MRI features of acquired immunodeficiency syndrome complicated with subtentorial progressive multifocal leukoencephalopathy
10.3969/j.issn.1002-1671.2024.12.003
- VernacularTitle:艾滋病合并小脑幕下进行性多灶性白质脑病的MRI影像特征
- Author:
Hui CHEN
1
;
Jingjing LI
;
Ming XUE
;
Zhibin LÜ
;
Ruming XIE
Author Information
1. 首都医科大学附属北京地坛医院放射科,北京 100015
- Keywords:
acquired immunodeficiency syndrome;
progressive multifocal leukoencephalopathy;
magnetic resonance imaging
- From:
Journal of Practical Radiology
2024;40(12):1945-1948
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the MRI manifestations of acquired immunodeficiency syndrome complicated with subtentorial progressive multifocal leukoencephalopathy(PML).Methods Sixteen patients with acquired immunodeficiency syndrome complicated with subtentorial PML confirmed by surgery,pathology,or clinical diagnosis were selected.The MRI features of plain scan and enhanced scan were analyzed and summarized,retrospectively.Results Among the 16 acquired immunodeficiency syndrome patients complicated with subtentorial PML,in terms of lesion distribution,the left cerebellar hemisphere was involved in 10 cases(62.5％),and the right cerebellar hemisphere was involved in 10 cases(62.5％).The left pontine arm was involved in 11 cases(68.8％),the right pontine arm was involved in 10 cases(62.5％),the medulla oblongata was involved in 6 cases(37.5％),the pontine region was involved in 11 cases(68.8％),the midbrain was involved in 7 cases(43.8％),and the supratentorial lesions were involved in 5 cases(31.3％).Subtentorial lesions were found to be asymmetrically distributed in all patients.In terms of MRI imaging findings,acquired immunodeficiency syndrome patients complicated with subtentorial PML lesions exhibited low signal on T,WI and high signal on T2 WI/T2-fluid attenuated inversion recovery(FLAIR)images.The"shrimp sign"and"crescent cerebellar lesion"was respectively observed in 3 and 7 cases on T2 WI.There were no diffusion limitations on diffusion weighted imaging(DWI),no significant enhancement after contrast-enhanced scanning,and no mass effect in all the 16 cases.Conclusion The MRI imaging findings of acquired immunodeficiency syndrome complicated with subtentorial PML exhibit similar features to those observed in PML affecting the cerebral hemispheres.A characteristic"shrimp sign"is often observed on T2WI.The presence of typical MRI imaging findings,along with the patient's clinical history and the detection of JC virus deoxyribonucleic acid(DNA)in the cerebrospinal fluid(CSF),can aid in the accurate diagnosis of PML.
