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Encephalopathy in AIDS patients: evaluation with MR imaging.
C H Flowers1, M F Mafee, R Crowell
1Department of Radiology, University of Illinois, Chicago 60680.
AJNR. American Journal of Neuroradiology
|November 1, 1990
Summary
Magnetic Resonance (MR) imaging effectively detects white matter disease and encephalopathy in patients with Acquired Immunodeficiency Syndrome (AIDS) or AIDS-related complex (ARC). This advanced imaging reveals widespread abnormalities, including atrophy and opportunistic infections, crucial for diagnosis.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Acquired Immunodeficiency Syndrome (AIDS) and AIDS-related complex (ARC) are associated with significant neurological complications, including encephalopathy.
- Early and accurate diagnosis of neurological involvement is critical for managing patients with HIV/AIDS.
Purpose of the Study:
- To evaluate the utility of Magnetic Resonance (MR) imaging in detecting and characterizing encephalopathy in patients with AIDS or ARC.
- To correlate MR findings with Computed Tomography (CT) scans and pathological diagnoses.
Main Methods:
- MR imaging was performed on 47 patients with AIDS or ARC to assess for white matter disease and encephalopathy.
- Findings were compared with initial CT scans and, where available, autopsy results.
- Signal intensity on T2-weighted images, lesion distribution, and presence of atrophy were analyzed.
Main Results:
- Sixty-two percent of patients exhibited white matter disease on MR imaging, characterized by high signal intensity on T2-weighted images.
- Focal white matter lesions were identified in 49% of patients, with diffuse disease in 13%.
- MR imaging revealed predominant disease in subinsular and peritrigonal white matter areas, with significant cerebral, cerebellar, and brainstem atrophy observed in a substantial number of patients. Opportunistic infections like toxoplasmosis and CNS lymphoma were also identified.
Conclusions:
- MR imaging is a valuable tool for detecting encephalopathy and white matter abnormalities in AIDS/ARC patients.
- MR imaging demonstrates higher sensitivity than CT for identifying white matter disease in this population.
- The findings underscore the significant impact of neurological complications in HIV/AIDS patients and the role of advanced imaging in their diagnosis.