Preliminary study of albendazole liposome treatment of cerebral alveolar echinococcosis by 1H-MR spectroscopy

Abstract

ObjectiveTo investigate the 1H-MRS characteristics of cerebral alveolar echinococcosis (CAE) treated by albendazole liposome. Materials and methodsNine patients with 20 lesions proven histologically and clinically to be CAE positive were examined via conventional MRI and 2D multivoxel spectroscopy with a 3.0 T double gradient superconductivity magnetic resonance scanner. In patients who took medication regularly for at least one year, the levels of NAA, CR, Cho, MI, Lip, Lac, and other metabolites from the same lesion parenchyma were observed and then used to calculate NAA/Cr, NAA/Cho, NAA/(Cho+Cr), and (Lip+Lac)/Cr. Statistical analysis was performed using the Wilcoxon signed-rank test. ResultsComparisons between cMRI scans taken before patients began taking medication and cMRI scans taken after patients completed one year of regular medication, the volume of legions increased slightly, and the signals of lesions increased on T2WI. The medians and interquartile ranges of NAA/Cho, NAA/CR, NAA/(Cho+Cr), and (Lip+Lac)/Cr in the same lesions in CAE patients prior to treatment via albendazole liposomes were: 2.285 (1.388–3.655), 3.620 (2.173–5.165), 0.651 (0.552–0938), and 29 (15.219–41.609), respectively. The medians and interquartile ranges of NAA/Cho, NAA/CR, NAA/(Cho+Cr), and (Lip+Lac)/Cr in the same lesions in CAE patients after treatment via albendazole liposomes were: 5.120 (1.853–12.00), 6.120 (3.690–9.733), 0.900 (0.651–1.218), and 26.427 (16.536–49.904), respectively. Proton magnetic resonance spectroscopy images of patients with CAE before and after one year of treatment via albendazole liposomes were characterized by the increase of NAA with ratios of NAA/Cho, NAA/CR, and NAA/(Cho+Cr) increasing by different degrees. Compared with the same lesion before and after treatment twice, the differences were statistically significant (P < 0.01). In regard to the change in (Lip+Lac)/Cr ratios, the differences were not statistically significant (P > 0.05). ConclusionIn patients with CAE, minimal change in CAE lesions imaged via conventional MRI, 1H-MRS was observed. Slight changes of cerebral alveolar echinococcosis lesions before and after treatment via albendazole liposome were observed, providing valuable imaging information for the treatment of CAE lesions.