Study on diagnosis of cerebral cysticercosis by antibody detection and imaging techniques

Objective To establish new criteria of antibody detection for the diagnosis of cerebral cysticercosis in combining with imaging examinations for reducing the missed and neglected diagnosis of the disease. Methods 1160 cases with adequate clinical data were collected for the study, among them all cases received antibody detection and comput- erized tomography(CT), 538 cases were examined by magnetic resonance imaging(MRI). Following the locations that cys- ticerci parasitized, the cases were grouped in four types of cerebral cysticercosis: 1 087 cases in brain parenchyma (93. 7%), 42 cases in brain ventricles (3. 6%), 22 cases in brain meninges (1. 9%), and 9 mixed cases (0. 8%). Accord- ing to the number of cysticerci showed by imaging analysis, cases involving parenchyma were further divided as subgroups of slight, moderate,and heavy infection with 1-2, 3-9 and over 10 parasites, with 552 cases(50. 8 %), 443 cases (39. 8%) and 102 cases (9. 4%) respectively. IHA and ELISA were used for detecting antibodies in the sera. Results 635 cases showed an IHA titer of 1: 8 and above (54. 7%), 700 cases (60. 3%) showed positive ELISA and 460 cases (39. 7%) showed weak positive. In the group of light infection (552 cases), 94. 7% showed an IHA titer of less than 1: 8, only 29 cases (5. 3%) with a titer of 1: 8 and above; 94 cases (17%) showed positive ELISA and 458 cases (83%) were weak positive. In the groups of moderate and heavy infections, all cases showed IHA titer of 1: 8 and over, and positive or weak positive ELISA. Conclusion Antibody titers are positively relevant to the intensity of Cysticercus infection. Most cases with light infection showed a low IHA titer (less than 1: 8) and a weak positive ELISA, a fact that these cases would have been missed by the immunological tests. Therefore, an integrated analysis of the results with immunological test and clinical imaging technique is important in diagnosing cerebral cysticercosis.