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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:285-286, February 2007
© 2007 American Society of Neuroradiology

Case Report
BRAIN

Progressive Multifocal Leukoencephalopathy: Serial High-b-Value Diffusion-Weighted MR Imaging and Apparent Diffusion Coefficient Measurements to Assess Response to Highly Active Antiretroviral Therapy

S.I. Usiskin^a, A. Bainbridge^c, R.F. Miller^b and H.R. Jäger^a,d,e

^a Department of Imaging, University College London Hospital
^b Centre for Sexual Health and HIV Research, Department of Population Sciences and Primary Care, Royal Free and University College Medical School, University College London
^c Department of Medical Physics, University College London Hospital, London
^d The Institute of Neurology, University College London, London
^e Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, London, England

Please address correspondence to H.R. Jäger, MD, Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, England; e-mail: r.jager{at}ion.ucl.ac.uk

SUMMARY: A patient with human immunodeficiency virus–related posterior fossa progressive multifocal leukoencephalopathy had serial diffusion-weighted imaging using b-values of 1000 and 3000 before and during highly active antiretroviral therapy (HAART). High-b-value images provided a superior definition of the leading edge of the lesion and additional information about the integrity of white matter tracts. Following HAART, there was a marked reduction of lesional apparent diffusion coefficient and reconstitution of anisotropy in the affected middle cerebellar peduncle.

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