The clinical and MR features of AIDS-associated cytomegalovirus encephalitis

ZHANG Zixin; LI Jingjing; DU Yanni; XUE Ming; XIE Rvming

Abstract：Objective To study the MRI findings in AIDS-associated cytomegalovirus encephalitis and to provide the reference in clinical diagnosis. Methods The imaging features of 11 AIDS patients complicated with cytomegalovirus were retrospectively analyzed and correlated with pathology and cerebrospinal fluid CMV-DNA detection. All cases had MRI enhancement of brain. The clinical manifestations and imaging features were observed. Results 1) Clinical manifestations: patients with neuropsychiatric symptoms (54. 54％) or fever (45. 46％) were more common; 90. 9％ of patients had the peripheral blood CD4 + T lymphocyte count below 50 cells / μl; 2) MRI findings: there were 90. 9％ of cases with more than one lesion. Lesion happened in basal ganglia nuclei was about 65. 22％ (30. 43％ of caudate nucleus,13. 04％ of lentiform nucleus and 8. 69％ of thalamus) , 34. 78％ of cases presented with gray matter involvement (21. 74％ of temporal lobe,13. 04％ in frontal,8. 69％ of occipital). MR showed low signal in T1WI,high signal in T2WI and FS-T2 ,slightly higher signal in DWI and equal / slightly lower signal in ADC,the lesions had mild to no enhancement with Gadolinium contrast agent; 3) Pathology: the tissues included typical intra nuclear inclusions accompanied with inflammatory changes of brain on HE staining. Conclusion MRI shows better intracranial lesions in patients with AIDS complicated with CMV encephalitis. FS-T2 and DWI are the best sequences for the observation of lesions. And the enhanced scanning as while FS-T2 has certain specificity.