[Study on diagnosis of atypical cerebral cysticercosis].

Objective: To analyze the characteristics of the results of serum immunological tests and brain CT image examinations of atypical cerebral cysticercosis patients, so as to provide the reference for improving the diagnosis of the disease.

Methods: Totally 446 suspected cerebral cysticercosis patients were chosen as the study objects, all of them were given experimental treatment with praziquantel, and then the patients with atypical cerebral cysticercosis were diagnosed according to the treatment effect and review results of brain CT or MRI. Meanwhile, all the 446 patients were tested for serum specific IgG and IgG4 antibodies and cysticercus circulating antigen (CAg) by ELISA, McAb ELISA and PEG-ELISA respectively, and the IHA test was also performed. All the patients received the brain CT examinations. The test results were analyzed statistically and the test performances of the methods above-mentioned were calculated.

Results: Among the 446 suspected cerebral cysticercosis patients, after the praziquantel treatment, there were 315 patients whose symptoms were alleviated, and they were diagnosed as atypical cerebral cysticercosis. Among the 446 suspected cerebral cysticercosis patients, the positive rates of specific IgG and IgG4 antibodies, and CAg were 15.47%, 15.02%, and 11.21% respectively, and the positive rate of IHA was 28.47% ( = 52.45, ＜ 0.01). The brain CT examinations showed that there were 79.14% (353/446) of patients with suspected cysticercus foci. The sensitivities of ELISA, McAb-ELISA, PEG-ELISA, IHA test and brain CT examination (suspected cysticercus foci) for the diagnosis of atypical cerebral cysticercosis were 15.36%-96.82%, the specificities were 63.36%-99.24%, the positive predictive values were 86.40%-98.52%, the negative predictive values were 32.83%-98.25%, the positive likelihood ratios were 2.64-27.86, the negative likelihood ratios were 0.05-0.81, and the values were 7.16-52.80. The consolidation of the five tests above-mentioned showed the value was 108.00, which was 2 times of the value of CT examination.

Conclusions: Atypical cerebral cysticercosis is definitely diagnosed mainly by means of evaluating the effect of the diagnostic therapy (anti-cysticercus), and the serum immunological examinations and brain CT examination also have important reference values.