T. Ernst et al., Progressive multifocal leukoencephalopathy and human immunodeficiency virus-associated white matter lesions in AIDS: Magnetization transfer MR imaging, RADIOLOGY, 210(2), 1999, pp. 539-543
Citations number
32
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
PURPOSE: To determine the magnetization transfer features of progressive mu
ltifocal leukoencephalopathy (PML) and human immunodeficiency virus (HIV)-a
ssociated white matter lesions(WML) (hereafter, HIV-WML) on magnetic resona
nce (MR) images obtained in patients with acquired immunodeficiency syndrom
e (AIDS).
MATERIALS AND METHODS: Conventional MR imaging and magnetization transfer M
R imaging were performed in 21 AIDS patients with 42 areas of white matter
hyperintensity on MR images (13 patients had 25 PML lesions, eight patients
had 17 WML). The magnetization transfer ratio was calculated for each lesi
on.
RESULTS: Compared with normal-appearing white matter (magnetization transfe
r ratio = 47.9%), both PML and HIV-WML showed reduced magnetization transfe
r ratio. The magnetization transfer ratio was significantly lower in PML le
sions (magnetization transfer ratio = 26.1%) than in HIV-WML (magnetization
transfer ratio = 38.0%, P < .0001), and there was no overlap in the magnet
ization transfer ratio between PML lesions and HIV-WML. The separation in m
agnetization transfer ratio between the two lesion types was valid for lesi
ons as small as 0.5 cm(2).
CONCLUSION: The larger reduction in magnetization transfer ratio for PML le
sions is most likely due to demyelination, whereas the reduction in HIV-WML
may be associated primarily with gliosis. ML lesions appear to cause stron
g reductions in magnetization transfer ratio early in the course of disease
. Magnetization transfer MR imaging is a noninvasive tool that improves the
differentiation between PML and HIV-WML in patients with AIDS.