Diagnosis of cerebral echinococcosis and analysis on the causes of misdiagnosis

Objective To elucidate the diagnosis and the causes of misdiagnosis for cerebral echinococcosis. Methods The clinical data of 59 cases with cerebral echinococcosis treated in our department from July 1978 to July 2008 were analyzed retrospectively. Results All cases underwent surgical treatments and were confirmed by pathological examinations. In all 11 cases from 1978 to 1982,7 were diagnosed as cerebral echinococcosis with a correspondent rate of 63.6%. Among 28 cases from 1983 to 1992,21 were diagnosed as cerebral echinococcosis with a correspondent rate of 75.0%. In 20 cases from 1993 to 2008,16 were diagnosed as cerebral cystic echinococcosis and 2 were diagnosed as cerebral alveolar echinococcosis,with a correspondent rate of 90.0%. All the cases were inspected with hydatid immunologic test. From 1978 to 2000,46 cases were inspected with routine hydatid immunologic test including 37 cases of positive reaction,with the positive rate of 80.4%. From 2000 to 2008,13 were inspected with hydatid 8-tests immunodiagnosis including 12 cases of positive reaction,with the positive rate of 92.3%. Pathological examinations showed 45 cases of granulosus echinococcus and 14 cases of alveolar echinococcus. Conclusion Cerebral echinococcosis is usually diagnosed by its special history,its characteristic radiographic manifestations and the positive results in hydatid immunologic test. But some cases are always misdiagnosed as a result of their non-characteristic clinical features,non-characteristic radiographic manifestations or the existence of false-positive and false-negative results in hydatid immunologic test. So cerebral MRI and hydatid 8-tests immunodiagnosis can obviously improve the diagnosis rate and the prognosis.