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Updated: Aug 15, 2026
Registered Bioimaging of Nanomaterials for Diagnostic and Therapeutic Monitoring
Published on: December 10, 2010
Pathological findings correlated with MRI in HIV infection
C P Hawkins1, J E McLaughlin, B E Kendall
1NMR Research Group, Institute of Neurology, London, UK.
Abstract:
MRI forms an important part of the assessment of patients with HIV-related disease presenting with cerebral symptoms. Eleven formalin-fixed brains were studied at 0.5 T using T2- and T1-weighted sequences. In two cases of progressive multifocal leucoencephalopathy and one case each of toxoplasmosis and lymphoma, the extent of white matter abnormality seen on MRI corresponded broadly with that on pathological examination. In general, however, histological changes were more frequent than lesions on MRI. Cases in which abnormalities were not seen with standard MRI included those with multiple tuberculous granulomata, multinucleate giant cells, microglial nodules, perivascular cuffing and cytomegalovirus inclusions. A common finding on MRI was punctate or patchy high signal in the basal ganglia on T2-weighted scans, seen in six cases. Corresponding histological changes included calcification of vessels with widened perivascular spaces, and mineralised neurones.
Insights
Magnetic Resonance Imaging (MRI) aids in assessing cerebral symptoms in HIV-related diseases. However, standard MRI may not detect all histological changes, especially in conditions like tuberculosis and cytomegalovirus infections.
Area of Science:
- Neuroimaging
- Neuropathology
- Infectious Diseases
Background:
- Cerebral symptoms are common in patients with Human Immunodeficiency Virus (HIV)-related diseases.
- Magnetic Resonance Imaging (MRI) is a key diagnostic tool for evaluating these neurological manifestations.
Purpose of the Study:
- To compare the findings of standard MRI with pathological examination in HIV-related cerebral diseases.
- To assess the sensitivity of MRI in detecting various neuropathological changes.
Main Methods:
- Study of eleven formalin-fixed human brains.
- Utilized 0.5 Tesla MRI with T1- and T2-weighted sequences.
- Correlated MRI findings with detailed histopathological examination.
Main Results:
- MRI correlated well with pathology in progressive multifocal leucoencephalopathy, toxoplasmosis, and lymphoma.
- Histological changes were more frequent than MRI-detected lesions overall.
- Standard MRI failed to detect abnormalities in cases with tuberculous granulomata, multinucleate giant cells, microglial nodules, perivascular cuffing, and cytomegalovirus inclusions.
- A common MRI finding was high signal in the basal ganglia on T2-weighted scans, associated with vascular calcification and mineralised neurons.
Conclusions:
- While MRI is valuable for certain HIV-related brain diseases, its sensitivity is limited for detecting diffuse or subtle pathological changes.
- Histopathological examination remains crucial for a comprehensive diagnosis, especially when MRI findings are negative or equivocal.
- Specific MRI patterns, like basal ganglia hyperintensities, may indicate underlying vascular or neuronal damage.
