study consecutive children between 3-12 years of age with single lesion parenchymal NCC from July 2012 to June 2014 were enrolled. These children were evaluated clinically, investigated with 3D MRI Spoiled Gradient Recalled Echo (SPGR) and T2* Weighted angiography (SWAN). Follow up assessment was clinical and CT scans at 3, 6 and 12 months.
[Results] One hundred children with single parenchymal NCC were enrolled. Mean age at diagnosis was 8.1±2.5 years and 62 were boys. Scolex was identified with SPGR in 68 and SWAN sequence in 60 lesions. Calcified scolex was seen in 60 lesions and wall calcification in 10 lesions. Seizure recurrence was seen in 26 children at 1 month, 14 in 3 months, 12 in 6 months and 9 at 1 year follow up. Calcified lesion was seen in 4 children at 3 months, 15 at 6 months and 27 at 1 year follow up. Calcified lesion were significantly larger at presentation as compared to the lesions with complete resolution (p<0.05) at presentation.
[Conclusion] 25% children with single parenchymal NCC have calcified granuloma at one year follow up. Our preliminary data suggests that NCC with larger size have high propensity to evolve into calcified granuloma.
[Methodology] In a prospective observational study consecutive children between 3-12 years of age with single lesion parenchymal NCC from July 2012 to June 2014 were enrolled. These children were evaluated clinically, investigated with 3D MRI Spoiled Gradient Recalled Echo (SPGR) and T2* Weighted angiography (SWAN). Follow up assessment was clinical and CT scans at 3, 6 and 12 months.
[Results] One hundred children with single parenchymal NCC were enrolled. Mean age at diagnosis was 8.1±2.5 years and 62 were boys. Scolex was identified with SPGR in 68 and SWAN sequence in 60 lesions. Calcified scolex was seen in 60 lesions and wall calcification in 10 lesions. Seizure recurrence was seen in 26 children at 1 month, 14 in 3 months, 12 in 6 months and 9 at 1 year follow up. Calcified lesion was seen in 4 children at 3 months, 15 at 6 months and 27 at 1 year follow up. Calcified lesion were significantly larger at presentation as compared to the lesions with complete resolution (p<0.05) at presentation.
[Conclusion] 25% children with single parenchymal NCC have calcified granuloma at one year follow up. Our preliminary data suggests that NCC with larger size have high propensity to evolve into calcified granuloma.