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Registered Bioimaging of Nanomaterials for Diagnostic and Therapeutic Monitoring
Published on: December 9, 2010
Human immunodeficiency virus 1-associated minor motor disorders: perfusion-weighted MR imaging and H MR spectroscopy
Frank Wenserski1, Hans-Juergen von Giesen, Hans-Joerg Wittsack
1Department of Diagnostic Radiology and Neurology, Heinrich-Heine-University, Moorenstr 5, 40225 Duesseldorf, Germany. wensersk@uni-duesseldorf.de
Purpose:
To investigate whether advanced magnetic resonance (MR) imaging techniques such as diffusion-weighted (DW) and perfusion-weighted (PW) MR imaging and hydrogen 1 (1H) MR spectroscopy can depict functional and pathophysiologic mechanisms in patients who have minor motor deficits (MMDs) associated with human immunodeficiency virus 1 (HIV-1).
Materials And Methods:
Thirty-two patients with results seropositive for HIV-1 and different degrees of HIV-1-related MMD underwent conventional brain MR imaging, as well as DW and PW MR imaging and 1H MR spectroscopy of the basal ganglia. PW MR imaging data were computed pixel by pixel for creation of time-to-peak, relative regional cerebral blood volume, and bolus amplitude parameter maps. In addition, quantitative regional cerebral blood flow (rCBF) maps were calculated with respect to the arterial input function by using the singular value decomposition algorithm. For 1H MR spectroscopy, a stimulated echo acquisition mode 20, or STEAM 20, sequence was used. Spectra were fit for determination of the signal intensities of the different metabolites. According to psychomotor testing results, patients were divided into three groups: group 1, 10 patients with normal motor function; group 2, eight patients with psychomotor slowing for the first time; and group 3, 14 patients who had had sustained pathologic psychomotor slowing for at least 6 months before the MR imaging examination.
Results:
No patients had an abnormality at either conventional or DW MR imaging. PW MR imaging depicted significantly elevated rCBF in group 2 patients (P =.039, analysis of variance [ANOVA]) and significantly elevated myo-inositol-to-creatine ratio levels in group 3 patients (P =.020, ANOVA).
Conclusion:
Quantitative PW MR imaging and 1H MR spectroscopy can depict pathologic changes in patients who have HIV-1-related MMD but normal clinical examination and conventional MR imaging findings.
Insights
Advanced MRI techniques like perfusion-weighted imaging and MR spectroscopy can detect subtle brain changes in HIV-1 patients with minor motor deficits, even when conventional scans appear normal.
Area of Science:
- Neuroimaging
- Neurology
- Infectious Diseases
Background:
- Human immunodeficiency virus type 1 (HIV-1) infection can lead to neurological complications, including minor motor deficits (MMDs).
- Conventional MRI may not reveal abnormalities in early-stage HIV-1-associated MMDs.
- Advanced MR imaging techniques offer potential for detecting subtle pathophysiological changes.
Purpose of the Study:
- To evaluate the utility of advanced MR imaging techniques in identifying functional and pathophysiologic mechanisms in HIV-1 patients with MMDs.
- To investigate diffusion-weighted (DW) and perfusion-weighted (PW) MR imaging and hydrogen 1 (1H) MR spectroscopy for assessing HIV-1-related MMDs.
Main Methods:
- Thirty-two HIV-1 seropositive patients with varying degrees of MMD underwent conventional, DW, and PW MR imaging, along with 1H MR spectroscopy of the basal ganglia.
- PW MR imaging data were processed to generate parameter maps including relative cerebral blood volume and quantitative regional cerebral blood flow (rCBF).
- Patients were stratified into three groups based on psychomotor testing: normal function, initial psychomotor slowing, and sustained psychomotor slowing.
Main Results:
- Conventional and DW MR imaging showed no abnormalities in any patients.
- PW MR imaging revealed significantly elevated rCBF in patients experiencing their first episode of psychomotor slowing (group 2).
- 1H MR spectroscopy indicated significantly elevated myo-inositol-to-creatine ratios in patients with sustained psychomotor slowing (group 3).
Conclusions:
- Quantitative PW MR imaging and 1H MR spectroscopy are effective in detecting pathological changes in HIV-1-related MMDs.
- These advanced MR techniques can identify abnormalities not apparent on conventional MRI or clinical examination.
- Advanced MR imaging aids in understanding the functional and pathophysiological mechanisms underlying HIV-1-associated neurological deficits.
