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FIG 1. MR findings in a 56-year-old man (patient 1) with HIV-leukoencephalopathy being treated with a combination therapy of nonnucleoside analogues and protease inhibitors. He presented with impairment in concentration and memory and depressive symptoms. Neuropsychological testing was consistent with subcortical dementia.
A–C, TSE-FLAIR (7374/130, TI = 2100) images show symmetric regions of abnormally increased signal intensity (arrows, B and C) without mass effect in the periventricular white matter bilaterally. Additionally, high signal intensity was observed in the midbrain (arrow, A) and left cerebral peduncle.
D–F, Nine months after the initiation of therapy, follow-up TSE-FLAIR (7374/130, TI = 2100) images show interval increase in the hyperintense signal abnormalities (asterisks, E and F) in the periventricular white matter and progression of the cerebral atrophy, as well as almost complete resolution of the signal abnormality in the midbrain (arrow, D). Neuropsychological testing revealed an improvement in mental status.
G–I, Subsequent TSE-FLAIR (9000/105, TI = 2370) images of the brain 22 months after start of treatment show no interval change in distribution or severity of the white matter abnormalities, and complete resolution of the signal abnormality in the midbrain (arrow, G).
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