PERSISTENT ENHANCEMENT AFTER TREATMENT FOR CEREBRAL TOXOPLASMOSIS IN PATIENTS WITH AIDS - PREDICTIVE VALUE FOR SUBSEQUENT RECURRENCE

To determine the predictive imaging (CT and/or MR) features of brain t oxoplasmosis recurrences in acquired immunodeficiency syndrome. METHOD S: The imaging studies of patients with brain toxoplasmosis were retro spectively reviewed. Forty-three patients with significant decrease or disappearance of brain lesions under specific treatment on follow-up imaging examinations were included. MR examinations were performed usi ng T2- and T1-weighted sequences, before and after intravenous adminis tration of gadolinium-DOTA. RESULTS: A recurrence occurred in 11 (26%) of 43 cases. Ten (91%) of these 11 patients with recurrence showed fo cal persistent enhancement after the initial treatment of toxoplasmosi s abscess. One of the 11 patients with recurrence showed no persistent enhancement; 3 patients showed persistent enhancement but had no recu rrence. CONCLUSIONS: Recurrences of brain toxoplasmosis in our series correlated with persistent contrast enhancement. We hypothesize that d emonstration of persistent areas of contrast enhancement after treatme nt for initial toxoplasmosis may be a valuable sign for identifying pa tients at risk for recurrence.