Follow-up magnetic resonance imaging findings in patients with progressive multifocal leukoencephalopathy: evaluation of long-term survivors under highly active antiretroviral therapy.
OBJECTIVE
The aim of this study was to clarify the early magnetic resonance imaging (MRI) findings of progressive multifocal leukoencephalopathy (PML) and to evaluate the relations of the clinical course and serial MRI findings in patients with acquired immunodeficiency syndrome (AIDS)-related PML treated with highly active antiretroviral therapy (HAART).


METHODS
The clinical course and serial MRI findings in five patients with AIDS-related PML who were treated with HAART are described.


RESULTS
Although all five patients were serologically naive to the therapy and alive at the end of the observation period, the lesions showed rapid extension on MRI for up to 3 months after the start of the therapy, and clinical symptoms progressed rapidly for a month after the start of the therapy. Newer margins in spreading lesions showed a diffuse pale hyperintensity and/or many discrete hyperintense dots on T2-weighted images


CONCLUSIONS
Early PML lesions may show a characteristic appearance on T2-weighted images. We should be aware of the progression of AIDS-related PML even under serologically effective HAART.
Department of Radiology, Osaka University Graduate School of Medicine, 565-0871, Japan. s-mio@umin.ac.jp
Mio
M
Sakai
Yusuke
Y
Inoue
Shigeki
S
Aoki
Takuma
T
Sirasaka
Tomoko
T
Uehira
Soichiro
S
Takahama
Hideaki
H
Nagai
Kenji
K
Yutani
Kohki
K
Yoshikawa
Hironobu
H
Nakamura
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018450:Disease Progression; D005260:Female; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000209:etiology* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017741:Survivors; D016896:Treatment Outcome