Article Figures & Data
Figures
- fig 1.
Signal characteristics of PML.
A and B, Axial MR studies show low-signal-intensity lesions on T1-weighted (533/25/1) image (A) and hyperintense lesions on T2-weighted (2000/80/1) image (B) in the centrum semiovale bilaterally, subcortical white matter, and corpus callosum. Note the asymmetrical white matter involvement, with the left cerebral hemispheric white matter more severely affected.
- fig 2.
Supratentorial and posterior fossa PML.A and B, Axial T2-weighted images (3700/150/2) show involvement of the medulla (arrow, A), right temporal lobe white matter, right thalamus, and right internal and external capsules, with mild cortical atrophy and no mass effect. Note the asymmetrical involvement of PML, with the right cerebral hemisphere affected to a much greater degree than the left. (Note also the maxillary sinus and left mastoid opacification.)
fig 3. Cerebellar PML. Axial T2-weighted image (2000/80/1) shows bilateral hyperintense lesions in the cerebellar white matter (right greater than left).
- fig 4.
Marked progression of PML documented by serial MR studies.
A and B, Axial T2-weighted images (3500/95/1) show the right frontal lobe confluent hyperintense signal abnormalities extending from the periventricular white matter to the subcortical white matter, with much milder white matter involvement in the right parietal lobe and minimal involvement of the left cerebral hemisphere.
C, Axial T1-weighted image (600/15/1) shows corresponding low signal abnormalities in the affected white matter on the right as well as minimal mass effect on cortical sulci.
D–F, Eight weeks later, marked progression of disease is evident with extension and increasing confluence of the right frontal and parietal lobe lesions, corpus callosum involvement, and greater involvement of the left cerebral hemisphere. Also seen is an increase in white matter low signal abnormality on axial T1-weighted image (600/15/1). Patient died 7 days after this study. (Biopsy tract is also evident in the right cerebral hemisphere.)
- fig 5.
PML progression.
A–D, Axial T2-weighted images before (3700/150/2) (A and B) and at 4½-month follow-up (2500/96/1) (C and D) show worsening of PML as evidenced by increasing cortical atrophy and ventricular dilatation, as well as by further extension of bilateral white matter disease.
Tables
TABLE 1:Frequency of pretreatment MR findings in 48 HIV-positive patients with biopsy proved PML
- TABLE 2:
Changes on follow-up MR studies in 15 HIV-positive patients with PML on treatment
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