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Progressive multifocal leukoencephalopathy in patients with AIDS: appearance on MR images
Abstract:
Progressive multifocal leukoencephalopathy (PML) is an uncommon demyelinating disease that occurs in immunocompromised patients. The authors evaluated magnetic resonance (MR) images of 10 patients with pathologically proved PML and clinically diagnosed acquired immunodeficiency syndrome (AIDS) to determine the MR characteristics of this disorder. All patients had asymmetric cerebral involvement. Lesions were distributed throughout the brain, including the brain stem and basal ganglia. White matter was affected in all 10 patients; gray matter was also involved in five. In one patient the lesion enlarged and crossed the corpus callosum and contained focal hemorrhage. The authors conclude that, contrary to reported findings on computed tomographic scans, PML in patients with AIDS has a variable appearance on MR images and has many characteristics that differ from those previously thought to be typical on imaging studies.
Insights
Magnetic resonance imaging (MRI) reveals variable appearances of progressive multifocal leukoencephalopathy (PML) in patients with acquired immunodeficiency syndrome (AIDS). These findings differ from typical computed tomography scan characteristics.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease affecting immunocompromised individuals.
- Acquired immunodeficiency syndrome (AIDS) is a significant risk factor for developing PML.
Purpose of the Study:
- To characterize the magnetic resonance (MR) imaging features of PML in patients diagnosed with AIDS.
- To compare MR imaging findings with previously reported computed tomography (CT) scan characteristics of PML.
Main Methods:
- Retrospective evaluation of MR images from 10 patients with pathologically confirmed PML and AIDS.
- Analysis of lesion distribution, affected brain matter (white vs. gray), and lesion morphology.
Main Results:
- All patients exhibited asymmetric cerebral involvement.
- Lesions were widespread, affecting white matter in all cases and gray matter in five patients.
- MR imaging demonstrated variable appearances, differing from typical CT findings.
Conclusions:
- PML in AIDS patients presents with diverse MR imaging characteristics.
- MR imaging findings for PML in AIDS differ from those typically observed on CT scans.