American Journal of Neuroradiology, Vol 11, Issue 6 1235-1245, Copyright © 1990 by American Society of Neuroradiology
ARTICLES |
Encephalopathy in AIDS patients: evaluation with MR imaging
CH Flowers, MF Mafee, R Crowell, B Raofi, P Arnold, G Dobben and N Wycliffe
Department of Radiology, University of Illinois, Chicago 60680.
The presence and extent of encephalopathy were evaluated in 47 patients with AIDS or AIDS-related complex (ARC) by the use of MR imaging. Twenty-nine (62%) of the patients showed some form of white matter disease, exhibited as high signal intensity on T2-weighted images. Focal white matter lesions were seen in 23 (49%) of the patients, while a diffuse white matter process was observed in six patients (13%). Of the 29 patients who had white matter disease on MR scans, 17 (36%) had a suggestion of white matter involvement on an initial CT study. Meanwhile, 12 (26%) of the patients had a normal CT scan on the initial examination. MR findings showed predominant disease in the subinsular and peritrigonal white matter areas. Marked cerebral atrophy was observed in 17 (36%) of 47 patients, cerebellar atrophy in 18 (38%), and brainstem atrophy in seven patients (15%). Pathologic findings showed that toxoplasmosis was present in eight patients (17%), and primary CNS lymphoma was present in three patients (6%). Cryptococcal meningitis was noted in two (4%) of the patients at autopsy, and Mycobacterium tuberculosis was seen in one (2%) of the patients at autopsy. MR imaging has been shown to be a valuable technique for the detection of encephalopathy in AIDS patients.
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