White matter disease in AIDS: findings at MR imaging.

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

White matter disease in AIDS: findings at MR imaging.

Radiology. 1988 Nov;169(2):445-8. Unique Identifier : AIDSLINE MED/89017883
Olsen WL; Longo FM; Mills CM; Norman D; Department of Radiology, University of California, San Francisco.

Abstract: A review of the magnetic resonance (MR) images of 365 patients with acquired immunodeficiency syndrome (AIDS) revealed that 112 (31%) had signal abnormalities confined to the white matter. Four patterns were observed: (a) diffuse: widespread involvement of a large area; (b) patchy: localized involvement with ill-defined margins; (c) focal: well-defined areas of involvement; and (d) punctate: small foci less than 1 cm in diameter. Clinical or pathologic findings were available in 60 of the 112 patients and were correlated with the white matter patterns seen on MR images. The diffuse pattern correlated with AIDS dementia complex (ADC), which was the most common clinical diagnosis. Patchy or punctate lesions may be seen with ADC but are less common. Focal white matter lesions were not seen in patients with ADC but were seen in all six patients with progressive multifocal leukoencephalopathy, in both patients with lymphoma, and in one patient with toxoplasmosis. The authors conclude that white matter lesions are are common in AIDS and are often secondary to direct infection of the brain with human immunodeficiency virus, which causes the ADC and usually produces a diffuse white matter pattern. Biopsy is probably not indicated in these patients. Focal white matter lesions suggest a focal infection or tumor, and biopsy may be warranted.

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Aged Brain/*PATHOLOGY Brain Diseases/DIAGNOSIS/*ETIOLOGY Dementia/DIAGNOSIS/*ETIOLOGY Human *Magnetic Resonance Imaging Middle Age JOURNAL ARTICLE

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