Analysis of MRI findings of AIDS related cryptococcal meningitis

LI Chao; DU Chao; XU Chuanjun

Abstract：Objective To summarize the MRI feature of AIDS with intracranial cryptococcal meningitis patients , in order to improve the early diagnosis of this disease , and improve the diagnostic accuracy , evaluation the prognosis and curative effect . Methods Retrospective analysis of brain MRI images of 41 cases diagnosed cryptococcal meningitis by cerebrospinal fluid detec-tion and exclusion of other brain infection in patients with AIDS .The MR image interpretation by two neuroimaging experts on the characteristics of MR ( edge number , location, signal characteristics ) .Thenr statistical analysis to summarizes its characteristics . Results Of 41 cases were diagnosed as cryptococcal meningitis in AIDS patients , 19 patients had positive MR findings in .MR ( positive group ) .There is no significant differences between the positive group and negative group in age and gender ( P >0.05), Abnormal lesions of MR positive group mostly located around the basal ganglia and the lateral ventricle (78.9%).The common MR manifestation is dilated Virchow-Robin spaces (42.1%); ventricular dilatation (15.8%); Restricted diffusion of gelatinous pseudocysts (21.1%).Cryptococcal meningitis (21.1%) occurred in the frontal or temporal lobe , and meningeal thickening and enhancement .Cryptococcal granuloma occurs in the brain (21.1%), it manifest T1 low signal T2 high signal and inhomogeneous enhancement .Cryptococcal ependymitis (5.3%) showed bilateral symmetrical per -ventricular halo T1 low signal T2 high signal .Conclusion The MRI manifestations of Cryptococcal meningitis is mostly dilated VR spaces in basal ganglia , and further development showed abnormal signal in basal ganglia with miliary enhancement and peripheral edema .Gelatinous pseudo-cysts and ventricular expansion has certain characteristics .Cryptococcal meningitis manifested leptomeningeal thickening and en-hancement and adjacent brain tissue edema .Cryptococcal ependymitis showed bilateral symmetrical per-ventricular halo abnormal signal.