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Pediatric AIDS: a longitudinal comparative MRI and CT brain imaging study
1Department of Neurosciences, University of California, San Diego, 92103.
Insights
This study compared magnetic resonance imaging (MRI) and computed tomography (CT) scans in children with acquired immune deficiency syndrome (AIDS). Both imaging techniques revealed similar brain abnormalities, highlighting their utility in assessing neurological complications.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Infectious Diseases
Background:
- Acquired immune deficiency syndrome (AIDS) can cause significant neurological complications in children.
- Early detection and monitoring of these complications are crucial for patient management.
Purpose of the Study:
- To prospectively compare nonenhanced cranial magnetic resonance imaging (MRI) and computed tomography (CT) scans in children with AIDS.
- To correlate neuroradiographic findings with neurologic and neuropsychological examinations over a 1-year period.
Main Methods:
- Fourteen children with AIDS underwent serial MRI and CT scans (entry and 1 year).
- Sequential neurologic and neuropsychological assessments were performed every 2 and 6 months, respectively.
- Neuroradiographic findings were analyzed for abnormalities such as volume loss, calcification, and white-matter lesions.
Main Results:
- At entry, 12 children had abnormal neurologic exams, with 10 exhibiting developmental delay; five had normal neuropsychological test results.
- Brain parenchymal volume loss was the most common abnormality (MRI = CT).
- At 1 year, MRI and CT showed comparable changes in brain volume loss and focal white-matter lesions, with some improvements noted.
Conclusions:
- Nonenhanced cranial MRI and CT scans are comparable in detecting neuroradiographic abnormalities in children with AIDS.
- Both imaging modalities are valuable for monitoring disease progression and treatment response.
- Neurologic and neuropsychological deficits are common in pediatric AIDS and warrant ongoing assessment.
Abstract:
Fourteen consecutive children with acquired immune deficiency syndrome (AIDS) (age range, 4 months to 11 years; median 4 years) were studied prospectively comparing nonenhanced cranial magnetic resonance imaging (MRI) and computed tomographic (CT) scans. MRI and CT were performed twice: at time of entry into protocol and again at 1 year. In addition, sequential neurologic (every 2 months) and neuropsychological examinations (every 6 months) were performed. At entry, 12 children had abnormal neurologic examinations; of these, 10 had developmental delay; two children were normal by developmental history and neurologic examination. Five children performed in the normal range on a standardized neuropsychological test, whereas nine children showed significant delays in verbal or motor/perceptual development. Following 1 year of study, four children had normal and six had abnormal neurologic examinations (six stable and four improved). Neuropsychological examinations were normal in five children and abnormal in five (seven stable, one improved, and two deteriorated). At entry, the following neuroradiographic abnormalities were seen: brain parenchymal volume loss (eight, MR = CT), cervical lymphatic enlargement (four, MR = CT), striatal-thalamic calcification (one, CT > MR), delayed myelination (one, MR > CT), and focal white-matter lesions (one, MR > CT). At 1 year the following neuroradiographic changes were seen: brain parenchymal volume loss (10, MR = CT; two improved, eight stable); cervical lymphatic enlargement (one, MR = CT; three improved, one stable), striatal-thalamic calcification (one, CT > MR; one new), and focal white-matter lesions (one, MR > CT; one stable).(ABSTRACT TRUNCATED AT 250 WORDS)